title: Implications of Isolated Transverse Process Fractures: Is Spine Service Consultation Necessary?
abstract: BACKGROUND
  Acute traumatic isolated transverse process fractures (ITPFs) are increasingly identified in trauma patients owing to the increased use of routine computed tomography imaging. Despite repeated demonstrations that these fractures are treated only symptomatically, patterns of consultation with a spine service have not changed. We aim to provide information on long-term outcomes following conservative treatment to help clarify the role of the spine service in the treatment of ITPFs.
  
  
  METHODS
  A retrospective chart review of 306 patients presenting with ITPFs was conducted to identify both short-term and long-term patient outcomes. A subsection of patients was identified with no other traumatic injuries besides isolated ITPFs (iITPFs).
  
  
  RESULTS
  No patient required surgical intervention for an ITPF, and 97.7% of all patients and 100% of the patients with iITPFs did not require bracing. At last follow-up, all patients were neurologically intact, 97.8% were fully ambulatory, and 87.9% had no ITPF-related back pain. When only patients with 6 or more months of follow-up were considered, all patients were fully ambulatory, and only 1.1% of all patients and none of the patients with iITPFs had persistent back pain.
  
  
  CONCLUSIONS
  ITPFs can be treated conservatively without concern for long-term outcome sequelae such as pain, neurologic deficits, or ambulatory difficulties. Consequently, a spine service consult is not required for patients with ITPFs.
authors.affiliation: Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Jason H
authors.initials: JH
authors.lastname: Boulter
authors.affiliation: Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Brendan P
authors.initials: BP
authors.lastname: Lovasik
authors.affiliation: Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Griffin R
authors.initials: GR
authors.lastname: Baum
authors.affiliation: Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Frerich
authors.affiliation: Neuroradiology Division, Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia, USA.
authors.forename: Jason W
authors.initials: JW
authors.lastname: Allen
authors.affiliation: Department of Neurological Surgery, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Grossberg
authors.affiliation: Department of Neurological Surgery, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Pradilla
authors.affiliation: Department of Neurological Surgery, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA. Electronic address: faiz.ahmad@emory.edu.
authors.forename: Faiz U
authors.initials: FU
authors.lastname: Ahmad
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000592:standards / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000592:standards / Q000639:trends*; D012017:Referral and Consultation / Q000592:standards / Q000639:trends*; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000175:diagnosis* / Q000628:therapy*
keywords: Outcomes; Quality improvement; Spinal fracture; Spine trauma; Transverse process