Cervical spinal stenosis and sports-related cervical cord neurapraxia

Department of Neurological Surgery, University of California, San Francisco, California 94143-0112, USA.
Neurosurgical FOCUS (Impact Factor: 2.11). 11/2011; 31(5):E7. DOI: 10.3171/2011.7.FOCUS11173
Source: PubMed


Cervical cord neurapraxia is a common sports-related injury. It is defined as a transient neurological deficit following trauma localizing to the cervical spinal cord and can be caused by hyperextension, hyperflexion, or axial load mechanisms. Symptoms usually last less than 15 minutes, but can persist up to 48 hours in adults and as long as 5 days in children. While a strong causal relationship exists between cervical spine stenosis and cervical cord neurapraxia in adult patients, this association has not been observed in children. Likewise, while repeated episodes of neurapraxia can be commonplace in adult patients, recurrences have not been reported in the pediatric population. Treatment is usually supportive, but in adults with focal cervical lesions or instability, surgery is an option. Surgery for neurapraxia in children is rarely indicated.

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    ABSTRACT: Spinal cord injuries are uncommon in sports. Planning and practice for their occurrence, however, remains an essential component of Sideline Medical Team preparedness. Evaluation of cervical nerve injury, cervical cord injury, and cervical disc disease can be complex. Medical management, diagnostic imaging techniques and surgical recommendations in this setting continue to evolve. Most published guidance offers occasionally opposed expert opinion with sport participation after Cervical Cord Neuropraxia in the setting of Cervical Spinal Stenosis appearing particularly polarizing. Such conflicts can present challenges to clinicians in forming management and Return to Play decisions for the health of their athletes.
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