Clinical and radiological cervical spine evaluation in retired professional rugby players

Abstract

<jats:sec> <jats:title>OBJECT</jats:title> <jats:p>Acute cervical spine injuries have been extensively studied in high-level contact sports. However, the relation between the appearance of degenerative cervical spine disease and the exposure to repeated trauma in such sports as rugby is still unclear. Using clinical and MRI evaluation, we aimed to determine if former professional rugby players had more serious degenerative cervical spine symptoms than the general population.</jats:p></jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>Two groups, one composed of 101 former rugby players (all men, mean age 40.3 years, range 35–47 years, SD 2.3 years) and the other of 85 male volunteers serving as a control group (mean age 41.6 years, range 35–49 years, SD 4.5 years) were studied. The former rugby players were evaluated on average 5.8 years after retirement (range 1–16 years, SD 3.5 years). The groups were matched in terms of sex, age, job, current sports training, and smoking habits. Each participant received a complete neurological evaluation. Clinical symptoms were evaluated using the Japanese Orthopaedic Association (JOA) questionnaire, and chronic neck pain was specifically evaluated using a visual analog scale (VAS) and the Neck Disability Index (NDI). Overall, 25 MRI studies were performed in each group. MRI studies, including dynamic sequences, focused on degenerative lesions (Matsumoto score and canal diameter) and on muscular and medullary morphological analysis.</jats:p></jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Significantly more former rugby players than controls complained of chronic neck pain (51 [50.50%] of 101 vs 27 [31.76%] of 85, p = 0.01). Rugby players also had significant reductions of neck mobility. Nevertheless, in those complaining of pain, there was no statistically significant difference between groups with respect to VAS and NDI scores (p = 0.57). On MRI, former rugby players had a narrower vertebral canal (on average 0.88 ± 0.167 cm vs 0.99 ± 0.130 cm, p = 0.007) and more foraminal stenosis (p = 0.01). No significant difference in the Matsumoto score was found between the 2 groups with respect to other degenerative lesions. Former rugby players had more often undergone surgery for a degenerative condition than had members of the control group (10 cases vs 0 in the control group, p = 0.0021).</jats:p></jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>A few years after retirement, former professional rugby players seem to have more frequent cervical spine pain and MRI degenerative lesions, such as foraminal stenosis and narrowing of the spinal canal, compared with controls who had not been professional rugby players. A longer evaluation is necessary to determine if these findings persist over time.</jats:p></jats:sec>

The Prevalence of Asymptomatic and Symptomatic Spinal Cord Compression on Magnetic Resonance Imaging: A Systematic Review and Meta-analysis

“…A high risk of bias resulted in 12 articles being excluded from further analysis. [33][34][35][36][37][38][39][40][41][42][43][44][45] Consequently, 19 articles from 10 countries were included in the present analysis [1][2][3]5,20,[46][47][48][49][50][51][52][53][54][55][56][57][58][59] (Table 1).…”

Self-reported sports injuries and later-life health status in 3357 retired Olympians from 131 countries: a cross-sectional survey among those competing in the games between London 1948 and PyeongChang 2018

“…Significant joint injury is a risk factor for the development of OA, and evidence in retired athletes from football, [57][58][59] Rugby Union 60 and most recently Olympic sports 25 speaks to an association between joint injury and ongoing pain, and the development and progression of OA. It is important, however, to understand if the rate of OA differs between Olympians and the general population.…”

Prevalence of and factors associated with osteoarthritis and pain in retired Olympians compared with the general population: part 1 – the lower limb

“…In order to truly understand the magnitude of the problem it is important to understand if and how Olympians differ compared with the general population 12. To date, few retired-athlete studies have included these comparisons, and where comparisons to a general population control are made, they are limited to a single sex, specific sport or geographical region 5 7–10…”