Thoracic spinous process nonunion as an unusual cause of back pain: a case report and review of the literature

• Published in: Journal of medical case reports Vol. 18; no. 1; p. 11
• Main Authors: Dietrich, Gilles, Richard, Raphaël, Akiki, Alain, Levy, Sebastien, Maeder, Benoit
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 03-01-2024; BioMed Central; BMC
• Subjects: Adult; Back pain; Back Pain - etiology; Backache; Case Report; Case reports; CT imaging; Fractures; Humans; Injuries; Literature reviews; Magnetic Resonance Imaging; Male; Neurological disorders; Nonunion; Pain management; Patients; Physical therapy; Pseudoarthrosis; Range of motion; Resection; SPECT imaging; Spinal Fractures - complications; Spinal Fractures - diagnostic imaging; Spinal Fractures - surgery; Spinous process; Steroids; Surgery; Surgical techniques; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - injuries; Thoracic Vertebrae - surgery; Tomography; Pseudoarthrosis; Case report; Nonunion; Resection; Spinous process
• ISSN: 1752-1947; 1752-1947
• DOI: 10.1186/s13256-023-04109-3

Purely isolated spinous processes fractures are rare and are usually treated conservatively, although a few authors have reported cases of nonunion that ultimately required surgical resection.
We present a case of an isolated T6 spinous process pseudoarthrosis that was treated by surgical resection of the tip of the spinous process. A 34-year-old Caucasian male patient was complaining of mid-thoracic back pain without neurologic impairment more than 2 years after an isolated spinous process fracture. Magnetic Resonance Imaging (MRI) and Single Photon Emission Computed Tomography (SPECT) revealed a nonunion. We performed a resection without further complication.
Although spinous process nonunions may in some cases be well tolerated, surgical resection appears to be a reliable option in case of persistent symptoms. This illustrated case shows the description of an isolated thoracic spinous process nonunion and its surgical treatment.