"Rugby neck": cervical degeneration in two front row rugby union players

To highlight the insidious effect of long term front row play on the cervical spine.

Two rugby union front row players presented with neck pain in the middle of the 1991-1992 season. Both had been playing rugby from an early age in the front row. Both had represented their country at school level. They also had both played senior rugby in the Leinster province of Ireland from the age of 19 years. One of the players presented with neck pain with associated radicular radiation. The other player presented with an insidious chronic neck pain. There was no history of acute trauma save the week-in/week-out collisions that occur in the front row of the rugby scrum. Radiological evaluation revealed chronic cervical vertebral and disk degeneration. One of the subjects had an acute disk prolapse. This was surgically removed. The second subject had evidence of chronic disk degeneration. Both players have now retired from rugby at the age of 31.

Both injuries would appear to be caused by the high loading that front row play places on the cervical spine.

A high index of suspicion is needed when assessing cervical spine injuries in front row rugby players. Seemingly, minor injuries may signpost more serious, and potentially catastrophic neck pathology.