Objective: To define the spectrum of injuries associated with cervical spinous process fractures as well as the management strategies.Materials and Methods: retrospective study over a three- year period. A total of 17 patients were analysed. The male to female ratio: 8:1. The age range was 17 - 57 years. The mechanisms of injury were ; motor-vehicle accidents, fall from a height, gunshot injuries, and a falling wall.Results: Most patients who had injuries were males. The lower cervical spine is the area most commonly involved. There was one case of isolated cervical spinous process involvement and one case of upper and lower cervical spine involvement. Sixteen patients had additional vertebral column involvement. About half of the patients had other body injuries. Five of the patients ( 29%) who had associated cervical spine injuries needed cervical fusion.Conclusion: Spinous process fractures may be associated with other serious injuries. Thorough diagnostic work-up is mandatory in patients who sustained high-risk injuries. Spinous process fractures of the cervical spine may be one aspect of a serious injury. Introduction Fractures of the cervical spinous processes are relatively rare injuries. Isolated cervical spinous processes fractures are even rarer ; most reported cases are case reports. Sixteen percent of isolated spinous processes fractures of the cervical spine involve more than one level [5]. Isolated cervical spinous process fractures are commonly referred to as clay-shoveler's fractures: this is a misnomer. X. Jordana et al. [11] defined a clay-shoveler's fracture as ‘an oblique , vertical break that affects the spinous processes from C6 to T3, but is most commonly found to involve C7, or both C7 and T1, and occasionally only T1'. It is a mechanical or repetitive stress fracture [4]. Occasionally, the fracture can be acute. They are generally considered stable injuries. The purpose of this study is to define and analyze the spectrum of injuries associated with fractures of the cervical spinous processes and suggest management strategies. Materials and Methods Institutional setting: The study was done in a secondary tertiary institution.Type of study: retrospective study, from March 2005 to March 2008.Study population: All adult patients referred to the Spinal Unit over a three – year period. The information was obtained from clinical and Radiological records. No approval from the ethics committee is necessary for retrospective studies.
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