Evidence-based Guidelines for Appropriate and Timely Management of Acute Spine Injuries in Athletes

Although rare, sports-related spine injuries can result in devastating, life-altering consequences, with the cervical spine injury being the most common with potentially devastating consequences, including quadriplegia and immediate death from cardiopulmonary compromise. Sports remain a leading cause of spinal cord injury (SCI) in the first 3 decades of life. Early, appropriate on-field management is critical to prevent further harm and improve outcomes. This manuscript outlines current evidence-based best practices for sideline evaluation and management of athletes with suspected spine injuries. Assessing and managing airway, breathing, and circulation (ABCs) as needed, along with minimizing spinal motion, are critical components of effective on-field emergency management. Rapid and accurate injury severity assessment is essential to guide the appropriate emergency response. Thorough preplanning and training are also vital to ensuring effective on-field management. Numerous practical considerations such as criteria for immobilization, helmet and shoulder pad removal, and transfer techniques are discussed.