The Response of the Cervical Spine to Axial Loading: Feasibility for Intervention

2009 ◽  
pp. 142-142-12
Author(s):  
AH Burstein ◽  
JC Otis
Keyword(s):  
Cervical Spine ◽  
Axial Loading

scholarly journals Operative Treatment of Severe Cervical Spine Injuries Sustained in Youth Sports: Experience from a Pediatric Level 1 Trauma Center over a 16-Year Period

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0008
Author(s):  
Bram P Verhofste ◽  
Daniel J Hedequist ◽  
Craig M Birch ◽  
Emily S Rademacher ◽  
Michael P Glotzbecker ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Trauma Center ◽  
Youth Sports ◽  
Axial Loading ◽  
Permanent Disability ◽  
Cervical Spine Injuries ◽  
Cord Injury ◽  
Spine Injuries ◽  
Level 1

Background: Sports-related cervical spine injuries (CSI) are devastating traumas with the potential for permanent disability. There is a paucity of literature on operative CSI sustained in youth athletes. Hypothesis/Purpose: The aims of this study aims were to review injury characteristics, surgical treatment, and outcomes of severe pediatric CSI encountered in youth sports. Methods: We reviewed children less than 18 years old with operative sports-related CSI at a pediatric Level 1 pediatric trauma center between 2004−2019. All cases underwent modern cervical spine instrumentation and fusion. SCI were stratified according to the American Spinal Injury Association Impairment Scale (ASIA). Clinical, radiographic, and surgical characteristics were compared between groups of patients with and without spinal cord injury (SCI). Results: Three thousand two hundred and thirty-one children (mean, 11.3y±4.6y) were evaluated for CSI at our institution during the 16-year period. The majority of traumas resulted from sports/recreational activities and were seen in 1365 cases (42.3%). Of these, 171/1365 patients (12.5%) were admitted and 29/1365 patients (2.1%) required surgical intervention (mean age, 14.5y±2.88y; range, 6.4y–17.8y). Sports included: eight football (28%), seven wrestling (24%), five gymnastics (17%), four diving (14%), two trampoline (7%), one hockey (3%), one snowboarding (3%), and one biking injury (3%). Mechanisms were 19 hyperflexion (65%), eight axial loading (28%), and two hyperextension injuries (7%). The majority of operative CSI were fractures (79%) and/or subaxial defects (72%). Seven patients (30%) sustained SCI and three patients (10%) spinal cord contusion or myelomalacia without neurologic deficits. The risk of SCI increased with age (15.8y vs. 14.4y; p=0.03) and axial loading mechanism (71% vs. 14%; p=0.003). Postoperatively, two SCI patients (29%) improved 1 ASIA Grade and one (14%) improved 2 ASIA Grades. Increased complications developed in SCI than patients without SCI (mean, 2.0 vs 0.1 complications; p=0.02). Clinical and radiographic fusion occurred in 24/26 patients (92%) with adequate follow-up (median, 32 months). Ten patients returned to their previous activity and nine to sports with a lower level of activity. Conclusion: The overall incidence of sports-related operative CSI is low. Age- and gender discrepancies exist, with male adolescent athletes most commonly requiring surgery. Hyperflexion injuries had a good prognosis; however, older males with axial loading CSI sustained in contact sports were at greatest risk of SCI, complications, and permanent disability. [Figure: see text][Table: see text][Table: see text]

Axial loading injuries to the middle cervical spine segment

1991 ◽  
Vol 19 (1) ◽  
pp. 6-20 ◽  
Author(s):  
Joseph S. Torg ◽  
Brian Sennett ◽  
Joseph J. Vegso ◽  
Helene Pavlov
Keyword(s):  
Cervical Spine ◽  
Axial Loading ◽  
Spine Segment

scholarly journals Cervical spine injuries in pediatric athletes: mechanisms and management

2006 ◽  
Vol 21 (4) ◽  
pp. 1-5 ◽  
Author(s):  
Jay Jagannathan ◽  
Aaron S. Dumont ◽  
Daniel M. Prevedello ◽  
Christopher I. Shaffrey ◽  
John A. Jane
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Pediatric Patients ◽  
Head Injuries ◽  
Axial Loading ◽  
Cervical Region ◽  
Spine Injury ◽  
Severe Injuries ◽  
Cervical Spine Injuries ◽  
Cord Injury

