scholarly journals Cervical Spine Injuries in the Ice Hockey Player: Current Concepts in Epidemiology, Management and Prevention

2020 ◽  
pp. 219256822097054
Author(s):  
Cole Morrissette ◽  
Paul J. Park ◽  
Ronald A. Lehman ◽  
Charles A. Popkin
Keyword(s):  
Cervical Spine ◽  
Injury Risk ◽  
Management Strategies ◽  
Ice Hockey ◽  
Return To Play ◽  
Cochrane Library ◽  
Spine Injury ◽  
Cervical Spine Injuries ◽  
Cervical Fractures ◽  
Spine Injuries

Study Design: This review article examines the biomechanics that underly hockey-related cervical spine injuries, the preventative measures to curtail them, optimal management strategies for the injured player and return to play criteria. Objective: Hockey is a sport with one of the highest rates of cervical spine injury, but by understanding the underlying pathophysiology and context in which these injuries can occur, it is possible to reduce their incidence and successfully manage the injured player. Methods: Multiple online databases including PubMed, Google Scholar, Columbia Libraries Catalog, Cochrane Library and Ovid MEDLINE were queried for original articles concerning spinal injuries in ice hockey. All relevant papers were screened and subsequently organized for discussion in our subtopics. Results: Cervical fractures in ice hockey most often occur due to an increased axial load, with a check from behind the most common precipitating event. Conclusions: Despite the recognized risk for cervical spine trauma in ice hockey, further research is still needed to optimize protocols for both mitigating injury risk and managing injured players.

Injuries to the head and cervical spine

2017 ◽  
Author(s):  
Robert V Cantu ◽  
Robert C Cantu
Keyword(s):  
Cervical Spine ◽  
Brain Injuries ◽  
Wide Spectrum ◽  
Signs And Symptoms ◽  
Return To Play ◽  
Spine Injury ◽  
Young Athletes ◽  
Cervical Spine Injuries ◽  
Cord Injury ◽  
Spine Injuries

Traumatic brain and cervical spine injuries in young athletes encompass a wide spectrum, with some injuries occurring in otherwise ‘safe’ sports, and others in high-risk sports where head and cervical spine injuries are the norm. Athletic brain injuries include concussion, intracranial haemorrhage, malignant brain oedema syndrome, and axonal shear. In the cervical spine, injuries include muscle strains, contusions, fractures, or ligamentous disruptions with nerve root or spinal cord injury. Knowledge of these injuries and their signs and symptoms is important for the physician covering a sporting contest or practice. Additionally, preparedness for potential head or cervical spine injury must be addressed by health professionals providing sporting event coverage. This chapter reviews how traumatic brain and cervical spine injuries typically occur in young athletes. It also discusses what the initial treatment of these injuries should entail, along with a discussion of return to play considerations.

scholarly journals Cervical Spine Injuries in Sports

2015 ◽  
Vol 5 (1) ◽  
pp. 58-62
Author(s):  
Daniel J Blizzard ◽  
Michael A Gallizzi ◽  
Lindsay T Kleeman ◽  
Melissa M Erickson
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Spinal Cord Injuries ◽  
Return To Play ◽  
Atlantoaxial Instability ◽  
Patient Specific ◽  
Spine Injury ◽  
Cervical Spine Injuries ◽  
Early Return ◽  
Spine Injuries

ABSTRACT Injuries to the cervical spine in athletes are rare but potentially devastating outcomes resulting from involvement in sports activities. New rules and regulations implemented by national sports organizations have helped to decrease the rate of cervical spine and spinal cord injuries sustained by athletes. A basic understanding of cervical spine anatomy, physical examination and spine precautions is necessary for any physi cian evaluating athletes on the field to determine if transfer to higher level of care is needed. It is particularly important to know the systematic protocol for spine immobilization, neuro logic exam and helmet removal in a patient with a suspected cervical spine injury. While cervical strain is the most common cervical spine injury, physicians should be familiar with the presentation for other injuries, such as Burner's syndrome (Stinger), cervical disk herniation, transient quadriplegia and cervical spine fractures or dislocations. Special consideration is needed when evaluating patients with Down syndrome as they are at higher risk for atlantoaxial instability. Determination of when an athlete can return to play is patient-specific with early return to play allowed only in a completely asymptomatic patient. Kleeman LT, Gallizzi MA, Blizzard DJ, Erickson MM. Cervical Spine Injuries in Sports. The Duke Orthop J 2015;5(1):5862.

scholarly journals Can emergency physicians accurately rule out clinically important cervical spine injuries by using computed tomography?

