• Dong-Hun Kang and Sun-Ho Lee.
• Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
• Spine. 2009 Jul 1; 34 (15): E534-7.

Study DesignA case report.ObjectiveThe authors report a unique experience with a 40-year-old male beginning golfer who presented with multiple isolated spinous process fractures of the upper thoracic spine.Summary Of Background DataStress fractures are caused by repetitive loading and overuse, and they account for 10% of all sports-related injuries. Fractures of isolated spinous processes of the cervical and thoracic vertebrae are referred to as Clay-Shoveler's fractures, and there is little clinical information on these injuries.MethodsA 40-year-old man was admitted to our clinic with a 2-week history of posterior neck pain that radiated bilaterally into the shoulder area. Radiograph findings were normal. However, with a suspicion of fracture due to severe tenderness in the upper thoracic area, we performed three-dimensional cervicothoracic spine computed tomography and magnetic resonance imaging, which revealed multiple spinous process fractures at upper thoracic vertebrae.ResultsConservative treatment was administered, and immobilization was maintained for more than 4 weeks. He has been symptom-free for more than 6 months.ConclusionAlthough stress fractures of the spinous process are very rare and can be overlooked in clinical settings, they should be considered in the differential diagnosis of severe dorsal neck pain in golfers, especially beginners.

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