No associated adverse events were observed. The initial treatment regimen was unrestricted movement in all patients. The seventh vertebra was involved predominantly (76%). Clinicians should maintain high indices of suspicion for associated injuries in patients with ITPFs, especially after high-velocity mechanisms 7).Ģ1 patients (2.4%) had 25 isolated TPFs of the subaxial cervical spine. Neck and chest pain were significantly associated with vascular injuries. Several factors were identified as significant markers of associated injuries, including female sex, MVA, and presenting symptoms. Spine consult (neurosurgery or orthopedic surgery) was frequent (n = 94, 72.9%) and was more common after MVA versus fall (P = 0.018). Chest and neck pain were associated with vascular injuries (P < 0.001 and P = 0.001, respectively). Back pain was the most common presenting symptom (n = 71, 64.6%) and was associated with intraabdominal and lower extremity injuries (P = 0.032 and P = 0.016, respectively). Motor vehicle accident (MVA) was the most common mechanism of injury (n = 81, 62.8%) and was associated with thoracic (P = 0.032) and lower extremity pain/injury (P = 0.005). Women were more likely to present with abdominal pain and associated kidney injury (P = 0.018 and P = 0.012, respectively). Mean age was 38.1 years (range 15-92 years). The Ronald Reagan UCLA Medical Center patient database was queried (years 2005-2016) using International Classification of Diseases, Ninth Revision, code 805: fracture of the vertebral column without mention of spinal cord injury.Ī total of 129 patients with isolated transverse process fractures (ITPFs) were identified. Vertebral artery angiography should be considered when patients with transverse process fractures extending into the transverse foramen develop signs and symptoms of vertebrobasilar disease 5).Ī case report demonstrates the severity of injury after minor trauma in the context of ankylosing spondylitis, the capacity for full recovery in oesophageal perforations in spinal trauma, and that clinical suspicion of such injuries allows early diagnosis, treatment and reduced complications 6). Isolated cervical transverse process fracture (TPF) of the subaxial cervical spine can be considered as clinically insignificant and do not require treatment 3)Ĭlinicians should maintain high indices of suspicion for associated injuries in patients with isolated transverse process fractures especially after high-velocity mechanisms 4).ġ.- Fracture of the right transverse process of C2 involving the transverse foramen.Ģ.- Similar fracture passing through right transverse foramen of C3. When TPF are identified, diligence in searching for a spine injury or abdominal injuries should be exercised, as these associated injuries occur frequently 2). Spine service (neurosurgical or orthopedic) consultation is frequently requested for patients with these fractures, stressing constraints on these practices. With the advent of whole body computed tomography of trauma patients, the radiologic diagnosis of transverse process fractures (TPF) has increased. Cervical transverse process fractures have a strong association with other cervical spine fractures and blunt cerebrovascular injury 1).
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