Cervical Spine and Brachial Plexus Injuries: Return-to-Play Recommendations

Area of Science:

• Sports Medicine
• Neurology
• Orthopedic Surgery

Background:

• Cervical spine and brachial plexus injuries pose significant management challenges in athletes.
• Understanding injury thresholds is crucial for safe return-to-play decisions.

Purpose of the Study:

• To outline criteria for managing cervical spine and brachial plexus injuries in athletes.
• To define absolute contraindications for participation in contact and collision sports.

Main Methods:

• Review of current literature and clinical guidelines for managing athletic neck and brachial plexus injuries.
• Analysis of specific injury parameters (e.g., vertebral displacement, rotation, spinal canal/vertebral body ratio) and their implications.

Main Results:

• Transient brachial plexus injuries ('burners') allow return to play if asymptomatic with full cervical motion.
• Vertebral displacement >3.5 mm or rotation >11 degrees are absolute contraindications.
• Specific conditions like unresolved spear tackler's spine, axial-load teardrop fracture, and extensive cervical fusion contraindicate collision sports.

Conclusions:

• Clear guidelines exist for managing cervical spine and brachial plexus injuries in athletes.
• Accurate assessment of injury severity is paramount to prevent catastrophic outcomes.
• Spinal cord resuscitation strategies include hemodynamic support and methylprednisolone administration.