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Cervical Spine Injuries

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Essential Sports Medicine

Abstract

Approximately 10% of the roughly 12,500 new spinal cord injuries (SCIs) sustained annually in the United States are sports related. The most frequent sports responsible for SCI in descending order of incidence and total percentage of all SCIs are: diving (4.5%), football (1.9%), cycling (1.9%), horseback riding (1.0%), and wrestling (0.5%). After motor vehicle accidents (MVAs), sports-related injuries are the second most common cause of neck-related emergency room visits. Cervical spinal cord injuries are most common among hockey, skiing, diving, and American football. Most sports-related cervical spine injuries involve soft tissue trauma such as ligament sprains, muscle strains, and soft tissue contusions. Fortunately, severe cervical spine injuries are rare. However, physicians who treat sports medicine injuries are often responsible for the emergency care of such injured athletes and must know the spectrum of injuries that can occur. Additionally, sports medicine physicians must be familiar with and recognize that these injuries may become chronic despite early management. Some of these chronic conditions include cervical facet arthropathy, myofascial pain syndrome, cervical radiculopathy, and thoracic outlet syndrome. Proper assessment and management of both acute and chronic cervical spine injures on and off the field is crucial for the sports medicine physician.

Special thanks to first edition authors of this chapter, Dorothy A. Miller, MD and Thomas N. Bryce, MD.

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References

  1. Banarjee R, Palumbo MA, et al. Catastrophic cervical spine injuries in the collision sport athlete, part 1: epidemiology, functional anatomy, and diagnosis. Am J Sports Med. 2004;32(4):1077–87.

    Article  Google Scholar 

  2. Chan CW, Eng JJ, Tator CH, Krassioukov A. Epidemiology of sport-related spinal cord injuries: a systematic review. J Spinal Cord Med. 2016;39(3):255–64.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bogduk N, Mercer S. Biomechanics of the cervical spine. I: Normal kinematics. Clin Biomech (Bristol, Avon). 2000;15(9):633–48. https://doi.org/10.1016/s0268-0033(00)00034-6.

  4. Torg JS, Guille JT, et al. Injuries to the cervical spine in American football players. J Bone Joint Surg North Am. 2002;84:112–22.

    Article  Google Scholar 

  5. White AA, Panjabe MM. Clinical biomechanics of the spine. Philadelphia: JB Lippincott; 1990.

    Google Scholar 

  6. White A, Johnson R, et al. Biomechanical analysis of clinical stability of the cervical spine. Clin Orthop Relat Res. 1975a;109:85–97.

    Article  Google Scholar 

  7. White AA, Johnson RM, Panjabi MM, Southwick WO. Biomechanical analysis of chemical stability in the cervical spine. Clin Orthop Relat Res. 1975b;109:85–96.

    Article  Google Scholar 

  8. Chang D, Bosco JA. Cervical spine injuries in the athlete. Bull NYU Hosp Jt Dis. 2006;64(3–4):119–29.

    PubMed  Google Scholar 

  9. Mercer S, Bogduk N. The ligaments and annulus fibrosus of human adult cervical intervertebral discs. Spine (Phila Pa 1976). 1999;24(7):619–26.

    Article  CAS  Google Scholar 

  10. Shen Francis H, Samartzis D, Fessler RG. Texbook of cervical spine. In: Dodwad SNM, Khan SN, An HS, editors. Cervical spine anatomy. Maryland Heights, Missouri: Elsevier; 2015.

    Google Scholar 

  11. Ramieri A, Domenicucci M, Miscusi M, Costanzo G. Functional anatomy and biomechanics of the cervical spine. In: Menchetti P, editor. Cervical spine. Cham: Springer; 2016.

    Google Scholar 

  12. Vopat LMG. Sideline response and transport. In: O’Brien M, Meehan III W, editors. Head and neck injuries in young athletes. Contemporary pediatric and adolescent sports medicine. Cham: Springer; 2016.

    Google Scholar 

  13. Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc. 2015;90(2):284–99.

