Brynin R, Gardiner L
Clinical Associate Professor, Los Angeles College of Chiropractic, Whittier, Calif 90609, USA.
J Manipulative Physiol Ther. 2001 Feb;24(2):123-6. doi: 10.1067/mmt.2001.112562.
To discuss the case of a football player who had suffered a transverse process fracture of the lumbar spine that was overlooked on initial chiropractic and medical examination.
A 17-year-old male football player had been speared in the back by another player. He reported severe initial pain that caused him to fall to the ground, and there was a moderate degree of pain at the time of his chiropractic examination 1 week after injury.
Initial chiropractic treatment consisted of spinal manipulation to the lumbar spine. Follow-up care consisted of lumbar spine radiographs that showed evidence of a lumbar transverse process fracture at 2 levels. The boy was referred to his medical doctor, who was not convinced of the presence of a fracture and returned him to play. A computed tomography scan was subsequently performed; this confirmed fractures of the transverse processes of L2 and L3. The patient was precluded from contact sports for 4 weeks. Chiropractic care 3 weeks after injury included physiotherapy and drop table mobilization to the sacroiliac joints. The patient returned to play 4 weeks after the injury.
Transverse process fractures commonly occur secondary to blunt trauma in contact sports such as football. With high-force direct trauma, radiographs should be performed to rule out fracture before returning the athlete to play or commencing spinal manipulation.
探讨一名足球运动员腰椎横突骨折的病例，该骨折在最初的整脊治疗和医学检查中被忽视。
一名17岁的男性足球运动员被另一名运动员从背后撞击。他报告最初疼痛剧烈，导致摔倒在地，受伤1周后接受整脊检查时仍有中度疼痛。
最初的整脊治疗包括对腰椎进行手法治疗。后续护理包括腰椎X光检查，结果显示2个节段存在腰椎横突骨折迹象。该男孩被转介给其医生，但医生不相信存在骨折，让他回去继续比赛。随后进行了计算机断层扫描；这证实了L2和L3横突骨折。患者被禁止参加接触性运动4周。受伤3周后的整脊护理包括物理治疗和对骶髂关节进行下掉式松动治疗。患者在受伤4周后恢复比赛。
横突骨折常见于足球等接触性运动中的钝性创伤。对于高力直接创伤，在让运动员恢复比赛或开始脊柱手法治疗之前，应进行X光检查以排除骨折。
