From the Research
Management of a C6 spinous process fracture typically involves conservative treatment with a cervical collar for 6-8 weeks, pain management with NSAIDs, and muscle relaxants for associated muscle spasm. These isolated spinous process fractures, often called "clay shoveler's fractures," are usually stable injuries that don't require surgical intervention unless there are neurological deficits or associated instability 1. The patient should maintain relative rest initially, followed by gradual return to activities as pain allows.
Key Considerations
- Pain management with NSAIDs like ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) is recommended 1.
- Muscle relaxants such as cyclobenzaprine (5-10mg three times daily) can be used for associated muscle spasm.
- Physical therapy focusing on gentle range of motion exercises and strengthening can begin after 2-3 weeks if pain permits.
- Follow-up imaging at 6-8 weeks is recommended to confirm healing.
Important Notes
- These fractures typically have excellent outcomes because the spinous process is primarily an attachment site for muscles and ligaments rather than a weight-bearing structure, and the fracture doesn't typically compromise spinal stability or neurological function 1.
- Any signs of neurological deterioration, severe pain, or inability to maintain neck position warrant immediate medical attention as they may indicate a more complex injury.
- The most recent and highest quality study, 1, supports the use of conservative treatment for C6 spinous process fractures, and this approach should be prioritized in management decisions.