RESUMEN
Objective To investigate the effect of cervical spinous process fracture with posterior ligamentous complex (PLC) injury on biomechanical stability of the goat cervical spine specimen in vitro, and evaluate the role of posterior structure in maintaining the stability of cervical spine. Methods Twenty-four fresh goat cervical spine C3-6 specimens were randomly and evenly divided into 3 groups: control group (group A), simple cervical spinous process fracture group (group B) and cervical spinous process fracture with PLC injury group (group C). Under loading of 1.5 N·m torque, the range of motion (ROM) in each group was respectively measured under 6 working conditions: flexion, extension, lateral bending and axial rotation, and the ROM differences among 3 groups were compared by using one-way ANOVA analysis. Results Simple cervical spinous process fracture had little effect on the stability of cervical spine and there was no significant difference in ROM between group B and control group (P>0.05) under all working conditions. Compared with control group, the ROM in flexion, extension and axial rotation significantly increased in group C (P0.05). Conclusions Simple cervical spinous process fracture does not affect the overall stability of cervical spine. Cervical spinous process fracture with PLC injury is more likely to cause cervical instability than simple cervical spinous process fracture, and surgical intervention is required in cervical spinous process fracture with PLC injury.
RESUMEN
Objective To investigate the effect of cervical spinous process fracture with posterior ligamentous complex (PLC) injury on biomechanical stability of the goat cervical spine specimen in vitro,and evaluate the role of posterior structure in maintaining the stability of cervical spine.Methods Twenty-four fresh goat cervical spine C3-6 specimens were randomly and evenly divided into 3 groups:control group (group A),simple cervical spinous process fracture group (group B) and cervical spinous process fracture with PLC injury group (group C).Under loading of 1.5 N · m torque,the range of motion (ROM) in each group was respectively measured under 6 working conditions:flexion,extension,lateral bending and axial rotation,and the ROM differences among 3 groups were compared by using one-way ANOVA analysis.Results Simple cervical spinous process fracture had little effect on the stability of cervical spine and there was no significant difference in ROM between group B and control group (P ＞ 0.05) under all working conditions.Compared with control group,the ROM in flexion,extension and axial rotation significantly increased in group C (P ＜ 0.05),and no significant ROM difference was found in lateral bending between control group and group C (P ＞ 0.05).Conclusions Simple cervical spinous process fracture does not affect the overall stability of cervical spine.Cervical spinous process fracture with PLC injury is more likely to cause cervical instability than simple cervical spinous process fracture,and surgical intervention is required in cervical spinous process fracture with PLC injury.
RESUMEN
Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.