{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T15:03:32Z","timestamp":1772895812348,"version":"3.50.1"},"reference-count":46,"publisher":"Japanese Society for Spine Surgery and Related Research","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Spine Surg Relat Res"],"published-print":{"date-parts":[[2025,1,27]]},"DOI":"10.22603\/ssrr.2024-0164","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T22:11:31Z","timestamp":1729289491000},"page":"11-21","source":"Crossref","is-referenced-by-count":1,"title":["Clay Shoveler's Fracture: A Pain in the Neck"],"prefix":"10.22603","volume":"9","author":[{"given":"Marc","family":"Boutros","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Saint Joseph University of Beirut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria R.","family":"Karam","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Saint Joseph University of Beirut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria El","family":"Asmar","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Saint Joseph University of Beirut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle","family":"Wakim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Saint Joseph University of Beirut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Labib","family":"Chebli","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Saint Joseph University of Beirut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre Maurice Doumit Bader","family":"Tarabay","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Saint Joseph University of Beirut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sami","family":"Roukoz","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Saint Joseph University of Beirut"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"9891","reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"1. Jordana X, Galt\u00e9s I, Busquets F, et al. Clay-shoveler&apos;s fracture: an uncommon diagnosis in palaeopathology. Int J Osteoarchaeol. 2006;16 (4):366-72.","DOI":"10.1002\/oa.829"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2. Matthes HG. Unsere Erfahrungen bei der Schipperkrankheit. Arch orthop Unfall-Chir. 1936;37 (1):232-45.","DOI":"10.1007\/BF02629206"},{"key":"3","unstructured":"3. Greenberg MS, Arredondo N. Handbook of neurosurgery. 5th ed. New York: Thieme; 2001. p 1183."},{"key":"4","doi-asserted-by":"crossref","unstructured":"4. Hirsh LF, Duarte LE, Wolfson EH, et al. Isolated symptomatic cervical spinous process fracture requiring surgery. Case report. J Neurosurg. 1991;75 (1):131-3.","DOI":"10.3171\/jns.1991.75.1.0131"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5. Cancelmo JJ. Clay shoveler&apos;s fracture. A helpful diagnostic sign. Am J Roentgenol Radium Ther Nucl Med. 1972;115 (3):540-3.","DOI":"10.2214\/ajr.115.3.540"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6. Posthuma de Boer J, van Wulfften Palthe AFY, Stadhouder A, et al. The clay shoveler&apos;s fracture: a case report and review of the literature. J Emerg Med. 2016;51 (3):292-7.","DOI":"10.1016\/j.jemermed.2016.03.020"},{"key":"7","doi-asserted-by":"crossref","unstructured":"7. Preutu GM. Diagnostic and therapeutic issues in a case of multiple clay shoveller&apos;s fractures with associated thoracic wedge compression fractures. Br J Chiropr. 1999;3 (2):31-5.","DOI":"10.1016\/S1466-2108(99)80025-4"},{"key":"8","doi-asserted-by":"crossref","unstructured":"8. Debuch L. Die Schipperkrankheit und ihre Behandlung. Arch orthop Unfall-Chir. 1936;37 (1):223-31.","DOI":"10.1007\/BF02629205"},{"key":"9","doi-asserted-by":"crossref","unstructured":"9. Jackson T, Blades D. Radiography of the cervical spine in trauma. Atlas Oral Maxillofac Surg Clin North Am. 2002;10 (2):167-87.","DOI":"10.1016\/S1061-3315(02)00010-0"},{"key":"10","doi-asserted-by":"crossref","unstructured":"10. Meyer PG, Hartman JT, Leo JS. Sentinel spinous process fractures. Surg Neurol. 1982;18 (3):174-8.","DOI":"10.1016\/0090-3019(82)90386-X"},{"key":"11","doi-asserted-by":"crossref","unstructured":"11. Kaewlai R, Wongwaisayawan S, Suwannanon R. Imaging of cervicothoracic junction trauma. Rep Med Imaging. 2013;6:11-27.","DOI":"10.2147\/RMI.S28865"},{"key":"12","doi-asserted-by":"crossref","unstructured":"12. Johnson GM, Zhang M, Jones DG. The fine connective tissue architecture of the human ligamentum nuchae. Spine. 