The Injury
CJ McCollum has a confirmed transverse process fracture of the spine which will make the playoffs incredibly tough. In sports, a transverse process fracture is a spine fracture that typically occurs due to a direct impact to the back or a hard pull from the back muscle while making an athletic move (video below). To put it in perspective, Philadelphia Eagles Jay Ajai sustained the fracture two years ago and was out 4 weeks. The key issue here for the athlete is that the abdominal and low back muscles that turn, flex and extend the trunk do so partial by pulling on these bones of the spine. Typical recovery time is approximately 4-6 weeks depending on the extent of the injury. Small fractures can potentially return back within a 2-3 week time frame. It is going to be interesting to see what CJ McCullom can do in fighting through this injury.
Anatomy of the Injury
The vertebrae that make up the spinal column consist of several different parts. The spinous process is the bony portion you can feel along the center of an athlete's back. Almost all of the vertebrae have two transverse processes that point outward from the sides of the vertebrae. The photo above is showing an oblique angle of the back. The transverse process is an attachment point for muscles of the back in order to flex, extend and rotate the spine. Additionally, the transverse process is the attachment site of the posterior aspect of the ribs. One can imagine it is difficult to participate in sports with this type of fracture, due to limited movement.
Oblique View Spine
Evaluation
The athlete usually will report sharp vague pain in the area of the back associated with site of injury. Usually, there will be difficulty with flexing and extending the back as well as there may be difficulty with deep breaths, coughing or sneezing such as in a rib injury. An x-ray is the first step in treatment, but usually the diagnosis is confirmed with a CT scan of the spine which is best at showing bony structures.
CT Scan Transverse Process Fracture
Treatment & Return
Due to the fact that the transverse process does not have any impact on the spinal cord, nerve structures or disc, a fracture of this structure is usually considered a stable fracture. It is also surrounded by significant muscle and soft tissue reducing the likelihood that the fracture will move or shift. Basically, the treatment involves supportive care to allow the fracture to heal on its own. Athletes might use a protective padding or brace to protect against impact while playing. Once the athlete can manage the pain and be appropriately protected they can be returned back to play. Typical recovery time is approximately 4-6 and small fractures can potentially return back within 2-3 weeks, so it is going to be interesting to see what CJ McCollum can do to fight through this one.