Spinal cord concussion in rugby players

Scher, A T

doi:10.1177/036354659101900511

Cited by 31 publications

(14 citation statements)

References 8 publications

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“…The significant difference in neck circumference between backs and forwards (Table I) might be considered a contributory factor to the differences in ACROM, although Pearl and Mayer (1979) reported that neck girth made no difference in neck movement in young American Football players. The factors underlying this difference between forwards and backs have yet to be elucidated, although it is likely to result from greater muscular resistance and/or cumulative musculoskeletal deterioration that has been identified in radiographic studies (O'Brien, 1996;Scher, 1990Scher, , 1991Torg & Pavlov, 1987).…”

Section: Discussionmentioning

confidence: 99%

The effects of a rugby playing season on cervical range of motion

Lark

McCarthy

2010

Journal of Sports Sciences

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Rugby players have a reduced active cervical range of motion (ACROM) mid-season compared with age-matched controls. This is most evident in rugby forwards, who have ACROM similar to patients with acute whiplash. This study aims to show if the change in ACROM over an entire rugby season (pre-, mid-, and end of season) shows a pattern of decline. A cross-sectional study of 22 rugby players (11 backs aged 24.9 +/- 1.3 years; 11 forwards aged 24.5 +/- 1.1 years) from elite English Premiership clubs had their cervical range of motion measured for flexion, extension, left and right side flexion, plus left and right rotation with a cervical range of motion device. The percentage change between start to mid-season, mid- to end of season, and start to end of season were calculated. Group means were compared for absolute ACROM (degrees) and percentage change over the season. The percentage change indicated a decrease in ACROM over the rugby playing season, with most of the decrement occurring in the second half of the season. Most of the relative change was observed in right lateral flexion, while rotation did not change significantly. In conclusion, ACROM declines throughout the playing season, which requires attention in terms of training and rehabilitation.

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Section: Discussionmentioning

confidence: 99%

The effects of a rugby playing season on cervical range of motion

Lark

McCarthy

2010

Journal of Sports Sciences

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“…Transient contact may be induced by primary or secondary spinal canal stenosis, relaxation of the ligament of the spinal column, 8 and/or hyperextensive motion that causes the posterior longitudinal ligament and the ligamentum flavum to thicken, the dural diameter to decrease in size and the diameter of the spinal cord to increase in size. 4 There was also a report suggesting that compression of the spinal cord during hyperextension by infolding of the laminar ligaments resulted in narrowing of the spinal canal. 7 Groat et al 19 emphasized the possibility of a functional block of neural activity.…”

Section: Discussionmentioning

confidence: 99%

“…Because of its rare incidence, there have been few reports concerning spinal cord concussion in English literatures and no reports in Japanese. [1][2][3][4][5][6] Previous reports of spinal cord concussion conclude that sports and falls were the leading cause of the injury, and that the most common site affected was the cervical or thoracolumbar junction among young subjects. There was controversy whether pre-existing abnormalities of the spine, such as spinal canal stenosis, can be a risk factor for the occurrence of spinal cord concussion.…”

Section: Introductionmentioning

confidence: 99%

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Importance of checking prehospital neurological findings to reveal incidence of spinal cord concussion

Yanagawa

Miyawaki

2012

Spinal Cord

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Objective: To clarify the incidence and characteristics of spinal cord concussion in an urban city in Japan. Methods: The current retrospective study was conducted by reviewing the medical records of patients with spinal cord injuries admitted between January 2007 and December 2010. The subjects were divided into two groups: a spinal cord concussion group and a spinal cord injury group. Results: There were 36 patients with spinal cord injuries admitted during this period. Among them, there were 8 patients with spinal cord concussions. No significant differences were apparent between the two groups with regard to sex, mechanism of injury, Glasgow Coma Scale, incidence of shock, inhospital Frankel classification, level of spinal cord injury, frequency of vertebral dislocation/fracture, surgery and the survival rate. However, the mean age in the spinal cord concussion group was lower than that in the spinal cord injury group. The systolic blood pressure, the heart rate and the diameter of minimum spinal canal in the concussion group were all higher than those in the spinal cord injury group. Half of the subjects in the spinal cord concussion group demonstrated immediate neurological improvement between prehospital and inhospital findings, however none of the subjects in the spinal cord injury group demonstrated such improvement. This difference was statistically significant. Conclusion: Spinal cord concussion is not rare in urban Japan. Checking neurological findings at the scene leads to the revelation of the true high incidence of spinal cord concussion among spinal cord injuries.

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“…[1][2][3][4][5][6][7][8] The most frequently injured vertebrae are C4 to C6. 1 7 Approximately half of all cervical spine injuries in rugby result in tetraplegia.…”

Section: Discussionmentioning

confidence: 99%

Paraplegia secondary to fracture-subluxation of the thoracic spine sustained playing rugby union football: Figure 1

Walsh

Shine²,

McManus³

2004

Br J Sports Med

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Fractures of the spinal column during rugby matches of all codes are rare but catastrophic, especially when associated with spinal cord injury. The cervical spine is vulnerable during trauma to the head and neck in contact sports. Spinal injuries reported during rugby matches have almost exclusively involved the cervical region, often with neurological sequelae. This is the first reported case of paraplegia caused by a fracture-dislocation of the thoracic spine resulting from a low velocity rugby union injury. CASE REPORTA 35 year old accountant, playing at wing forward, was admitted to our spinal injuries unit after an injury during a junior level rugby match. He had sustained a forced hyperflexion injury to his spine. The player was in a seated position, when a maul, in which he had just been involved, collapsed over him. He complained of instant severe thoracolumbar back pain associated with an immediate loss of all power and sensation from his lower abdomen distally.On examination in the emergency room, he had tenderness over his lower thoracic spine with palpable malalignment of the posterior elements at this level. A complete neurological injury with a sensory level at T12 was diagnosed. He had no associated injuries and was otherwise healthy. Of note, the patient had undergone lumbar spinal surgery 11 years previously. Anteroposterior ( fig 1A) and lateral (fig 1B) plain radiographs showed a fracture-subluxation of the T11/T12 vertebrae. The radiographs also showed previous bilateral fusions for spondylolysis of L3 and L4.The patient was nursed on a spinal bed and taken to the operating theatre. Reduction and stabilisation of the fracturedislocation with posterior instrumentation from T10 to L1 was carried out. Postoperative anteroposterior (fig 2A) and lateral ( fig 2B) radiographs showed adequate alignment of the thoracolumbar spine. The patient was subsequently transferred to a neurorehabilitation unit, but has since showed no significant neurological recovery. DISCUSSIONInjuries to the spine in rugby have been widely reported, with a high rate of cervical spine and spinal cord injury.

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Spinal cord concussion in rugby players

Cited by 31 publications

References 8 publications

The effects of a rugby playing season on cervical range of motion

The effects of a rugby playing season on cervical range of motion

Importance of checking prehospital neurological findings to reveal incidence of spinal cord concussion

Paraplegia secondary to fracture-subluxation of the thoracic spine sustained playing rugby union football: Figure 1

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