CJEM ◽  
2014 ◽  
Vol 16 (02) ◽  
pp. 131-135 ◽  
Author(s):  
Hendrik P. Van Zyl ◽  
James Bilbey ◽  
Alan Vukusic ◽  
Todd Ring ◽  
Jennifer Oakes ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Clinical Skills ◽  
Ct Scans ◽  
Spine Injury ◽  
Emergency Physicians ◽  
Cervical Spine Injuries ◽  
Spine Ct ◽  
Spine Injuries ◽  
Rule Out

ABSTRACT Objective: Emergency physicians are expected to rule out clinically important cervical spine injuries using clinical skills and imaging. Our objective was to determine whether emergency physicians could accurately rule out clinically important cervical spine injuries using computed tomographic (CT) imaging of the cervical spine. Method: Fifteen emergency physicians were enrolled to interpret a sample of 50 cervical spine CT scans in a nonclinical setting. The sample contained a 30% incidence of cervical spine injury. After a 2-hour review session, the participants interpreted the CT scans and categorized them into either a suspected cervical spine injury or no cervical spine injury. Participants were asked to specify the location and type of injury. The gold standard interpretation was the combined opinion of two staff radiologists. Results: Emergency physicians correctly identified 182 of the 210 abnormal cases with cervical spine injury. The sensitivity of emergency physicians was 87% (95% confidence interval [CI] 82–91), and the specificity was 76% (95% CI 74–77). The negative likelihood ratio was 0.18 (95% CI 0.12–0.25). Conclusion: Experienced emergency physicians successfully identified a large proportion of cervical spine injuries on CT; however, they were not sufficiently sensitive to accurately exclude clinically important injuries. Emergency physicians should rely on a radiologist review of cervical spine CT scans prior to discontinuing cervical spine precautions.

Return-to-play decisions after cervical spine injuries

2007 ◽  
Vol 6 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Jessica L. Ellis ◽  
Jamie E. Gottlieb
Keyword(s):  
Cervical Spine ◽  
Return To Play ◽  
Cervical Spine Injuries ◽  
Spine Injuries

Neck Injury

1995 ◽  
Vol 16 (1) ◽  
pp. 28-28
Author(s):  
Jeffrey R. Avner
Keyword(s):  
At Risk ◽  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Pediatric Patients ◽  
Neck Injury ◽  
Spine Injury ◽  
Clinical Markers ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Spine Radiographs

Although rare in pediatrics, cervical spine injuries still are associated with serious morbidity, disability, and mortality. Many of these injuries are exacerbated by inadequate neck immobilization or improper manipulation. Thus, the physician should be aware of which children are at risk for cervical spine injury and how to assess these patients properly. To find clinical markers that identify children who actually have cervical spine injuries, Rachesky et al reviewed 2133 cervical spine radiographs obtained in pediatric patients during a 7-year period. Of these children, 25 (1.2%) had abnormalities confirmed on radiographs. The incidence of injury increased with age; only four of the children who had cervical spine injuries were less than 8 years old.

Cervical spine injuries

2019 ◽  
pp. 789-800
Author(s):  
Calan Mathieson ◽  
Chris Barrett ◽  
Likhith Alakandy
Keyword(s):  
Cervical Spine ◽  
Classification Systems ◽  
Neurological Injury ◽  
Spine Injury ◽  
Spine Fractures ◽  
Cervical Spine Injuries ◽  
Heterogenous Group ◽  
Spine Injuries ◽  
Spine Surgeon ◽  
Cervical Spine Fractures

The management of cervical spine fractures is a complex and fascinating topic. A multitude of descriptive terminologies and classification systems have been developed over the years in an attempt to better understand this heterogenous group of patients. Despite this however, there is often little consensus with regards to the best way to manage this population. This chapter will predominantly discuss the decision-making process involved in the management of cervical spine fractures. The goal of the spine surgeon in managing patients with acute cervical spine injury is to prevent secondary neurological injury, deformity, and pain by re-establishing stability if necessary. Assessing how to achieve this goal can be very challenging. The surgeon will be faced with many questions. Which patients should undergo surgical intervention? Which operation will best stabilize the spine? Which patients should be treated with a collar or a halo vest? Does the injury require reduction with traction initially? There are also questions of timing. When should the surgeon plan the proposed procedure?

Halo-thoracic brace immobilization in 188 patients with acute cervical spine injuries

1983 ◽  
Vol 58 (4) ◽  
pp. 508-515 ◽  
Author(s):  
Richard C. Chan ◽  
Joseph F. Schweigel ◽  
Gordon B. Thompson
Keyword(s):  
Cervical Spine ◽  
Early Mobilization ◽  
Fusion Rate ◽  
Spine Injury ◽  
Cervical Cord ◽  
Content Type ◽  
Cervical Spine Injuries ◽  
Cervical Fractures ◽  
Cord Injury ◽  
Skull Traction

✓ The authors report 188 patients with acute cervical spine injury with fracture who underwent Halothoracic brace immobilization. The majority of the fractures were considered unstable. Early neurological assessment revealed 24 patients without neurological deficit. There were 164 patients with associated cervical cord injury; 84 patients with incomplete, and 80 patients with complete tetraplegia. Management consisted of skull traction and application of the Halo-thoracic brace about 1.3 weeks after admission. The average radiological union time was 11.5 weeks following a mean of 10.2 weeks of immobilization in a Halo apparatus. Satisfactory restoration of bone and ligament stability, with no significant posttreatment neck pain, was obtained in 168 cases (89%). This is comparable to the fusion rate achieved for cervical fractures in the literature. The follow-up periods range from 1 month to 6 years, with a mean of 10.8 months. The management and results in 73 patients with unilaterally and bilaterally locked facets with or without fractures are discussed. Complete tetraplegia is not considered a contraindication to Halo apparatus immobilization. The multiple factors responsible for overcoming the barrier of anesthetic skin are elucidated. Use of the Halo apparatus offers early mobilization and rehabilitation without neurological deterioration. Complications are few and insignificant.

