Abstract
Objective. To report the sign of ”spinolaminar breach” and its likely importance in fractures of the cervical spinous processes.
Design. Six cases of spinous process fractures demonstrating disruption of the spinolaminar line or ”spinolaminar breach” were analyzed. Lateral and anteroposterior radiographs (n=6), CT scans (n=3) and MRI scans (n=1) were reviewed together by the authors, with consensus being reached as to the radiographic findings. Clinical records were also reviewed.
Results. The levels of injury were C6 (n=5) and C5 (n=2). Injuries were associated with delayed anterior subluxation (n=4) and neurological deficit (n=2). Five patients were male and one was female with a mean age of 31 years (range 8–59 years). Injuries resulted from motor vehicle accidents (n=4), a motor cycle accident (n=1) and a fall (n=1).
Conclusion. ”Spinolaminar breach”, or disruption of the spinolaminar line, indicates a complex spinous process fracture with extension into the lamina and spinal canal. Spinous process fractures with spinolaminar breach may have associated posterior ligamentous injury with potential for delayed instability and neurological deficit. It is important that radiologists and physicians caring for the trauma patient be aware of this sign in order to avoid misdiagnosis as a ”clay shoveler’s fracture”, which can lead to adverse outcome.
Similar content being viewed by others
Author information
Authors and Affiliations
Additional information
Received: 20 July 1999 Revision requested: 14 September 1999 Revision received: 13 October 1999 Accepted: 26 October 1999
Rights and permissions
About this article
Cite this article
Matar, L., Helms, C. & Richardson, W. ”Spinolaminar breach”: an important sign in cervical spinous process fractures. Skeletal Radiol 29, 75–80 (2000). https://doi.org/10.1007/s002560050013
Issue Date:
DOI: https://doi.org/10.1007/s002560050013