J Korean Neurosurg Soc.  2012 Dec;52(6):570-573. 10.3340/jkns.2012.52.6.570.

Multiple Cervical Spinous Process Fractures in a Novice Golf Player

• Kim SY
• Chung SK
• Kim DY

• KMID: 1426272
• DOI: http://doi.org/10.3340/jkns.2012.52.6.570

Abstract

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.

Keyword

Golf injury; Cervical spinous process fracture; Trapezius muscle

MeSH Terms

Braces
Female
Golf
Head
Humans
Magnetic Resonance Imaging
Neck
Neck Pain
Spinal Cord
Spine

Figure

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  Fig. 1 Lateral radiographs showing C6 and C7 spinous process fractures (A) and no instability on lateral extension (B) and flexion (C) radiographs.

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  Fig. 2 Sagittal T1, T2-weighted magnetic resonance images (A and B) showing C6 and C7 spinous process fracture without spinal cord pathology. Fat saturation image (C) revealing high signal areas in interspinous and supraspinous between the C6 and C7 vertebra suggestive of an acute injury to cervical spine.

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  Fig. 3 Schematic draws of trapezius muscle during each swing phase. Trapezius muscle thickness is increased in the lower cervical and upper thoracic region (A). During back swing, right upper and middle trapezius muscle contract from address-neutral state (B and C). During forward swing, the left middle trapezius muscle contracts (D). The force may amplify during the acceleration phase (E). When a right-handed golfer swings such that the club contacts the ground before the ball back swing arc energy cannot be transmitted to the ball (F).

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