Kim Sei-Yoon, Chung Sang Ki, Kim Dong-Yun
Department of Neurosurgery, Seoul Chuk Spine Hospital, Seoul, Korea.
J Korean Neurosurg Soc. 2012 Dec;52(6):570-3. doi: 10.3340/jkns.2012.52.6.570. Epub 2012 Dec 31.
Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.
棘突撕脱伤,也称为泥瓦匠骨折,在从事重体力劳动的人群中最为常见。据作者所知,仅报道过一例新手高尔夫球手发生上胸椎多个棘突骨折的病例。一名45岁女性因顽固性后颈部疼痛就诊。患者在挥杆击球时,球杆头触地后颈部突然剧痛。颈椎动态影像学检查发现C6和C7棘突骨折。磁共振成像显示C6和C7棘突骨折,无脊髓病变。患者接受了止痛药物和颈部支具治疗。患者疼痛逐渐缓解。推测其损伤机制与泥瓦匠骨折相似。下颈椎棘突骨折可能与高尔夫挥杆动作有关。如果患者主诉颈部长期疼痛且有高尔夫运动史,应进一步检查以排除下颈椎棘突骨折。