{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:52Z","timestamp":1787755612797,"version":"build-2784847793"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 71-year-old man with a history of C5-7 anterior cervical discectomy and fusion (ACDF) sustained a C7 spinous process fracture after falling from a ladder. He was initially managed nonoperatively but developed anterolisthesis and kyphosis at C7-T1 with left hand weakness over the course of 11 days. Surgical treatment included spinous process wiring and C5-T3 posterior fusion. At 14-month follow-up, he demonstrated resolution of pain and returned motor function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The patient's ACDF likely created a longer lever arm, allowing the force of his fall to be concentrated at C7-T1. Patients with a suspected Clay-Shoveler's fracture require close follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.24.00149","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T14:05:17Z","timestamp":1727964317000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["When Is a Clay-Shoveler's Fracture, Not a Clay-Shoveler's Fracture?"],"prefix":"10.2106","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4111-7590","authenticated-orcid":false,"given":"Matthew J.","family":"Schultz","sequence":"first","affiliation":[{"name":"Jefferson Health New Jersey, Stratford, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Oregon Health & Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loren O.","family":"Black","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Oregon Health & Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9240-7614","authenticated-orcid":false,"given":"Aidan T.","family":"Morrell","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Oregon Health & Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7800-5907","authenticated-orcid":false,"given":"Travis C.","family":"Philipp","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Oregon Health & Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,10]]},"reference":[{"issue":"1","key":"bib1-20241003","first-page":"63","article-title":"Clay-Shoveler's fracture","volume":"22","author":"Hall","year":"1940","journal-title":"JBJS."},{"key":"bib2-20241003","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1001\/jama.1964.03070230017004","article-title":"Stress fracture of the spinous process","volume":"190","author":"Venable","year":"1964","journal-title":"JAMA."},{"issue":"3","key":"bib3-20241003","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.jemermed.2016.03.020","article-title":"The clay Shoveler's fracture: a case report and review of the literature","volume":"51","author":"Posthuma de Boer","year":"2016","journal-title":"J Emerg Med."},{"issue":"1","key":"bib4-20241003","first-page":"67","article-title":"Case report: the impact of pseudoarthrosis on clinical outcome in isolated spinous process fractures of six adjacent level thoracic vertebrae","volume":"8","author":"Kose","year":"2006","journal-title":"MedGenMed."},{"issue":"2","key":"bib5-20241003","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s002560050013","article-title":"Spinolaminar breach: an important sign in cervical spinous process fractures","volume":"29","author":"Matar","year":"2000","journal-title":"Skeletal Radiol."},{"issue":"1","key":"bib6-20241003","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.jcot.2015.04.010","article-title":"Contiguous multiple cervicothoracic spinous process fractures in an adult: a case report","volume":"7","author":"Upadhyaya","year":"2016","journal-title":"J Clin Orthop Trauma."},{"issue":"3","key":"bib7-20241003","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.wem.2015.03.003","article-title":"A Pain in the Neck. 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