• Journal of Korean Neurosurgical Society
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• 제52권6호
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• pp.570-573
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• 2012

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.

• 대한정형외과스포츠의학회지
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• 제11권2호
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• pp.96-98
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• 2012

경추 또는 흉추의 극돌기에 단독으로 발생하는 골절을 Clay shoveler 골절이라 한다. 이 골절이 스포츠 활동 중에 발생하는 경우는 매우 드물다. 본 증례에서는 27세 남성으로 반복적인 골프 스윙으로 인하여 제 7경추 극돌기에 골절이 발생하였다. 환자는 진통제, 근육이완제 복용과 4주간의 토마스 칼라를 착용하였다. 통증은 호전되었고, 수상 후 5개월 째에 다시 골프를 시작하였다.

• Clinical Pain
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• 제19권2호
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• pp.138-141
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• 2020

Clay-shoveler's fractures are rare stress-type avulsion fractures of the spinous processes especially in sports. There have been two case reports that discussed clay-shoveler's fractures in golf. A 36-year-old beginner golfer presented with a pain in the back after practicing golf swing. No fractures were detected using cervical radiography; however, computed tomography (CT) and magnetic resonance imaging (MRI) revealed T2~T3 spinous process fractures. The patient was treated conservatively and his pain subsided. The mechanism of injury is speculated to that of clay-shoveler's fractures. Therefore, if a golfer suffers persistent pain in the cervicothoracic region, clay-shoveler's fracture is one possibility to consider.

• The Journal of Korean Physical Therapy
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• 제35권6호
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• pp.163-166
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• 2023

A 30-year-old male novice golfer was diagnosed with a clay-shoveler's fracture. During golf practice, he experienced persistent posterior neck and upper back pain for a month. Cervical radiographs and computed tomography revealed a series of sequential spinous process fractures from C7 to T3. The patient was prescribed analgesic medication and fitted with a cervical brace alongside extracorporeal shockwave therapy (ESWT) directed explicitly toward the upper back region, subsequently leading to a notable reduction in pain. Therefore, ESWT could be considered an additional method for pain management in patients with clay-shoveler's fractures.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2009년도 추계학술대회 논문집
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• pp.621-622
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• 2009

• Journal of Trauma and Injury
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• 제34권1호
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• pp.31-38
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• 2021

Purpose: Traumatic vertebral injuries have a prevalence of 4-5% at level I centers. Studies have demonstrated that isolated thoracolumbar transverse process fractures (iTPF) rarely require brace or surgical interventions. We hypothesized that similarly isolated thoracolumbar spinous process fractures (iSPF) would have less need for bracing and operative interventions than SPFs with associated vertebral body (VB) fractures (SPF+VB). We performed a similar analysis for iTPF compared to transverse process fractures associated with VB injury (TPF+VB). Methods: In this single-center, retrospective study from 2012 to 2016, patients were classified into iSPF, SPF+VB, iTPF, and TPF+VB groups. Data including the fracture pattern, neurologic deficits, and operative intervention were obtained. The primary outcome studied was the need for bracing and/or surgery. A statistical analysis was conducted. Results: Of 98 patients with spinous process fractures, 21 had iSPF and 77 had SPF+VB. No iSPF patients underwent surgery, whereas 24 (31.17%) SPF+VB patients did undergo surgery (p=0.012). In the iSPF group, three patients (15%) received braces only for comfort, whereas 37 (48.68%) of the SPF+VB group required bracing (p=0.058). Of 474 patients with transverse process fractures, 335 had iTPF and 139 had TPF+VB. No iTPF patients underwent surgery, whereas 28 (20.14%) TPF+VB patients did (p≤0.001). Of the iTPF patients, six (1.86%) were recommended to receive braces only for comfort, while 68 (50.75%) of the TPF+VB patients required bracing (p<0.001). Conclusions: No patients with iSPF or iTPF required surgical intervention, and bracing was recommended to patients in these groups for comfort only. It appears that these injures may be safely managed without interventions, calling into question the need for spine consultation.

• Journal of Yeungnam Medical Science
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• 제15권2호
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• pp.254-262
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• 1998

골수의 손상정도률 민감하게 반영하는 Tc-99m 표지 항과립구항체 면역신티그라피를 이용하여 척추압박골절의 원인을 감별할 수 있는지를 알아보기 위하여, 척추압박골절 환자중에서 병리조직학적(수술 혹은 생검) 혹은 3개월 이상의 임상경과를 추적 관찰하여 원인이 밝혀진 16명의 환자를 대상으로 Tc-99m 표지 항과립구항체 면역신티그라피의 결과를 분석하였다. 16명의 환자중 외상이나 골다공증에 의한 압박골절 부위가 16부위 (8명), 전이암에 의한 압박골절이 3부위 (3명), 결핵에 의한 압박골절이 6부위 (5명) 이었다. 외상이나 골다공증과 같은 양성원인에 의한 척추압박골절 16 부위 모두 척추뿌리, 추궁판, 가시돌기의 섭취는 정상이었고, 척추체는 섭취저하가 7례, 섭취결손이 8례, 섭취정상이 2례에서 관찰되었다. 결핵에 의한 압박골절 6례에서 척추체의 섭취결손이 6례 모두, 척추뿌리의 섭취결손이 5례에서 관찰되었고, 가시돌기와 추궁판의 섭취결손은 발견되지 않았다. 전이암에 의한 3례의 경우는 2례에서 척추체, 척추뿌리, 추궁판, 가시돌기의 섭취결손이 보였고, 1례에서는 척추체와 가시돌기에만 섭취결손이 관찰되었다. Tc-99m 표지 항과립구항체 면역신티그라피의 단층영상에서 섭취결손부위를 평가함으로서 양성원인과 병적원인에 의한 척추압박골절의 원인의 감별에 도움이 될 수 있을 것으로 사료된다.

