title: Case report: the impact of pseudoarthrosis on clinical outcome in isolated spinous process fractures of six adjacent level thoracic vertebrae.
abstract: METHODS
  Case report.
  
  
  OBJECTIVE
  To report a peculiar case of spinous process fractures of 6 adjacent thoracic vertebrae along with its evaluation, management, and follow-up.
  
  
  BACKGROUND
  Isolated fractures of adjacent level spinous processes are extremely rare and are often treated conventionally. There is insufficient data about pseudoarthrosis of the spinous processes and its functional impact on the patient.
  
  
  METHODS
  Computed tomographic (CT) scanning was used for diagnosis and follow-up. Conservative treatment with 3 months brace application was the treatment protocol chosen for this patient.
  
  
  RESULTS
  Pseudoarthrosis at all levels was detected at follow-up; however, there was significant reduction in pain and improved function.
  
  
  CONCLUSIONS
  Isolated thoracic spinous process fractures are extremely rare. Because 3 months application of a brace did not prevent pseudoarthrosis in this instance, and because this nonunion was found to be clinically insignificant, we recommend that the use of a brace be limited to the control of pain in the acute setting.
authors.affiliation: Faculty of Medicine, Department of Orthopedics and Traumatology, Afyon Kocatepe University, Afyon, Turkey.
authors.forename: Kamil Cagri
authors.initials: KC
authors.lastname: Kose
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D011542:Pseudarthrosis / Q000628:therapy*; D016103:Spinal Fractures / Q000628:therapy*; D013904:Thoracic Vertebrae / Q000293:injuries*