Jason H Boulter1, Brendan P Lovasik1, Griffin R Baum1, Jason M Frerich1, Jason W Allen2, Jonathan A Grossberg3, Gustavo Pradilla3, Faiz U Ahmad4. 1. Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, USA. 2. Neuroradiology Division, Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia, USA. 3. Department of Neurological Surgery, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA. 4. Department of Neurological Surgery, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA. Electronic address: faiz.ahmad@emory.edu.
Abstract
BACKGROUND: Acute traumatic isolated transverse process fractures (ITPFs) are increasingly identified in trauma patients owing to the increased use of routine computed tomography imaging. Despite repeated demonstrations that these fractures are treated only symptomatically, patterns of consultation with a spine service have not changed. We aim to provide information on long-term outcomes following conservative treatment to help clarify the role of the spine service in the treatment of ITPFs. METHODS: A retrospective chart review of 306 patients presenting with ITPFs was conducted to identify both short-term and long-term patient outcomes. A subsection of patients was identified with no other traumatic injuries besides isolated ITPFs (iITPFs). RESULTS: No patient required surgical intervention for an ITPF, and 97.7% of all patients and 100% of the patients with iITPFs did not require bracing. At last follow-up, all patients were neurologically intact, 97.8% were fully ambulatory, and 87.9% had no ITPF-related back pain. When only patients with 6 or more months of follow-up were considered, all patients were fully ambulatory, and only 1.1% of all patients and none of the patients with iITPFs had persistent back pain. CONCLUSIONS: ITPFs can be treated conservatively without concern for long-term outcome sequelae such as pain, neurologic deficits, or ambulatory difficulties. Consequently, a spine service consult is not required for patients with ITPFs.
BACKGROUND: Acute traumatic isolated transverse process fractures (ITPFs) are increasingly identified in traumapatients owing to the increased use of routine computed tomography imaging. Despite repeated demonstrations that these fractures are treated only symptomatically, patterns of consultation with a spine service have not changed. We aim to provide information on long-term outcomes following conservative treatment to help clarify the role of the spine service in the treatment of ITPFs. METHODS: A retrospective chart review of 306 patients presenting with ITPFs was conducted to identify both short-term and long-term patient outcomes. A subsection of patients was identified with no other traumatic injuries besides isolated ITPFs (iITPFs). RESULTS: No patient required surgical intervention for an ITPF, and 97.7% of all patients and 100% of the patients with iITPFs did not require bracing. At last follow-up, all patients were neurologically intact, 97.8% were fully ambulatory, and 87.9% had no ITPF-related back pain. When only patients with 6 or more months of follow-up were considered, all patients were fully ambulatory, and only 1.1% of all patients and none of the patients with iITPFs had persistent back pain. CONCLUSIONS: ITPFs can be treated conservatively without concern for long-term outcome sequelae such as pain, neurologic deficits, or ambulatory difficulties. Consequently, a spine service consult is not required for patients with ITPFs.