1Department of Orthopaedic Surgery, Hahnemann University Hospital, Broad and Vine Streets, Mail Stop 420, Philadelphia, PA 19102
2Department of Orthopaedics, Alfred I. duPont Hospital for Children, P.O. Box 269, Wilmington, DE 19899
Abstract
A national registry has documented data on more than 1300 cervical spine injuries resulting from tackle football. Axial loading of the cervical spine is the primary injury mechanism, an observation with profound implications regarding implementation of preventative measures.
Characteristic injury patterns involving the middle (third and fourth) cervical segment and the more favorable response to prompt reduction of these injuries are emphasized.
The marked instability and grave prognosis of axial load teardrop fractures are attributed to the associated sagittal vertebral body and posterior arch fractures.
Spear tackler’s spine is described and is classified as an absolute contraindication to participation in collision sports.
Cervical cord neurapraxia, with or without transient quadriplegia, is neither associated with nor presages permanent neurologic sequelae. However, there is a considerable risk of recurrence, which can be predicted on the basis of canal diameter data.
The concept of spinal cord resuscitation is proposed as a means of obtaining maximum neurologic recovery by reversing the secondary injury phenomenon that occurs in acute spinal cord trauma.