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Transverse process fracture

Changed by Mostafa Elfeky, 7 Jul 2020

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Transverse process fractures are a common sequelae of trauma, although they are considered a minor and stable lumbar spine fracture. There is a strong association between transverse process fractures and other traumatic injuries.

Pathology

Transverse process fracture most commonly ~~occur~~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.

Aetiology

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 ²andblunt 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:

hypoplastic 12th rib
~~non-fused lumbar~~unfused transverse process ossification ~~centres~~centre

-<p><strong>Transverse process fractures</strong> are a common sequelae of trauma, although they are considered a minor and stable <a href="/articles/lumbar-spine-fracture">lumbar spine fracture</a>. There is strong association between transverse process fractures and other traumatic injuries.</p><h4>Pathology</h4><p>Transverse process fracture most commonly occur in the upper <a href="/articles/lumbar-spine">lumbar spine</a> and are commonly multiple <sup>2</sup>. The fracture line can extend into the <a href="/articles/transverse-foramen">transverse foramen</a>, and in the cervical spine there is a risk of complicating <a href="/articles/vertebral-artery-dissection">vertebral artery dissection</a>.</p><h5>Aetiology</h5><ul>
+<p><strong>Transverse process fractures</strong> are common sequelae of trauma, although they are considered a minor and stable <a href="/articles/lumbar-spine-fracture">lumbar spine fracture</a>. There is a strong association between transverse process fractures and other traumatic injuries.</p><h4>Pathology</h4><p>Transverse process fracture most commonly occurs in the upper <a href="/articles/lumbar-spine">lumbar spine</a> and are commonly multiple <sup>2</sup>. The fracture line can extend into the <a href="/articles/transverse-foramen">transverse foramen</a>, and in the cervical spine there is a risk of complicating <a href="/articles/vertebral-artery-dissection">vertebral artery dissection</a>.</p><h5>Aetiology</h5><ul>
~~-<a href="/articles/psoas-major-1">psoas muscle</a> avulsion</li>~~
+<a href="/articles/psoas-major-muscle-1">psoas muscle</a> avulsion</li>
~~-<li>hypoplastic 12th rib</li>~~
~~-<li>non-fused lumbar transverse process ossification centres</li>~~
+<li>hypoplastic <a title="12th rib" href="/articles/twelfth-rib">12th rib</a>
+</li>
+<li><a title="unfused transverse process ossification centre" href="/articles/unfused-transverse-process-ossification-centre">unfused transverse process ossification centre</a></li>

Images Changes:

Image 6 CT (bone window) ( create )

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