Transverse process fracture
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View Joachim Feger's current disclosures- Transverse process fractures
Transverse process fractures are common sequelae of trauma, although they are considered minor and stable lumbar spine fractures. There is a strong association between transverse process fractures and other traumatic injuries.
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Pathology
Transverse process fracture most commonly occurs 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.
Etiology
- blunt trauma
- lateral flexion-extension injury
- psoas muscle avulsion
- Malgaigne pelvic fracture
Associations
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
- ~35% (range 20-50%) of patients with lumbar transverse process fractures have hepatic and splenic injuries, genitourinary and/or diaphragmatic injuries 1
Radiographic features
CT is the modality of choice. Up to 60% of lumbar transverse process fractures identified on CT will be missed on plain radiographs 1.
Differential diagnosis
In the lumbar region, consider anatomical variants such as:
References
- 1. Patten R, Gunberg S, Brandenburger D. 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
- 2. Neil E. Green. Skeletal Trauma in Children. (2009) ISBN: 9781416049005 - Google Books
- 3. Dennis M. Marchiori. Clinical Imaging. (2005) ISBN: 9780323022644 - Google Books
Incoming Links
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