Cervical Spinal Stenosis with Cord Neurapraxia and Transient Quadriplegia
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Cervical cord neurapraxia is a transient, totally reversible phenomenon that results from compressive deformation of the spinal cord. It occurs as a result of developmental narrowing of the cervical canal, either as an isolated entity or in combination with degenerative changes, instability or congenital abnormalities. Uncomplicated stenosis of the cervical canal in an individual with a stable spine does not predispose to permanent neurological injury. Our data do not indicate a correlation between developmental narrowing and permanent neurological sequelae in a spine rendered unstable by football-induced trauma. However, there are data indicating that the occurrence of an episode of cervical cord neurapraxia is not a harbinger, or an indication of susceptibility to permanent neurological sequelae. Nevertheless, we recommend that continued participation in collision activities be restricted in individuals who have had a documented episode of cervical cord neurapraxia associated with (i) ligamentous instability; (ii) intervertebral disc disease with cord compression; (iii) significant degenerative changes; (iv) magnetic resonance imaging evidence of cord defect or swelling; (v) symptoms of positive neurological findings lasting more than 36 hours; and (vi) more than one recurrence.
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