Transverse process fractures

Rita,

Sorry about your accident.

When the physician said that you had fluid around the facets, he/she was stating that you have some extra synovial fluid inside the facet joints of your spine. The facet joints are located in the posterior elements. They are the posterior articulations between the superior and inferior vertebra. They are involved in the flexion and extension motions, i.e. bending forward and backwards. That is why he/she gave you antiinflammatory medication, to reduce the inflammation in those joints.

Since the transverse processes are surrounded by muscles, they usually heal readily. One problem with the MRI, is that sometimes it cannot tell the difference between an older healed fracture (a scar essentially) and a fracture that has not healed. A CT scan, which is better for looking at bone, would actually be able to tell if there was bridging bone across the fractures.

After a year and a half, if the fractures are not healed by now, they most likely will not heal on their own. Usually by this time, the fractures will be filled with fibrous tissue. Sometimes, a fibrous union is fine, and causes no problems. But, if a fibrous union is present, and it is causing pain, then it probably needs to be addressed.

The problem is trying to find a surgeon to do something about them. As most surgeons will feel that they never cause any problems. But, they obviously do. Another problem is trying to figure out how to treat them.

They can be resected, meaning just to take out the piece of bone that did not heal back together. The muscles are then sutured to each other. A theoretical way to treat them, would be like any other fibrous union in a bone. Which would be do remove the fibrous tissue, then using a screw, fix the two pieces back together. This is a much bigger operation.


As to the clicking or rubbing you are feeling, yes it could be coming from the transverse processes. But the lumbar vertebra can also shift during valsalva maneuvers (such as straining to go to the bathroom). So, it might be necessary to do a fluoscopic x-ray (real time) to actually see the bones move.


You may have to search for a surgeon to take care of you. An orthopedic spine surgeon may be more comfortable taking care of the bones.

Hope you find someone to take care of your problem. Good luck.