Spinous process fractures in a jockey: a case report.

Spinous process fractures typically represent avulsion injuries involving the lower cervical spine. This case report describes the clinical and radiographic findings in a patient with spinous process fractures at the T-2, T-3, and T-4 vertebral levels. The fractures, which were obscured on conventional radiographs by overlying osseous and soft-tissue structures, were optimally shown on axial and computer-reconstructed sagittal computed tomographic (CT) images. Although isolated spinous process fractures do not compromise spinal stability, chronic sequelae associated with fracture nonunion may occur if a fracture is not recognized and treated. Because conventional radiographic assessment of the thoracic posterior elements is often limited, cases of clinically suspected spinous process fracture often require CT evaluation to confirm the diagnosis.