TRANSVERSE PROCESS FRACTURES OF THE CERVICAL-VERTEBRAE - ARE THEY INSIGNIFICANT

Transverse process fractures of the cervical vertebrae have been consi dered rare and insignificant. In a retrospective study of 216 patients with cervical fractures evaluated by plain films and computed tomogra phy, we found that transverse process fractures were common. Transvers e process fractures were present in 24% of patients with cervical frac tures and accounted for 13.2% of all cervical fractures. Cervical radi culopathy and brachial plexus palsy were present in 10% of patients wi th transverse process fractures. In 78% of transverse process fracture s, CT scanning showed that the fracture extended into the transverse f oramen. Vertebral angiography, performed in eight patients with fractu res involving the transverse foramen, showed dissection or occlusion o f the vertebral artery in seven (88%) instances. Two of these seven pa tients had clinical evidence of vertebral-basilar artery stroke. Verte bral angiography should be considered when patients with transverse pr ocess fractures extending into the transverse foramen develop signs an d symptoms of vertebral-basilar artery insufficiency.