Discontinuity of the spinous process on standard roentgenographs as an aid in the diagnosis of unstable fractures of the spine.

It has been observed that discontinuity in the outline of the spinous process on standard anteroposterior radiographs is a characteristic finding in some unstable spine fractures. Since the spinous processes are often not depicted clearly on lateral views of the trauma victim's spine, these are less reliable; however, if a transverse fracture through the spinous process at the level of, or adjacent to, an anterior compression fracture is demonstrable, this confirms the unstable nature of the injury. Recognition of this sign, when present, may eliminate excessive pretreatment manipulations in some patients who have sustained major trauma and are suspected of having unstable spine fractures.