2000;25 (1):5-9.","DOI":"10.1097\/00007632-200001010-00003"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13. Johnson G, Bogduk N, Nowitzke A, et al. Anatomy and actions of the trapezius muscle. Clin Biomech. 1994;9 (1):44-50.","DOI":"10.1016\/0268-0033(94)90057-4"},{"key":"14","doi-asserted-by":"crossref","unstructured":"14. Ono A, Tonosaki Y, Yokoyama T, et al. Surgical anatomy of the nuchal muscles in the posterior cervicothoracic junction: significance of the preservation of the C7 spinous process in cervical laminoplasty. Spine. 2008;33 (11):E349-54.","DOI":"10.1097\/BRS.0b013e31817152cc"},{"key":"15","doi-asserted-by":"crossref","unstructured":"15. Ono A, Tonosaki Y, Numasawa T, et al. The relationship between the anatomy of the nuchal ligament and postoperative axial pain after cervical laminoplasty: cadaver and clinical study. Spine. 2012;37 (26):E1607-13.","DOI":"10.1097\/BRS.0b013e318274101b"},{"key":"16","doi-asserted-by":"crossref","unstructured":"16. Sorell R, Wieschhaus K, Simons SM. A nontraumatic clay shoveler&apos;s fracture in a runner. Curr Sports Med Rep. 2021;20 (1):7-9.","DOI":"10.1249\/JSR.0000000000000794"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17. Kang DH, Lee SH. Multiple spinous process fractures of the thoracic vertebrae (clay-shoveler&apos;s fracture) in a beginning golfer: a case report. Spine. 2009;34 (15):E534-537.","DOI":"10.1097\/BRS.0b013e3181a983bb"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18. Nattiv A, Kennedy G, Barrack MT, et al. Correlation of MRI grading of bone stress injuries with clinical risk factors and return to play: a 5-year prospective study in collegiate track and field athletes. Am J Sports Med. 2013;41 (8):1930-41.","DOI":"10.1177\/0363546513490645"},{"key":"19","doi-asserted-by":"crossref","unstructured":"19. Tenforde AS, Parziale AL, Popp KL, et al. Low bone mineral density in male athletes is associated with bone stress injuries at anatomic sites with greater trabecular composition. Am J Sports Med. 2018;46 (1):30-6.","DOI":"10.1177\/0363546517730584"},{"key":"20","doi-asserted-by":"crossref","unstructured":"20. Berritto D, Pinto A, Michelin P, et al. Trauma imaging of the acute cervical spine. Semin Musculoskelet Radiol. 2017;21 (3):184-98.","DOI":"10.1055\/s-0037-1602713"},{"key":"21","doi-asserted-by":"crossref","unstructured":"21. Paulus S, Kennedy DJ. Return to play considerations for cervical spine injuries in athletes. Phys Med Rehabil Clin N Am. 2014;25 (4):723-33.","DOI":"10.1016\/j.pmr.2014.06.005"},{"key":"22","doi-asserted-by":"crossref","unstructured":"22. Olivier EC, Muller E, Janse van Rensburg DC. Clay-shoveler fracture in a paddler: a case report. Clin J Sport Med Off J Can Acad Sport Med. 2016;26 (3):e69-70.","DOI":"10.1097\/JSM.0000000000000243"},{"key":"23","unstructured":"23. Feldman VB, Astri F. An atypical clay shoveler&apos;s fracture: a case report. J Can Chiropr Assoc. 2001;45 (4):213-20."},{"key":"24","doi-asserted-by":"crossref","unstructured":"24. Nuber GW, Schafer MF. Clay shovelers&apos; injuries. A report of two injuries sustained from football. Am J Sports Med. 1987;15 (2):182-3.","DOI":"10.1177\/036354658701500217"},{"key":"25","doi-asserted-by":"crossref","unstructured":"25. Upadhyaya GK, Shukla A, Jain VK, et al. Contiguous multiple cervicothoracic spinous process fractures in an adult: A case report. J Clin Orthop Trauma. 2016;7 (1):45-9.","DOI":"10.1016\/j.jcot.2015.04.010"},{"key":"26","doi-asserted-by":"crossref","unstructured":"26. Yunoki M, Suzuki K, Uneda A, et al. Analysis of associated spinal fractures in cases of traumatic intracranial hemorrhage or skull fracture. Malays Orthop J. 2016;10 (1):11-5.","DOI":"10.5704\/MOJ.1603.003"},{"key":"27","doi-asserted-by":"crossref","unstructured":"27. Hetsroni I, Mann G, Dolev E, et al. Clay shoveler&apos;s fracture in a volleyball player. Phys Sportsmed. 