scholarly journals A study on functional outcome following surgical fixation for lower spine injuries

2021 ◽  
Author(s):  
M. Sivakumar ◽  
M. Ganesh Kumar
Keyword(s):  
Cervical Spine ◽  
Functional Outcome ◽  
Tamil Nadu ◽  
Spinal Injury ◽  
Spine Injury ◽  
Trauma Patients ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Disc Bulge ◽  
Surgical Fixation

<p class="abstract"><strong>Background:</strong> Cervical spine injuries are one of the common causes of serious morbidity mortality following trauma. 6% of trauma patients have spine injuries of which &gt;50% is contributed by a cervical spine injury. The aim of the study was to determine the functional outcome following surgical fixation for sub-axial cervical spine.</p><p class="abstract"><strong>Methods:</strong> this prospective study involving 17 patients who were all admitted with sub-axial cervical spine injuries and amenable to intervention in our department of orthopedics and traumatology, government Theni medical college, Tamil Nadu, India in the year 2019-2020. Duration of 6 months from December 2019 to may 2020.<strong></strong></p><p class="abstract"><strong>Results:</strong> Most of the injuries presented within 24 hours of injury. Most of the patients presented with an incomplete neurological deficit. C5-C6 subluxation with disc bulge was the most common spinal injury. 5 patients were operated on more than 2 levels. The rest of the patients were operated on at 2 levels.</p><p class="abstract"><strong>Conclusions:</strong> We consider that the anterior decompression and fusion with a locking compression plate is a viable procedure in sub-axial cervical spine injuries.</p>

scholarly journals Currently available classification systems for lower cervical spine injuries. Part 1. Overview of the most popular scales and classifications

2019 ◽  
Vol 21 (1) ◽  
pp. 90-102 ◽  
Author(s):  
A. A. Grin ◽  
I. S. Lvov ◽  
S. L. Arakelyan ◽  
A. E. Talypov ◽  
A. Yu. Kordonsky ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Classification System ◽  
Injury Severity ◽  
Scoring Systems ◽  
Classification Systems ◽  
Spine Injury ◽  
Lower Cervical Spine ◽  
Cervical Spine Injuries ◽  
Advantages And Disadvantages ◽  
Spine Injuries

This article provides a detailed illustrated description of currently available classification and scoring systems for lower cervical spine injuries (including Allen–Fergusson, J. Harris et al., C. Argenson et al., and AOSpine classifications, Subaxial Injury Classification System and Cervical Spine Injury Severity Score). The present review primarily aims to discuss the advantages and disadvantages of each classification system. 

Delay in clearing cervical spine injuries in obtunded trauma patients and its implications

Trauma ◽  
2017 ◽  
Vol 20 (4) ◽  
pp. 273-280
Author(s):  
Kamaljit K Parmar ◽  
Kwok M Ho ◽  
Timothy Bowles
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Weekend Effect ◽  
Spine Injury ◽  
Trauma Patients ◽  
Prospective Audit ◽  
Cervical Spine Injuries ◽  
Increased Risk ◽  
Spine Injuries ◽  
Injury Status

Introduction Prompt recognition of cervical spine injuries may limit spinal cord damage. This prospective audit assessed the time needed to formally confirm the status of cervical spine using a computed tomography scan, the reasons for any delays, and the subsequent outcomes. Methodology Prospective audit analysed the data of 100 consecutive unconscious trauma patients, admitted over a seven-month period, to ascertain whether there was a ‘weekend’ effect in validating the cervical spine status radiologically, and whether the delays were associated with an increased risk of pneumonia and other complications. The sensitivity and specificity of using bony fractures and mal-alignment on the computed tomography scans to diagnose cervical spine injuries were calculated. Results Significant radiological evidence of cervical spine injuries occurred in 37 patients (37%). A delay in >48 h to ascertain the cervical spine status occurred in 36 patients, mostly due to logistical (58%) reasons, and this was associated with an increased risk of pneumonia requiring antibiotics (p < 0.001). A ‘weekend’ effect and presence of cervical spine injuries were not significantly related to the time to confirm the cervical spine injury status radiologically. The specificity (98%) of using bony fractures and mal-alignment on the computed tomography to diagnose cervical spine injuries was high, but its sensitivity (83.8%) was only modest. Conclusions A delay to confirm the cervical spine injury status was common and associated with an increased risk of pneumonia in unconscious trauma patients, particularly among those who did not sustain any cervical spine injuries. The low sensitivity of computed tomography to exclude non-bony cervical spine injuries suggests that selective early use of magnetic resonance imaging scans for high-risk unconscious trauma patients may improve patient outcomes.

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