SENTINEL SPINOUS PROCESS FRACTURES

Fractures of the spinous processes of cervical vertebrae are a well-described clinical entity. In the literature they were attributed to stress injury secondary to muscle tension and stress injury secondary to hyperflexion-hyperextension and are considered to be in the category of severe fracture-dislocations. Two cases of cervical spinous process fracture due to direct trauma to the posterior aspect of the cervical thoracic junction are presented. Further radiographic analysis, including conventional tomography and computed axial tomography [CT], revealed there were lamina fractures in these patients as well. Fortunately, no neurological deficits were observed. Although the spinous processes actually guard the underlying spinal cord, with this mechanism of injury, laminal depressed fractures could occur and cause neurological deficit. Because of the heightened awareness of these fractures and with the help of CT, these fractures now may be easily diagnosed.