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Updated: Jun 19, 2026

Pseudofracture: An Acute Peripheral Tissue Trauma Model
Published on: April 18, 2011
When Is a Clay-Shoveler's Fracture, Not a Clay-Shoveler's Fracture?: A Case Report
Matthew J Schultz1, Michael R Wheeler2, Loren O Black2
1Jefferson Health New Jersey, Stratford, New Jersey.
Case:
A 71-year-old man with a history of C5-7 anterior cervical discectomy and fusion (ACDF) sustained a C7 spinous process fracture after falling from a ladder. He was initially managed nonoperatively but developed anterolisthesis and kyphosis at C7-T1 with left hand weakness over the course of 11 days. Surgical treatment included spinous process wiring and C5-T3 posterior fusion. At 14-month follow-up, he demonstrated resolution of pain and returned motor function.
Conclusion:
The patient's ACDF likely created a longer lever arm, allowing the force of his fall to be concentrated at C7-T1. Patients with a suspected Clay-Shoveler's fracture require close follow-up.
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Assessment:
1. Clinical Evaluation:
History: