Injuries and abnormalities of the cervical spine and return to play criteria

Cervical spine injury has a wide spectrum of consequences for the contact athlete, ranging from minimal to catastrophic. Because of the potentially grave sequelae of cervical injury, it is incumbent on team physicians or treating spine surgeons to be knowledgeable of postinjury treatment and return-to-play algorithms. Sideline physicians must have a rehearsed, comprehensive protocol for ensuring rapid treatment should an on-field injury occur with contingency plans to transport an injured player to a medical facility if necessary. Likelihood of return to play is variable with the extent of injury, but high for stingers, relatively low for patients who suffer episodes of transient neuropraxia, and intermediate for players who undergo cervical fusion for disk herniation based on the best available evidence. However, patients must be evaluated carefully on a case-by-case basis because of the heterogeneity of injury severity and associated pathology.