Emergency Cases Northwest Group
011 Back Hack
Situation
Man fell, transverse process fractures treated conservatively
Background
A man fell a full flight of stairs. Polytrauma CT revealed multiple
transverse spinous process fractures of the thoracolumbar vertebrae.
There were no other injuries and no abnormal neurology. Question raised:
did the case need discussion with neurosurgery? ED senior advice: no
discussion needed, treat conservatively with analgesia and mobilisation
only, discharge if OK.
Assessment
Isolated transverse spinous process fractures of the vertebrae can
indeed be managed conservatively, in the absence of other spinal or
neurological findings. Such injuries can be managed by ED staff without
involving neurosurgery but a ED doctor of suitable seniority should be
consulted.
Recommendation
Before contacting neurosurgery for isolated transverse spinous process
fractures; talk to the ED senior first.
PLEASE DO NOT INCLUDE ANY PATIENT IDENTIFIABLE DATA OR
GEO-LOCATION DATA IN THE SUBMISSION OR IN ANY ATTACHED
IMAGES
Emergency Cases Northwest Group