A hard fall: an isolated fracture of lumbarized S1 spinous process: a case report and review of the literature

Spine
Josh E SchroederYair Barzilay

Abstract

A case of an isolated lumbarized S1 spinous process fracture due to direct trauma from a fall on the lower back is reported here. The patient was treated nonoperatively. Pain subsided and he returned to every day. To alert physicians of this rare fracture as part of the differential diagnosis in cases of direct trauma to the lower spine. The method of diagnosing such pathology and its treatment are described. A 22-year-old man was admitted with lower back pain after falling down a flight of stairs during which, he sustained a direct blow to his lower back. The patient had a scrape over L5-S1 area and midline tenderness around the L5-S1 area. He was neurologically intact. Radiographs revealed a lumbarized S1 vertebra and an isolated fracture of the spinous process of S1. The fracture resulted from the direct trauma to the S1 lumbarized vertebrae. The direct trauma and the fact that the patient has a lumbarized S1 vertebra with a thin spinous process contributed to the fragility of the spinous process. Nonoperative measures, physical therapy, primarily analgesics, and local heat, were employed. The patient returned to his normal routine after 3 weeks. Few cases of isolated spinous process fractures have been described, and, to ou...Continue Reading

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