Twenty-eight fractures of the spinous processes of the lower and upper thoracic vertebrae were found in 24 patients. All were engaged in an occupation known as metal dipping. This type of work places repetitive stress on the lower cervical and upper thoracic vertebrae which may result in a fracture in certain susceptible individuals. A presumptive diagnosis can be made on the history and physical examination. The diagnosis is confirmed by x-ray, and special techniques are necessary to visualize the fracture. Ten patients were treated surgically with excision of the avulsed fragment. Fourteen patients were treated conservatively. Diagnosis of this fracture may be overlooked due to the difficulty in demonstrating it roentgenologically.
Venable JR, Flake RE, Kilian DJ. Stress Fracture of the Spinous Process. JAMA. 1964;190(10):881–885. doi:10.1001/jama.1964.03070230017004
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