Dr. Ebraheim’s educational animated video describes Fracture of the Lumbar Transverse Process.
Is it benign? The transverse processes are covered by thick muscles. Fracture of the transverse process is rare. It may occur as an avulsion fracture due to strong contracture of the muscles. The injury may also be due to sudden extreme twisting, side bending or by direct impact to the process itself.
The injury will not cause instability of the spine or spinal cord injury. Transverse process fractures are usually treated with a corset or brace, but not by surgery. Associated injuries may occur to the abdominal viscera, retroperitoneum and the pelvis.
This is a minor injury caused by a major force. There is a frequent association with intra-abdominal injuries. If you can see the fracture on x-ray, look for other injuries.
The fracture may be missed on a routine x-ray. CT scan is better at defining the fracture.
Here is an example of a patient with a benign looking transverse process fracture with an associated significant injury to the back.
An L% transverse process fracture in the presence of a pelvic fracture is a predictor of pelvic fracture instability. Its presence should alert the clinician to this possibility. For example, an L% transverse process fracture may be a sign of an unstable pelvis. It occurs due to an avulsion of the iliolumbar ligament.
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