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Isolated transverse process fractures: spine service management not needed
Lucus H Bradley1, Wayne C Paullus, James Howe
1Division of Neurological Surgery, University of Missouri-Columbia School of Medicine, Columbia, Missouri 65212, USA.
The Journal of Trauma
|October 14, 2008
Summary
Isolated transverse process fractures (TPF) in trauma patients are stable injuries. These fractures do not require neurosurgical or orthopedic intervention, suggesting conservative management is appropriate.
Area of Science:
- Traumatology
- Radiology
- Neurosurgery
Background:
- Holo-body CT scans have increased diagnosis of transverse process fractures (TPF).
- The clinical significance of TPF remains unclear.
- Spine service consultations are frequently requested for TPF, straining resources.
Purpose of the Study:
- To determine if isolated transverse process fractures (iTPF) are structurally and neurologically stable.
- To assess the necessity of spine service intervention for iTPF.
Main Methods:
- Retrospective chart review of trauma patients with TPF from July 2004 to February 2007.
- Patients categorized into isolated TPF (iTPF) and associated TPF (aTPF).
- Evaluated fracture location, associated injuries, stability, neurologic status, and treatment.
Main Results:
- 84 patients identified: 47 iTPF, 37 aTPF.
- All patients were neurologically intact.
- No iTPF required surgery or bracing; 22 aTPF required neurosurgical intervention.
Conclusions:
- iTPF are not associated with neurologic deficits or instability.
- Conservative management without spine service consultation is appropriate for iTPF.
- Associated spinal or abdominal injuries should be diligently sought when TPF are identified.
