Multiple Contiguous Thoracic Spinous Process Fractures with Lumbar Transverse Process Fractures: A Rare Case Report

Isolated fractures of the spinous process, commonly referred to as clay-shoveler's fractures, are typically stable avulsion-type injuries most often seen in the lower cervical and upper thoracic spine. While single-level fractures are relatively common, contiguous spinous process fractures remain rare, and their coexistence with lumbar transverse process fractures is exceptional. We report the case of a 46-year-old male who sustained multiple thoracic spinous process fractures (T3–T10) along with unilateral lumbar transverse process fractures (L1–L5) following a high-energy road traffic accident. Computed tomography (CT) imaging confirmed the unique fracture pattern, associated rib fractures, and absence of vertebral body, pedicle, facet, or spinolaminar involvement, thereby indicating stability. The patient was managed conservatively with analgesia, orthosis, and activity modification. At 6 months, he demonstrated complete clinical recovery with no deformity or complications. This case highlights the importance of early CT-based diagnosis to exclude instability and visceral injury, guiding safe nonoperative management.