Asymptomatic Spinal Cord Compression: Is Surgery Necessary to Return to Play
Yunsoo Lee1, Stephen Selverian1, Wellington K Hsu2
1Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Neurosurgery
|January 11, 2021
Summary
Athletes with asymptomatic cervical canal stenosis face return-to-play dilemmas. Specific imaging criteria can help identify high-risk athletes, guiding decisions for those in contact sports.
Area of Science:
- Orthopedics
- Sports Medicine
- Radiology
Background:
- Cervical canal stenosis in athletes presents a significant return-to-play challenge due to a lack of clear guidelines.
- Predicting injury risk for athletes with asymptomatic cervical canal stenosis is difficult, complicating medical decisions.
Purpose of the Study:
- To identify radiographical and MRI-based criteria for distinguishing athletes at risk of severe consequences from asymptomatic cervical canal stenosis.
- To aid physicians and athletes in making informed return-to-play decisions.
Main Methods:
- Evaluation of Torg-Pavlov ratio (<0.7) from X-rays.
- Assessment of MRI metrics including minimal disc-level canal diameter (<8 mm), cord-to-canal area ratio (>0.8), and space available for the cord (<1.2 mm).
Main Results:
- Specific Torg-Pavlov ratios and MRI measurements can help identify athletes at higher risk.
- These criteria assist in differentiating athletes who may be safe for return to play.
Conclusions:
- Radiographical and MRI criteria offer valuable tools for managing asymptomatic cervical canal stenosis in athletes.
- Further research, particularly in elite athletes, is warranted to refine these criteria and improve decision-making.