• 한국임상수의학회지
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• 제34권2호
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• pp.115-118
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• 2017

A Korean goral (immature, female) was presented with paraplegia following motor vehicle trauma. The patient was diagnosed with an L5-6 vertebral fracture-luxation based on digital radiographs. Surgical reduction and stabilization of the fracture-luxation were performed via a dorsal approach to the lumbar spine. It was confirmed in surgery that the patient had L5-7 spinous process fractures, L6 bilateral articular process fractures, and an L5-6 luxation. Free fragments were removed and the luxation was reduced. During reduction, caudodorsal dislocation of the L5 caudal vertebral end plate was discovered and the displaced end plate was removed. The L5-6 vertebral luxation was stabilized using pins and bone cement. However, the presence of an intact spinal cord was not confirmed. Two weeks postoperatively the patient became dyspneic and arrested. A necropsy was performed, which revealed that the surgical stabilization was intact. Pulmonary edema was identified and the immediate cause of death was determined to be systemic inflammatory response syndrome.

• Journal of Trauma and Injury
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• 제26권1호
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• pp.30-33
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• 2013

A 55-year-old woman was seen in the emergency department with posterior neck pain and a headache after a traffic accident. Physical examination revealed tenderness on palpation over the posterior skull and a midline spinous process of the cervical spine without neurologic deficit. A plain radiograph of the cervical spine demonstrated the absence of the lateral portion of the posterior arch of the atlas and very lucent shadowing of the anterior midline of the atlas, suggesting a fracture of the anterior arch. On three-dimensional computed tomography (CT) of the cervical spine, anterior and posterior bony defects of the atlas were noted. Well-corticated defects were noted with sclerotic change and with no evidence of soft tissue swelling adjacent to the bony discontinuities, consistent with a congenital abnormality. With conservative therapy, the patient gradually showed a lessening of the midline tenderness. Careful investigation with radiography or CT is needed for these patients to avoid confusion with a fracture, because these patients seldom need surgical treatment.

• 대한핵의학회지
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• 제38권6호
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• pp.522-527
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• 2004

목적 : 본 연구는 골다공증에 의한 척추 골절 환자를 대상으로 골SPECT를 시행하고 골 섭취 증가 병변의 형태와 분포를 분석하여, 척추 골절에서 골SPECT의 유용성을 알아보고자 하였다. 대상 및 방법: 골다공증에 의한 척추 골절이 있었던 32명의 환자를 대상으로 하였다. 평균 연령은 $67{\pm}8$세였으며, 남자 5명, 여자 27명이었다. 79개의 척추골절이 발견되었으며, 병소는 흉부 및 흉요추부 척추가 38개, 요추부 척추가 41개였다. 척추체의 골절 형태는 압박 형태에 따라 쐐기형, 양요형, 압박형으로 분류하였고, SPECT 상 척추체의 골 섭취 증가 병변은 국소성 혹은 미만성, 대칭성 혹은 비대칭성으로 분류하였다. 척추 후방부의 SPECT 소견은 척추경, 척추 후관절, 관절간부, 극상 돌기의 골섭취 증가 병변 유무로 분류하였다. 척추체 골절 형태와 골절 척추의 위치에 따른 골 SPECT소견에 차이가 있는지를 분석하였다. 결과: 79개의 척추제 압박 골절 중 쐐기형 병소가 47개, 양요형 병소가 20개, 압박형 병소가 12개이었다. 골 SPECT에서는 척추체의 섭취 증가가 모든 예에서 관찰되었으며, 골절의 형태와 관계없이 국소형 보다는 미만형이, 대칭성 보다는 비대칭성 골 섭취 증가가 많았다. 척추 후방부에 병소가 발견된 경우는 69개(87.3%) 였으며, 쐐기형이 40개(85.1%), 양요형 17개(85.0%), 압축형 12개(100%)에서 관찰되었다. 흉부 및 흉요추부 척추에서는 쐐기형 골절이 많은 반면, 요추부 척추에서는 골절형태 분포가 비교적 균일한 것으로 나타났다(p=0.04). 극상돌기의 골섭취는 흉부 및 흉요추부 골절의 5예(13.2%)에서 있었던 반면 요추부 척추 골절에서는 16개(39.0%)에서 발견되어 분포의 차이가 있었다(p=0.009). 요추부 척추에서 발생한 양요형 골절에서 척추 후관절에 골 섭취 증가를 보인 경우가 12개(92.3%)인데 반해 흉부 및 흉요추부 척추에 발생한 경우 4개(57.1%) 에서만 골섭취 증가 병변이 있었다. 극상돌기의 골섭취에도 차이가 있어서 요추가 8개(38.5%)인데 비해 흉부 및 흉요추부 척추에서는 1개(14.3%)에서만 골섭취가 있었다(p=0.043). 결론: 골SPECT는 골다공증에 의한 척추 골절 진단에 유용하며, 특히 척추 후방부의 골 섭취 증가 병변의 평가에 유용하였다.