✓Sports-related injuries to the spine, although relatively rare compared with head injuries, contribute to significant morbidity and mortality in children. The reported incidence of traumatic cervical spine injury in pediatric athletes varies, and most studies are limited because of the low prevalence of injury. The anatomical and biomechanical differences between the immature spine of pediatric patients and the mature spine of adults that make pediatric patients more susceptible to injury include a greater mobility of the spine due to ligamentous laxity, shallow angulations of facet joints, immature development of neck musculature, and incomplete ossification of the vertebrae. As a result of these differences, 60 to 80% of all pediatric vertebral injuries occur in the cervical region. Understanding pediatric injury biomechanics in the cervical spine is important to the neurosurgeon, because coaches, parents, and athletes who place themselves in positions known to be associated with spinal cord injury (SCI) run a higher risk of such injury and paralysis. The mechanisms of SCI can be broadly subclassified into five types: axial loading, dislocation, lateral bending, rotation, and hyperflexion/hyperextension, although severe injuries often result from a combination of more than one of these subtypes. The aim of this review was to detail the characteristics and management of pediatric cervical spine injury.

Lower Cervical Posterior Element Fractures in the National Football League: A Report of 2 Cases and a Review of the Literature

Neurosurgery ◽  
2011 ◽  
Vol 68 (6) ◽  
pp. E1743-E1749 ◽  
Author(s):  
Mark C. Drakos ◽  
Brian T. Feeley ◽  
Ronnie Barnes ◽  
Mark Muller ◽  
T. Pepper Burruss ◽  
...  
Keyword(s):  
Cervical Spine ◽  
National Football League ◽  
Clinical Presentation ◽  
Axial Loading ◽  
Football Players ◽  
Unstable Fracture ◽  
Professional Football ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Posterior Element

Abstract BACKGROUND AND IMPORTANCE: Injuries in professional football players are common because of the nature of the collisions and the frequency of axial loading to the cervical spine. These injuries should be thoroughly evaluated because they can put the player at risk of future injury and even paralysis. The focus of this report is to present 2 cases of this injury and review the current body of literature. CLINICAL PRESENTATION: We present 2 cases of professional football players who experienced injuries to the lower posterior elements of their cervical spine simultaneously on a kickoff during a game. Both players described transient symptoms consistent with a “stinger,” which is commonly encountered. Workup revealed fractures of the lower cervical spine in both patients. One patient was able to be managed conservatively and returned to football the following season. The second patient had an unstable fracture that ultimately required operative intervention, and the patient retired from professional football. CONCLUSION: Cervical spine injuries in football players need to be adequately evaluated, and in many cases can be career threatening. We recommend that players with persistent pain after a transient neurapraxia undergo radiography and computed tomography of the cervical spine to evaluate for a fracture.

Axial loading injuries to the middle cervical spine segment

1991 ◽  
Vol 1 (3) ◽  
pp. 211
Author(s):  
Torg JS ◽  
Sennett B ◽  
Vegso JJ ◽  
Pavlov H
Keyword(s):  
Cervical Spine ◽  
Axial Loading ◽  
Spine Segment

The effect of lateral eccentricity on failure loads, kinematics, and canal occlusions of the cervical spine in axial loading

2014 ◽  
Vol 47 (5) ◽  
pp. 1164-1172 ◽  
Author(s):  
C. Van Toen ◽  
A.D. Melnyk ◽  
J. Street ◽  
T.R. Oxland ◽  
P.A. Cripton
Keyword(s):  
Cervical Spine ◽  
Axial Loading ◽  
Failure Loads

scholarly journals Fracture of the Atlas through a Synchondrosis of Anterior Arch

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Gamze Turk ◽  
Ismail M. Kabakus ◽  
Erhan Akpinar
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Axial Loading ◽  
Paediatric Population ◽  
Lower Cervical Spine ◽  
Older Population ◽  
Anterior Arch ◽  
Cervical Fractures ◽  
Cord Injury

Cervical fractures are rare in paediatric population. In younger children, cervical fractures usually occur above the level of C4; whereas in older population, fractures or dislocations more commonly involve the lower cervical spine. Greater elasticity of intervertebral ligaments and also the spinal vertebrae explains why cervical fractures in paediatric ages are rare. The injury usually results from a symmetric or asymmetric axial loading. In paediatric cases, most fractures occur through the synchondroses which are the weakest links of the atlas. The prognosis depends on the severity of the spinal cord injury. In this case, we presented an anterior fracture in synchondrosis of atlas after falling on head treated with cervical collar. There was no neurologic deficit for the following 2 years.

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