The Spinous Process and Vertebral Fractures

Question: What could happen if I don't undergo surgery for a fracture?

On June 20, 2002, I suffered a spinal fracture of my C-7 vertebrae by doing a somersault on a hard surface. I have seen a neurosurgeon who says we will play the “wait and see game.” I pretty much have broken off the whole spinal process and have some ligament damage.

What are some of the health ramifications I could face by not having surgery to remove this bone fragment? Please note that I am a very active 32-year-old mom. I just completed a half marathon this spring.

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Doctor’s response:

Without knowing which piece of the C7 bone you have broken, I cannot accurately advise you. However, it sounds as though you may have pulled off part of the C7 spinous process. This is a common injury and is known as a “clay shoveler’s fracture.” (When clay used to be shoveled by hand, the workers would pull up hard and tear off their spinous process).

The spinous process does not impart any structural support to the spine and is not needed. Therefore, there is no reason to operate or remove this bone. The bone will not heal to itself, but will form a fibrous union. This is really more of a ligamentous injury than a bony injury and a bony union is not needed. It will hurt for months but the pain will eventually improve. Please ask your surgeon if this is a spinous process or a “clay shoveler’s fracture”.

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In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.