Presentation
The patient presented to the emergency department with back pain after being kicked in the back while playing rugby. Bruising was noted over T11-L2, which is associated with tenderness. There was no associated neurological deficit.
Patient Data
There is a mildly displaced fracture of the spinous process of L2.
A cortical irregularity in the spinous process of L1 is suspicious for a further minimally displaced fracture.
Elsewhere, mild degenerative changes occur in the lower thoracic spine with intervertebral disc space narrowing and small anterior endplate osteophyte formation.
Vertebral body heights and alignment are preserved.
Pedicles and facet joints are patent.
Right-sided lumbosacral transitional vertebra are noted.
Costo-chondral calcification is noted.
Case Discussion
Isolated spinous process fractures are relatively uncommon 1. A careful check of the X-ray images in spinal trauma cases should be done to avoid missing them.
This case was managed conservatively.
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