OVERLOOKED SPINE INJURIES ASSOCIATED WITH LUMBAR TRANSVERSE PROCESS FRACTURES

Transverse process fractures of the lumbar spine often are considered benign fractures related to direct trauma or psoas muscle avulsion, Tr eatment of these usually stable injuries is primarily administered whe n the patient becomes symptomatic. However, significant force often is required to cause these injuries, and other injuries may occur concom itantly, For this study, all patients who presented with identified lu mbar transverse process fractures were further evaluated radiographica lly with computed tomography for the detection of other possible spine injuries, Medical and radiology records of 28 consecutive patients wh o had plain radiographs and computed tomography scans taken of their l umbar spine were reviewed retrospectively; these patients presented wi th lumbar spine transverse process fractures between January 1, 1989 a nd June 30, 1992, Three of the 28 patients (11%) had a lumbar spine fr acture that was identified by computed tomography but overlooked on pl ain radiographs. Approximately 11% of patients with major injuries may be misdiagnosed if only plain radiographs are used in the evaluation of transverse process fractures, Computed tomography scanning of ail l umbar spine transverse process fractures resulting from acute trauma s hould be considered because this diagnostic measure decreases the risk of overlooking potentially serious injuries.