Sports Trauma: Cervical Spine Injuries and On-Field Examination


Understanding cervical spine injuries and how they occur in contact sports such as football, lacrosse, and hockey is critical for the prevention of injury and for the on-field management of the injured athlete. Cervical spine injuries occur at all levels of play, from the high school to the professional level, and are usually caused by high-energy collisions between players, resulting in acceleration and deceleration of the head and neck. On-field evaluation of the player with a potential cervical spine injury begins with an assessment of the injured player's breathing and neurologic status. Radiographs should be obtained if necessary, and MRI should be performed if there is evidence of radiculopathy or brachioplexopathy. The decision to allow an injured athlete to return to play depends on 1) whether the injury has healed; and 2) the risk of reinjury. Contraindications to return to play include significant stenosis, ongoing weakness or paresthesias, significant loss of motion at more than one spinal segment, and any upper cervical injury.

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