    Article  PubMed  Google Scholar 

  14. Cole AJ, Farrel JP, Stratton SA. Cervical spine athletic injuries: a pain in the neck. Phys Med Rehabil Clin N Am. 1994;5(1):37–6.

    Article  Google Scholar 

  15. Noormohammadpour P, Farahbakhsh F, Rostami M, Kordi R. Prevalence of neck pain among athletes: a systematic review. Asian Spine J. 2018;12(6):1146–53.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Villavicencio AT, Hernández TD, Burneikiene S, Thramann J. Neck pain in multisport athletes. J Neurosurg Spine. 2007;7(4):408–13.

    Article  PubMed  Google Scholar 

  17. Zmurko MG, et al. Cervical sprains, disc herniations, minor fractures, and other cervical injuries in the athlete. Clin Sports Med. 2003;22:513–21.

    Article  PubMed  Google Scholar 

  18. Rosenfeld M, Gunnarsson R, Borenstein P. Early intervention in whiplash-associated disorders: a comparison of two treatment protocols. Spine. 2000;25(14):1782–7.

    Article  CAS  PubMed  Google Scholar 

  19. Rosenfeld M, Seferiadis A, Carlsson J, Gunnarsson R. Active intervention in patients with whiplash-associated disorders improves long-term prognosis: a randomized controlled clinical trial. Spine. 2003;28(22):2491–8.

    Article  PubMed  Google Scholar 

  20. Jarvinen TA, et al. Muscle strain injuries. Curr Opin Rheumatol. 2000;12:155–61.

    Article  CAS  PubMed  Google Scholar 

  21. Mundt DJ, et al. An epidemiologic study of sports and weight lifting as possible risk factors for herniated lumbar and cervical discs. The Northeast Collaborative Group on low back pain. Am J Sports Med. 1993;21(6):854–60.

    Article  CAS  PubMed  Google Scholar 

  22. Hershman EB, et al. Brachial plexus injuries. Clin Sports Med. 1990;9:311.

    Article  CAS  PubMed  Google Scholar 

  23. Feinberg JH. Burners and stingers. Phys Med Rehab Clin North Am. 2000;11:771–84.

    Article  CAS  Google Scholar 

  24. Levitz CL, et al. The pathomechanics of chronic, recurrent cervical nerve root neurapraxia: the chronic burner syndrome. Am J Sports Med. 1997;25:73–6.

    Article  CAS  PubMed  Google Scholar 

  25. Kurian PA, Light DI, Kerr HA. Burners, stingers, and cervical cord neurapraxia/transient quadriparesis. In: O’Brien M, Meehan III W, editors. Head and neck injuries in young athletes. Contemporary pediatric and adolescent sports medicine. Cham: Springer; 2016.

    Google Scholar 

  26. Meyer SA, et al. Cervical spinal stenosis and stingers in collegiate football players. Am J Sports Med. 1994;22:158–66.

    Article  CAS  PubMed  Google Scholar 

  27. Weinberg J, et al. Etiology, treatment, and prevention of athletic “stingers”. Clin Sport Med. 2003;21:493–500.

    Article  Google Scholar 

  28. Wyss JF, Patel AD. Therapeutic programs for musculoskeletal disorders. New York: Demos Medical; 2012.

    Google Scholar 

  29. Meyer PR Jr, Heim S. Surgical stabilization of the cervical spine. In: Meyer Jr PR, editor. Surgery of spine trauma. New York: Churchill Livingstone; 1989. p. 397–423.

    Google Scholar 

  30. Torg JS, et al. Suggested management guidelines for participation in collision activities with congenital, developmental, or post-injury lesions involving the cervical spine. Med Sci Sports Exerc. 1997;29:S256–72.

    CAS  PubMed  Google Scholar 

  31. Zelenock GB, Kazmers A, Whitehouse WM Jr, Graham LM, Erlandson EE, Cronenwett JL, Lindenauer SM, Stanley JC. Extracranial internal carotid artery dissections: noniatrogenic traumatic lesions. Arch Surg. 1982;117(4):425–32.

