Clay-shoveler fracture

Dr Jeremy Jones and Radswiki et al.

Clay-shoveler fractures are fractures of the spinous process of a lower cervical vertebra (usually C7), and are usually a stress fracture.

Clinical presentation

Often these injuries are unrecognised at the time and only found incidentally years later when the cervical spine is imaged for other reasons.

Acutely they tend to be associated with 1:

  • motor vehicle accidents
  • sudden muscle contraction
  • direct blows to the spine

Radiographic features

The fracture is seen on lateral radiographs as an oblique lucency through the spinous process, usually of C7. There is usually significant displacement.

History and etymology

Originally described in Australia, in (no prizes for guessing) clay shovelers. Why clay rather than dirt or sand? The reason is due to the stickiness of clay. As a clay shovelers tossed the shovel upward, the clay sometimes stuck to it which produced a sudden flexion force on the neck and back muscles, resulting in the fracture.

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