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riding with C7 fracture?

stefan43's picture

By stefan43 - Posted on 10 December 2013

hi guys,
had a follow up call from the hospital today and it appears they've missed a little detail on the weekend..
it's called an 'undisplaced fracture of the C7 spinous process' ?
in my case they said everything was sitting exactly where it's supposed to be and i don't even have to wear a neck brace and should do gentle neck exercises and to just keep things easy until i feel better.

the question is.. at what point would one consider an easy ride on a fire trail a 'gentle neck exercise".

just wondering if anyone's been through this before and how long you've been off the bike.


hawkeye's picture

But I'd be staying off the bike for at least the next four weeks, probably six to 8.

Think of the price of failure, man. A little off that would otherwise be laughed off has the potential to put you in a wheelchair.

On the upside, you can start spin classes in a couple of weeks and rip our legs off next time we do a group ride Evil

I'd go see your GP and get a referral to see a specialist for more accurate advice

stefan43's picture

unfortunately i think your spot on - on both counts.
i really didn't see it that way when i wrote the post (in my defence i'm still on painkillers)
and here i was, already considering myself the luckiest bastard alive after walking away from saturdays crash.
well, i suppose i'm still the second luckiest bastard alive. it could have been so much worse.
i suppose this also puts an end to my ski, snowboard plans for my christmas trip to germany.

anyway, i would still like to hear your story if anyone has been through this. any tips, warnings etc...

Slowpup's picture

Bad news about the C7 Stefan.

Get a referral and go see a proper specialist. Please.

Tell them that you are a keen MTB'er and want to get back on the bike ASAP then follow their advice.

I've escaped fractures so far but have had several neck and spine injuries. 12-14 months ago I took 12 weeks off the bike for a pair of ruptured discs C2/C3. I hear fractures heal faster but if I were you I'd get some proper advice and management before making any risk judgements.

Hope you heal quickly.

hawkeye's picture

I haven't been through a spinal fracture but a collarbone break at the start of a weekend away with Little Ditty gave me recent experience of fractures.

Like yours, mine was undisplaced and required no intervention.

However I was severely warned off doing anything that would load it prior to 8 weeks. At 6 weeks it was joined but weak. .. "sticky" was the word used, kinda like the glue had started to set but was in no way near fully cured.

At week 6 I started doing sessions on the hydraulic trainer and limited core work, but could only sustain short sessions before it got real sore. At By 8-9 weeks I was allowed out on the road with strict instructions not to fall off under any circumstances.

Finally, week 12 I was allowed on the trails again. The trainer and core work helped that go smoothly as far as technique and control were concerned but fitness needed work and I'd gained a few kgs.

Andy Bloot's picture

I would be seeing a sports physio with my xrays
This way you're not left guessing and will optimise recovery
Sports physios understand the need to recover quickly but safely
This is not so important to the average punter whos main concern is avoiding pain
The spine is something you don't want to leave to chance

You are already coming to terms with the time off your bike
And the ski holiday - god that sucks
But as you say, could have been so much worse

The physio may say it is not so bad
And you can do some easy runs down the hill
But until then, it is all speculation

stefan43's picture

really helpful and much appreciated.
got an MRI done today and will take that (together with the X-rays) to the specialist tomorrow.
physio is next on the list...

stefan43's picture back. just got news that the MRI shows no fracture !!!! so the X-ray guy at the hospital got it wrong. how good is this! (i'm too happy to be annoyed with them). it's been confirmed by 2 specialists.
this changes things dramatically. will still need physio though for other issues, but this is much much better.
anyway, thanks for your comments and might see you on the trails sooner than expected. (not on the jumps though)

hawkeye's picture

But how did the radiographer get it so wrong?

stefan43's picture

...but the guys on the weekend had it right. it was the guy who came in monday and went through the X-rays again who got it wrong. they do the monday check because they're not operating on full staff on the weekend. and apparently it is quite easy to 'see (as in misread) a fracture on a spinous process in a posterior view'... something along those lines...
i can live with that Smiling

andyfev's picture

Great to hear you're ok.

In answer to Hawkeye's question I can shed light on this. Firstly, the terminology is a little out of shape. The Radiographer performs the imaging and has no formal image interpretation training to provide a legal diagnosis. The images are interpreted by a Radiologist whom provides a diagnostic report.

Many factors influence the report. Here's a few:

The anatomical quality of the images performed
The number of image artefacts overlaying the anatomy resulting in misrepresentation of what could be considered fracture lines
C7 sits between the shoulders requiring good imaging technique to penetrate through the shoulders and visualise the vertebrae
Spinous processes are external to the vertebral foramina and project to the skin edge (what you feel when you feel the back of your neck)
If the image is taken with the patient supine such as laid on a trolley with a neck brace then the tips of the spinous process can be missed
T1 should also be clearly shown to demonstrate spinal alignment
The number of images acquired. Radiographs are 2 dimensional so perpendicular views are required to appreciate the anatomy concisely and clearly
Movement artefact of the anatomical region
All of these difficulties, ad many more, often result in suboptimal imaging in the trauma cervical spine. If a Radiologist is presented with poor imaging technique, not saying this is the case here, they will often be more cautious in their diagnosis.

Misdiagnosis is also a factor of life, though Radiologist sensitivity and specificity rates are around the 98% mark.

In this case, an MRI was performed and cleared the fracture. A great outcome. MRI is completely safe and excellent for trauma cervical spine.

stefan43's picture

that has just about answered all my remaining questions. and regarding this:
'if the image is taken with the patient supine such as laid on a trolley with a neck brace' ... that's exactly how it was done.
you seem to know what you're talking about.

pancakes's picture

As a specialist told a close family member recently, after a diagnosis that was proven incorrect after exploratory surgery.

"You're a vomit. A victim of modern imaging technology."

We were pretty happy they got it wrong as the alternative was not good. Buy a lotto ticket (and that new helmet).

andyfev's picture

No worries Stefan, I'm a Radiographer though spend most of my life in meetings now (as all good clinical staff end up doing Eye-wink)

X-rays of the cervical spine have, if anything, become a victim of the modern radiographer rather than modern imaging equipment. New technologies provide excuisite detail at half the radiation dose seen just 10 years ago. The difference nowadays is the role of CT in trauma imaging has largely obliterated the skills of the trauma radiographer. Skull and facial bones are another classic example. The exception is if you're in a major trauma hospital where good old fashioned technique alongside sophisticated and dose reducing imaging technologies provide excellent diagnostic imaging.

Pancakes, glad you're family member was also cleared though at the trauma of exploratory surgery.

Edit: if a Radiologist questions a diagnosis there's a 99% chance their right to question it. In your case you were the 1%!

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