    Article  CAS  PubMed  Google Scholar 

  32. Cothren CC, Moore EE, Biffl WL, Ciesla DJ, Ray CE Jr, Johnson JL, Moore JB, Burch JM. Cervical spine fracture patterns predictive of blunt vertebral artery injury. J Trauma. 2003;55(5):811–3.

    Article  PubMed  Google Scholar 

  33. Harrast MA, Finnoff JT. Sports medicine: study guide and review for boards. New York: Demos Medical; 2012.

    Google Scholar 

  34. Schlemm L, Nolte CH, Engelter ST, Endres M, Ebinger M. Cervical artery dissection after sports – An analytical evaluation of 190 published cases. Eur Stroke J. 2017;2(4):335–45.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Simons DG, Dommerholt J. Myofascial pain syndromes–trigger points. J Musculoskeletal Pain. 2005;13(2):63–74.

    Article  Google Scholar 

  36. Borg-Stein J, Zaremski JL, Hanford MA. New concepts in the assessment and treatment of regional musculoskeletal pain and sports injury. PMR. 2009;1(8):744–54.

    Article  Google Scholar 

  37. Borg-Stein J, Simons DG. Myofascial pain. Arch Phys Med Rehabil. 2002;83 Suppl 1:40–7.

    Article  Google Scholar 

  38. Desai MJ, Saini V, Saini S. Myofascial pain syndrome: a treatment review. Pain Ther. 2013;2(1):21–36.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Cooper G, Bailey B, Bogduk N. Cervical zygapophysial joint pain maps. Pain Med. 2007;8(4):344–52.

    Article  PubMed  Google Scholar 

  40. Manchikanti L, Kaye AD, Boswell MV, et al. A systematic review and best evidence synthesis of the effectiveness of therapeutic facet joint interventions in managing chronic spinal pain. Pain Physician. 2015;18(4):E535–82.

    Article  PubMed  Google Scholar 

  41. Hoppenfeld JD. Cervical facet arthropathy and occipital neuralgia: headache culprits. Curr Pain Headache Rep. 2010;14:418.

    Article  CAS  PubMed  Google Scholar 

  42. Ozoa G, Alves D, Fish DE. Thoracic outlet syndrome. Phys Med Rehabil Clin N Am. 2011;22(3):473–83. Am J Sports Med. 2004;32(4):1063-76.

    Article  PubMed  Google Scholar 

  43. Safran MR. Nerve injury about the shoulder in athletes, part 2: long thoracic nerve, spinal accessory nerve, burners/stingers, thoracic outlet syndrome. Am J Sports Med. 2004;32(4):1063–76.

    Article  PubMed  Google Scholar 

  44. Sanders RJ. Chapter 3: Anatomy of the thoracic outlet and related structures. In: Ilig KA, editor. Thoracic outlet syndrome. London: Springer; 2013. p. 19.

    Google Scholar 

  45. Moriarty JM, Bandyk DF, Broderick DF, Cornelius RS, Dill KE, Francois CJ, et al. ACR appropriateness criteria imaging in the diagnosis of thoracic outlet syndrome. J Am Coll Radiol. 2015;12(5):438–43.

    Article  PubMed  Google Scholar 

  46. Hussain MA, Aljabri B, Al-Omran M. Vascular thoracic outlet syndrome. Semin Thorac Cardiovasc Surg. 2016;28(1):151–7.

    Article  PubMed  Google Scholar 

  47. Leonhard V, Caldwell G, Goh M, Reeder S, Smith HF. Ultrasonographic diagnosis of thoracic outlet syndrome secondary to brachial plexus piercing variation. Diagnostics (Basel). 2017;7(3). pii: E40.

    Google Scholar 

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Ramin, J., Chang, L.G., Chang, R.G. (2021). Cervical Spine Injuries. In: Miranda-Comas, G., Cooper, G., Herrera, J., Curtis, S. (eds) Essential Sports Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-64316-4_9

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  • DOI: https://doi.org/10.1007/978-3-030-64316-4_9

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