Multiple episodes of golf-related isolated spinous process fractures (clay-shoveler's fracture) and its ten-year follow-up

We present a case of a 28-year-old beginner golfer who sustained multiple episodes of isolated spinous process fractures of the lower cervical and upper thoracic vertebrae (clay-shoveler's fracture) and its ten-year follow-up. The patient is complaining of intermittent mild dull pain and discomfort in the posterior aspect of the cervicothoracic junction even after 10 years from initial injury. Radiologic evaluation revealed non-union of avulsed fragments and the patient's symptoms are possibly associated with non-union. Nevertheless, he recovered to full activity with no limitations in activities of daily living. In case of non-union of previous fractures, it seems to affect biomechanical stability of surrounding muscles and ligaments of the spinous processes and increase stress in motion on spinous processes of adjacent vertebrae during vigorous activity. It is associated with additional fractures of adjacent vertebrae.