2005;33 (7):38-42.","DOI":"10.3810\/psm.2005.07.144"},{"key":"28","doi-asserted-by":"crossref","unstructured":"28. Herrick RT. Clay-shoveler&apos;s fracture in power-lifting. A case report. Am J Sports Med. 1981;9 (1):29-30.","DOI":"10.1177\/036354658100900106"},{"key":"29","doi-asserted-by":"crossref","unstructured":"29. Gershon-Cohen J, Glauser F. Whiplash fractures of cervicodorsal spinous processes: resemblance to shoveler&apos;s fracture. JAMA. 1954;155 (6):560-1.","DOI":"10.1001\/jama.1954.03690240026007"},{"key":"30","doi-asserted-by":"crossref","unstructured":"30. Mercer SR, Bogduk N. Clinical anatomy of ligamentum nuchae. Clin Anat. 2003;16 (6):484-93.","DOI":"10.1002\/ca.10121"},{"key":"31","doi-asserted-by":"crossref","unstructured":"32. Venable JR, Flake RE, Kilian DJ. Stress fracture of the spinous process. JAMA. 1964;190:881-5.","DOI":"10.1001\/jama.1964.03070230017004"},{"key":"32","doi-asserted-by":"crossref","unstructured":"31. Weston WJ. Clay shoveller&apos;s disease in adolescents (Schmitt&apos;s disease); a report of two cases. Br J Radiol. 1957;30 (355):378-80.","DOI":"10.1259\/0007-1285-30-355-378"},{"key":"33","doi-asserted-by":"crossref","unstructured":"33. McAllister AS, Nagaraj U, Radhakrishnan R. Emergent imaging of pediatric cervical spine trauma. Radiographics. 2019;39 (4):1126-42.","DOI":"10.1148\/rg.2019180100"},{"key":"34","doi-asserted-by":"crossref","unstructured":"34. Fayyazi AH, Segal L. Surgical excision of symptomatic lumbar spinous process pseudoarthrosis. J Spinal Disord Tech. 2004;17 (5):439-41.","DOI":"10.1097\/01.bsd.0000112081.04960.2e"},{"key":"35","doi-asserted-by":"crossref","unstructured":"35. Han SR, Sohn MJ. Twelve contiguous spinous process fracture of cervico-thoracic spine. Korean J Spine. 2014;11 (3):212-3.","DOI":"10.14245\/kjs.2014.11.3.212"},{"key":"36","doi-asserted-by":"crossref","unstructured":"36. Matar LD, Helms CA, Richardson WJ. &quot;Spinolaminar breach&quot;: an important sign in cervical spinous process fractures. Skeletal Radiol. 2000;29 (2):75-80.","DOI":"10.1007\/s002560050013"},{"key":"37","doi-asserted-by":"crossref","unstructured":"37. Unay K, Karatoprak O, Sener N, et al. A clay-shoveler&apos;s fracture with renal transplantation and osteoporosis: a case report. J Med Case Rep. 2008;2:187.","DOI":"10.1186\/1752-1947-2-187"},{"key":"38","doi-asserted-by":"crossref","unstructured":"38. Kaloostian PE, Kim JE, Calabresi PA, et al. Clay-shoveler&apos;s fracture during indoor rock climbing. Orthopedics. 2013;36 (3):e381-3.","DOI":"10.3928\/01477447-20130222-31"},{"key":"39","doi-asserted-by":"crossref","unstructured":"39. Baker BK, Sundaram M, Awwad EE. Case report 688. Fractures of the spinous processes of multiple thoracic vertebrae. Skeletal Radiol. 1991;20 (6):463-4.","DOI":"10.1007\/BF00191093"},{"key":"40","doi-asserted-by":"crossref","unstructured":"40. Kim SY, Chung SK, Kim DY. Multiple cervical spinous process fractures in a novice golf player. J Korean Neurosurg Soc. 2012;52 (6):570-3.","DOI":"10.3340\/jkns.2012.52.6.570"},{"key":"41","doi-asserted-by":"crossref","unstructured":"41. Watson DJ, Dolbeer JA. C6 spinous process fracture in a young adult. J Orthop Sports Phys Ther. 2017;47 (9):692.","DOI":"10.2519\/jospt.2017.7357"},{"key":"42","unstructured":"42. Kose KC. Case report: the impact of pseudoarthrosis on clinical outcome in isolated spinous process fractures of six adjacent level thoracic vertebrae. MedGenMed. 2006;8 (1):67."},{"key":"43","doi-asserted-by":"crossref","unstructured":"43. Zanca P, Lodmell EA. Fracture of the spinous processes; a new sign for the recognition of fractures of cervical and upper dorsal spinous processes. Radiology. 1951;56 (3):427-9.","DOI":"10.1148\/56.3.427"},{"key":"44","unstructured":"44. Murphy RF, Hedequist D. Excision of symptomatic spinous process non-union in adolescent athletes. Am J Orthop Belle Mead NJ. 2015;44 (11):515-7."},{"key":"45","unstructured":"45. Harris JH, Harris WH. The radiology of emergency medicine. 5th ed. Baltimore; Williams &amp; Wilkins; 2013. p. 692-3."},{"key":"46","unstructured":"46. Wu R, Min JK, Huang SF, et al. The effects of cervical spinous process fracture with posterior ligamentous complex injury on stability of the goat cervical spine. J Med Biomech. 2017;E422-6."}],"container-title":["Spine Surgery and Related Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/ssrr\/9\/1\/9_2024-0164\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T04:30:21Z","timestamp":1738384221000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/ssrr\/9\/1\/9_2024-0164\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,27]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.22603\/ssrr.2024-0164","relation":{},"ISSN":["2432-261X"],"issn-type":[{"value":"2432-261X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,27]]},"article-number":"2024-0164"}}