Thoracic Spinal Fracture in a Rugby League Footballer

Geffen, Saul; Gibbs, Nathan; Geffen, L. B.

doi:10.1097/00042752-199704000-00014

Cited by 6 publications

(5 citation statements)

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“…Most of the existing data are related to trauma to the cervical spine; likely due to the potentially devastating clinical consequences of injuries at this region [7] . The first report of thoracic spine fractures in a rugby league player was in 1997 [17] . Investigations were conducted after the player complained of persistent dorsal mid-thoracic pain, and revealed fracture to T6 and T7 without neurological complications [17] .…”

Section: Discussionmentioning

confidence: 99%

“…The first report of thoracic spine fractures in a rugby league player was in 1997 [17] . Investigations were conducted after the player complained of persistent dorsal mid-thoracic pain, and revealed fracture to T6 and T7 without neurological complications [17] . Elsewhere, symptomatic spinal injuries have been reported in rugby union players, including nerve root injury [13] .…”

Section: Discussionmentioning

confidence: 99%

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Prevalent Morphometric Vertebral Fractures in Professional Male Rugby Players

2014

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There is an ongoing concern about the risk of injury to the spine in professional rugby players. The objective of this study was to investigate the prevalence of vertebral fracture using vertebral fracture assessment (VFA) dual energy X-ray absorptiometry (DXA) imaging in professional male rugby players. Ninety five professional rugby league (n = 52) and union (n = 43) players (n = 95; age 25.9 (SD 4.3) years; BMI: 29.5 (SD 2.9) kg.m2) participated in the research. Each participant received one VFA, and one total body and lumbar spine DXA scan (GE Lunar iDXA). One hundred and twenty vertebral fractures were identified in over half of the sample by VFA. Seventy four were graded mild (grade 1), 40 moderate (grade 2) and 6 severe (grade 3). Multiple vertebral fractures (≥2) were found in 37 players (39%). There were no differences in prevalence between codes, or between forwards and backs (both 1.2 v 1.4; p>0.05). The most common sites of fracture were T8 (n = 23), T9 (n = 18) and T10 (n = 21). The mean (SD) lumbar spine bone mineral density Z-score was 2.7 (1.3) indicating high player bone mass in comparison with age- and sex-matched norms. We observed a high number of vertebral fractures using DXA VFA in professional rugby players of both codes. The incidence, aetiology and consequences of vertebral fractures in professional rugby players are unclear, and warrant timely, prospective investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalent Morphometric Vertebral Fractures in Professional Male Rugby Players

2014

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“…1 7 The only thoracic spine fracture reported in a rugby player occurred at the T6/7 level, with no neurological sequelae. 9 A compression fracture of the thoracic spine in an American footballer, with intact neural elements, has also been reported. 10 Thoracic spine fractures during field sports are uncommon owing to the extra stability afforded to the dorsal spine by the rest of the chest wall.…”

Section: Discussionmentioning

confidence: 95%

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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“…[2] To date, the only thoracic spinal fracture reported in a rugby player was a traumatic fracture that occurred in a rugby league game. [4] According to these authors, this is the first case study describing a thoracic stress fracture in a rugby union game. This injury should be considered as a differential diagnosis when evaluating rugby players, especially in front row players, who are more susceptible to spinal injuries due to the repeated extreme force experienced during scrum engagement.…”

Section: Discussionmentioning

confidence: 99%