Transverse process fractures are a common sequelae of trauma, although they are considered a minor and stable lumbar spine fracture. There is strong association between transverse process fractures and other traumatic injuries.
Transverse process fracture most commonly occur in the upper lumbar spine and are commonly multiple 2. The fracture line can extend into the transverse foramen, and in the cervical spine there is a risk of complicating vertebral artery dissection.
Although a minor injury to the lumbar spine, transverse process fractures require major force:
- cervical transverse process fractures have a strong association with other cervical spine fractures 2 and blunt cerebrovascular injury (BCVI)
- approximately 35% (range 20-50%) of patients with lumbar transverse process fractures have hepatic and splenic injuries, genitourinary and diaphragmatic injuries 1
CT is the modality of choice. Up to 60% of lumbar transverse process fractures identified on CT will be missed on plain radiographs 1.
- 1. Patten RM, Gunberg SR, Brandenburger DK. Frequency and importance of transverse process fractures in the lumbar vertebrae at helical abdominal CT in patients with trauma. Radiology. 2000;215 (3): 831-4. doi:10.1148/radiology.215.3.r00jn27831 - Pubmed citation
- 2. Green NE, Swiontkowski MF. Skeletal Trauma in Children: Expert Consult - Print and Online, 4e. Saunders. ISBN:1416049002. Read it at Google Books - Find it at Amazon
- 3. Marchiori D, Marichori D. Clinical Imaging. Mosby. (2005) ISBN:0323022642. Read it at Google Books - Find it at Amazon
- fractures by location
- cervical spine fracture classification systems
- thoracolumbar spinal fracture classification systems
- three column concept of spinal fractures (Denis classification)
- classification of sacral fractures
- facet dislocation