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Transverse process fracture

Changed by Joachim Feger, 18 Dec 2021

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

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.

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
unfused transverse process ossification centre

-<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>
+<p><strong>Transverse process fractures</strong> are common sequelae of trauma, although they are considered minor and stable <a href="/articles/lumbar-spine-fracture">lumbar spine fractures</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>

References changed:

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. <a href="https://doi.org/10.1148/radiology.215.3.r00jn27831">doi:10.1148/radiology.215.3.r00jn27831</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/10831706">Pubmed</a>
2. Neil E. Green. Skeletal Trauma in Children. (2009) ISBN: 9781416049005 - <a href="http://books.google.com/books?vid=ISBN9781416049005">Google Books</a>
3. Dennis M. Marchiori. Clinical Imaging. (2005) ISBN: 9780323022644 - <a href="http://books.google.com/books?vid=ISBN9780323022644">Google Books</a>
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. <a href="http://dx.doi.org/10.1148/radiology.215.3.r00jn27831">doi:10.1148/radiology.215.3.r00jn27831</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/10831706">Pubmed citation</a><span class="auto"></span>
2. Green NE, Swiontkowski MF. Skeletal Trauma in Children: Expert Consult - Print and Online, 4e. Saunders. ISBN:1416049002. <a href="http://books.google.com/books?vid=ISBN1416049002">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/1416049002">Find it at Amazon</a><span class="auto"></span>
3. Marchiori D, Marichori D. Clinical Imaging. Mosby. (2005) ISBN:0323022642. <a href="http://books.google.com/books?vid=ISBN0323022642">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/0323022642">Find it at Amazon</a><span class="ref_v3"></span>

Tags changed:

fracture
spine

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