Displaced C7 spinous process (clay-shoveler) fracture

Case contributed by Dr Jack Ren


Surfboard vs posterior neck, neck pain with tenderness at cervicothoracic junction, altered sensation at scene

Patient Data

Age: 49
Gender: Male


Routine non contrast CT scan of the cervical spine has been performed. 

There is a displaced fracture of the base of the C7 spinous process with up to 2 to 3mm of displacement of the fracture fragments. Fracture extends to but does not involve facet joints bilaterally.

There is satisfactory alignment of the spinous processes, vertebral bodies and facet joints. There is satisfactory alignment of the occipitoatlantal and atlantoaxial joints. No significant prevertebral soft tissue swelling is identified.

Note is made of degenerative changes involving the cervical spine and the upper thoracic spine at multiple levels.


Mildly displaced fracture of the C7 spinous process.

Alignment of the cervical spine is normal. Cord signal is normal. Disc signal is normal.

Fracture of the spinous process of C7 is again demonstrated with surrounding bone edema. There is also edema in the subcutaneous fat posterior to the spinous process at this level.Disc/osteophyte complex at C5/6 and C6/7 with ligamentum flavum hypertrophy results in moderate canal stenosis with a thin cleft of CSF dorsal to the cord. The complex also results in severe narrowing of the left C6/7 neural exit foramen. There is no evidence of ligamentous disruption.


C7 spinous process fracture. No evidence of ligamentous injury.

Degenerative change at C5/6 and C6/7 results in moderate canal stenosis and severe narrowing of the left C6/7 neural exit foramen.

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Case information

rID: 29718
Published: 30th Jun 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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