Transverse Process Fracture – What is this term

Transverse process fracture, which is also called a rotation spine fracture, is a break in a transverse process. Bones of the spine (vertebrae) have portions that extend off to either side of the spine. These portions of bone are called transverse processes.

What are the causes?

This condition may be caused by:

• A fall from a great height.
• A car accident.
• A sports injury.
• A gunshot wound.
• A hard, direct hit to the back.

This kind of fracture often results from a sudden and severe bending of the spine to one side. Depending on the cause of the fracture, one or more bones may be affected.

What increases the risk?

You are more likely to develop this condition if:

• You have thinning and loss of density in the bones (osteoporosis).
• You play a contact sport.

What are the signs or symptoms?

The main symptom of this condition is back pain. The pain may:

• Be felt on the side of the spine (flank) where the fracture is.
• Get worse when you move or take a deep breath.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms.
• Your medical history.
• A physical exam.

You may also have other tests, including:

• X-rays.
• A CT scan.
• MRI.

How is this treated?

Most transverse process fractures heal on their own with time and rest. Treatment may involve supportive care, such as:

• Limiting activity.
• Medicines, such as:
  • Pain medicine.
  • Muscle-relaxing medicine.
• Physical therapy.
• A neck or back brace.

Follow these instructions at home:

If you have a brace:

• Wear the neck or back brace as told by your health care provider. Remove it only as told by your health care provider.
• Keep the brace clean.
• If the brace is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or a shower.

Managing pain, stiffness, and swelling

• If directed, put ice on the injured area:
  • If you have a removable brace, remove it as told by your health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or use heavy machinery while taking prescription pain medicine.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.

Activity

• Stay in bed (on bed rest) only as directed by your health care provider.
  • Avoid being in bed for a long time without moving. Get up to take short walks every 1–2 hours. This is important to improve blood flow and breathing. Ask for help if you feel weak or unsteady.
• Return to your normal activities when your health care provider says it is okay. Ask if there are any activities that you should not do.
• Do physical therapy exercises as recommended by your health care provider.

General instructions

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important. Visits can help to prevent permanent injury, disability, and long-lasting (chronic) pain.

Contact a health care provider if:

• You have a fever.
• You develop a cough that makes your pain worse.
• Your pain medicine is not helping.
• Your pain does not get better over time.
• You cannot return to your normal activities as planned or expected.

Get help right away if:

• Your pain is very bad and it suddenly gets worse.
• You are unable to move any body part (paralysis) that is below the level of your injury.
• You have numbness, tingling, or weakness in any body part that is below the level of your injury.
• You cannot control your bladder or bowels.

Summary

• A transverse process fracture is a break in the portion of the bone that extends to the side of the spine.
• Most transverse process fractures heal on their own with time and rest.
• You may also have supportive treatments such as a back brace, pain medicines, and physical therapy.
• Keep all follow-up visits. This is important and will help to prevent permanent injury, disability, and long-lasting (chronic) pain.