The Injury
In sports, a transverse process fracture is a spine fracture that typically occurs due to a helmet to the back or a hard pull from the back muscle while making an athletic move. This post will give a full understanding of this fracture and how it will impact an athletes play.
Side View Spine
Photo by Michael Dorausch (Modified), Flickr
Anatomy of the Injury
The vertebrae that make up the spinal column consist of several different parts. As can be seen by the model above, the body is the large portion to the front of the spinal cord and the spinous process is the bony prominence that points towards the back. The spinous process is the bony portion you can feel along the center of an athlete's back. Almost all of the vertebrae have two transverse processes that point outward from the sides of the vertebrae. The photo above is showing only one side of the back. The transverse process is an attachment point for muscles of the back in order to flex, extend and rotate the spine. Additionally the transverse process is the attachment site of the posterior aspect of the ribs. One can imagine it is difficult to participate in sports with this type of fracture, due to limited movement.
Oblique View Spine
Photo by Michael Dorausch (Modified), Flickr
Evaluation
The athlete usually will report sharp vague pain in the area of the back associated with site of injury. Usually there will be difficulty with flexing and extending the back as well as there may be difficulty with deep breaths, coughing or sneezing such as in a rib injury. An x-ray is the first step in treatment, but usually the diagnosis is confirmed with a CT scan of the spine which is best at showing bony structures.
CT Scan Transverse Process Fracture
Treatment & Return
Due to the fact that the transverse process does not have any impact on the spinal cord, nerve structures or disc, a fracture of this structure is usually considered a stable fracture. It is also surrounded by significant muscle and soft tissue reducing the likelihood that the fracture will move or shift. Basically, the treatment involves supportive care to allow the fracture to heal on its own. Athletes might use a protective padding or brace to protect against impact while playing. Once the athlete can manage the pain and be appropriately protected they can be returned back to play. Typical recovery time is approximately 4-6 weeks depending on the extent of the injury. Small fractures can potentially return back with in a 2-3 week time frame.