Clay-Shoveler's fracture is an isolated spinous process fracture typically observed in the lower cervical or upper thoracic spine [1]. Multiple involvements are rare [1-4]. A 40-year-old car driver was involved in a road traffic accident with the seat belt buckled up. Clinical examination revealed an extensive tenderness on the skin over the posterior thoracic spine without neurological deficits. Computed tomography scanning of the cervicothoracic spine showed multiple thoracic spinous process fractures extended from T2 to T8 (Figure) without evidence of vertebral bodies lesions. There were no additional injuries. The patient was treated conservatively by analgesic therapy and immobilization for 6 weeks with a good clinical outcome.
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