Return-to-play decisions after cervical spine injuries

Area of Science:

• Sports Medicine
• Neurology
• Orthopedics

Background:

• Cervical spine injuries in athletes pose complex challenges for return-to-play (RTP) decisions.
• Numerous injury types, including fractures, neuropraxia, and disc herniations, can affect RTP.
• Coexisting congenital, developmental, or disease processes further complicate RTP evaluations.

Purpose of the Study:

• To summarize current evidence and expert consensus on RTP decisions following cervical spine injuries.
• To provide guidance for clinicians managing athletes with these injuries.

Main Methods:

• Review of current literature and expert opinion.
• Analysis of case series, case reports, and biomechanical studies.
• Discussion of various cervical spine injury types and associated conditions.

Main Results:

• Guidelines for RTP are primarily supported by expert opinion and limited study types.
• Specific injuries discussed include fractures, central cord neuropraxia, stingers, disc herniations, strains, sprains, and instability.
• Congenital/developmental conditions (e.g., Klippel-Feil syndrome, spinal stenosis) and diseases (e.g., rheumatoid arthritis) are considered.

Conclusions:

• RTP decisions require a comprehensive evaluation of injury severity, type, and individual athlete factors.
• Expert opinion, while valuable, highlights the need for further research to establish definitive RTP guidelines.
• Postsurgical considerations are crucial in the RTP decision-making process for athletes with cervical spine injuries.