Catastrophic Cervical Spine Injuries in the Collision Sport Athlete, Part 1

Abstract

Catastrophic cervical spine injuries can lead to devastating consequences for the collision athlete. Improved understanding of these injuries can facilitate early diagnosis and effective on-field management. This article is the first of a 2-part series. The first part reviews the current concepts regarding the epidemiology, functional anatomy, and diagnostic considerations relevant to cervical spine trauma in collision sports. In the second part, to be published later, the principles of emergency care of the cervical spine-injured athlete are reviewed. This article provides a rational approach to the early recognition of the different clinical syndromes associated with catastrophic cervical spine injury. Rapid on-field diagnosis can help to optimize the outcomes of these catastrophic injuries.

Tackling in Youth Football

“…Indeed, the 1976 banning of spear tackling has been widely credited with reducing the numbers of cervical spinal injuries resulting in quadriplegia. [70][71][72][73]77,87,88 Unfortunately, spear tackling has persisted even since the 1976 rule change, and cervical spine injuries continue to occur. 73,88,89 Modification and consistent enforcement of the rules may lead to a further decrease in the risk of injury, including catastrophic injuries.…”

Penetrating chest trauma secondary to a composite hockey stick injury

“…Although facial lacerations and contusions have been reduced through the use of helmet and facemask protection, spinal injuries have increased to 15 cases per year in Canada, and concussions to approximately 18.6% of all injuries. 1,3,5,6 In addi- Penetrating hockey stick injury tion, the number of traumatic brain injuries has increased. 3,5 An estimated 17 000 head injuries and approximately 4800 concussions occurred in the US from 1993-1999 as a result of ice hockey.…”

“…3 The annual incidence of spinal cord injury with paralysis as a result of an injury acquired while playing hockey in Canada is 3 times greater than that reported for American football. 5 The majority of injuries are secondary to blunt trauma and are minor in nature; however, accounts of significant morbidity and mortality have been published. 5,6 Although not commonly reported, hockey sticks can cause significant harm and may account for up to 14% of hockey-related injuries.…”

“…5 The majority of injuries are secondary to blunt trauma and are minor in nature; however, accounts of significant morbidity and mortality have been published. 5,6 Although not commonly reported, hockey sticks can cause significant harm and may account for up to 14% of hockey-related injuries. 1,7,8 We report a case of penetrating chest trauma requiring surgical intervention after a player's broken composite hockey stick impaled a teammate's thoracic cavity.…”

Evaluating the Risks and Benefits of Participation in High-School Football

“…Therefore, Jesse's mom is right to view this as a risk. Participation in American football also carries the risk of injuries besides concussions and chronic traumatic encephalopathy, including catastrophic injuries-those that result in death or permanent neurologic damage-the rates of which are higher in American football than most other team sports [28][29][30][31][32][33][34][35][36][37][38].…”