scholarly journals Cervical spine surgery in professional athletes: a systematic review

2016 ◽  
Vol 40 (4) ◽  
pp. E10 ◽  
Author(s):  
Andrei F. Joaquim ◽  
Wellington K. Hsu ◽  
Alpesh A. Patel
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Disc Herniation ◽  
Cervical Disc Herniation ◽  
Return To Play ◽  
Cervical Disc ◽  
Cervical Spine Surgery ◽  
Spine Pathology ◽  
High Level

Cervical surgery is one of the most common surgical spinal procedures performed around the world. The authors performed a systematic review of the literature reporting the outcomes of cervical spine surgery in high-level athletes in order to better understand the nuances of cervical spine pathology in this population. A search of the MEDLINE database using the search terms “cervical spine” AND “surgery” AND “athletes” yielded 54 abstracts. After exclusion of publications that did not meet the criteria for inclusion, a total of 8 papers reporting the outcome of cervical spine surgery in professional or elite athletes treated for symptoms secondary to cervical spine pathology (focusing in degenerative conditions) remained for analysis. Five of these involved the management of cervical disc herniation, 3 were specifically about traumatic neurapraxia. The majority of the patients included in this review were American football players. Anterior cervical discectomy and fusion (ACDF) was commonly performed in high-level athletes for the treatment of cervical disc herniation. Most of the studies suggested that return to play is safe for athletes who are asymptomatic after ACDF for cervical radiculopathy due to disc herniation. Surgical treatment may provide a higher rate of return to play for these athletes than nonsurgical treatment. Return to play after cervical spinal cord contusion may be possible in asymptomatic patients. Cervical cord signal changes on MRI may not be an absolute contraindication for return to play in neurologically intact patients, according to some authors. Cervical contusions secondary to cervical stenosis may be associated with a worse outcome and a higher recurrence rate than those those secondary to disc herniation. The evidence is low (Level IV) and individualized treatment must be recommended.

Return-to-Play Outcomes in Elite Athletes After Cervical Spine Surgery: A Systematic Review

2021 ◽  
pp. 194173812110078
Author(s):  
Joseph Leider ◽  
Joshua David Piche ◽  
Moin Khan ◽  
Ilyas Aleem
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Surgical Management ◽  
Spine Surgery ◽  
Elite Athletes ◽  
Disc Replacement ◽  
Return To Play ◽  
Cervical Disc ◽  
Cervical Spine Surgery ◽  
Cervical Disc Replacement

Context: Return-to-play (RTP) outcomes in elite athletes after cervical spine surgery are currently unknown. Objective: To systematically review RTP outcomes in elite athletes after anterior cervical discectomy and fusion (ACDF), cervical disc replacement (CDR), or posterior foraminotomy (PF) surgery. Data Sources: EMBASE, PubMed, Cochrane, and Medline databases from inception until April 2020. Keywords included elite athletes, return to play, ACDF, foraminotomy, and cervical disc replacement. Study Selection: Eligible studies included those that reported RTP outcomes in elite athletes after cervical spine surgery. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Data were extracted by 2 independent reviewers. Results: The primary outcomes of interest were rates and timing of RTP. Secondary outcomes included performance on RTP. A total of 1720 studies were initially screened. After inclusion criteria were applied, 13 studies with a total of 349 patients were included. A total of 262 (75%) played football, 37 (11%) played baseball, 19 (5%) played rugby, 10 (3%) played basketball, 10 (3%) played hockey, 9 (3%) were wresters, and 2 (1%) played soccer. ACDF was reported in 13 studies, PF in 3 studies, and CDR in 2 studies. The majority of studies suggest that RTP after surgical management is safe in elite athletes who are asymptomatic after their procedure and may lead to higher rates and earlier times of RTP. There is limited evidence regarding RTP or outcomes after CDR or multilevel surgery. Conclusion: The management and RTP in elite athletes after cervical spine injury is a highly complex and multifactorial topic. The overall evidence in this review suggests that RTP in asymptomatic athletes after both ACDF and PF is safe, and there is little evidence for decreased performance postoperatively. Surgical management results in a higher RTP rate compared with athletes managed conservatively.

scholarly journals Three-level cervical disc herniation

2015 ◽  
Vol 29 (3) ◽  
pp. 309-315
Author(s):  
Andrei St. Iencean ◽  
Ion Poeata
Keyword(s):  
Cervical Spine ◽  
Disc Herniation ◽  
The Elderly ◽  
Cervical Disc Herniation ◽  
Herniated Disc ◽  
Cervical Disc ◽  
Disc Disease ◽  
Degenerative Disc ◽  
Spine Pathology ◽  
Rapid Relief

Abstract Multilevel cervical degenerative disc disease is well known in the cervical spine pathology, with radicular syndromes or cervical myelopathy. One or two level cervical herniated disc is common in adult and multilevel cervical degenerative disc herniation is common in the elderly, with spinal stenosis, and have the same cause: the gradual degeneration of the disc. We report the case of a patient with two level cervical disc herniation (C4 – C5 and C5 – C6) treated by anterior cervical microdiscectomy both levels and fusion at C5 – C6; after five years the patient returned with left C7 radiculopathy and MRI provided the image of a left C6 – C7 disc herniation, he underwent an anterior microsurgical discectomy with rapid relief of symptoms. Three-level cervical herniated disc are rare in adults, and the anterior microdiscectomy with or without fusion solve this pathology.

scholarly journals Esophageal perforation after anterior cervical spine surgery: a systematic review of the literature

2016 ◽  
Vol 25 (3) ◽  
pp. 285-291 ◽  
Author(s):  
Sameer H. Halani ◽  
Griffin R. Baum ◽  
Jonathan P. Riley ◽  
Gustavo Pradilla ◽  
Daniel Refai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Esophageal Perforation ◽  
Spinal Surgery ◽  
Esophageal Injury ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Pubmed Search ◽  
Anterior Spinal Surgery

OBJECTIVE Esophageal perforation is a rare but well-known complication of anterior cervical spine surgery. The authors performed a systematic review of the literature to evaluate symptomatology, direct causes, repair methods, and associated complications of esophageal injury. METHODS A PubMed search that adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines included relevant clinical studies and case reports (articles written in the English language that included humans as subjects) that reported patients who underwent anterior spinal surgery and sustained some form of esophageal perforation. Available data on clinical presentation, the surgical procedure performed, outcome measures, and other individual variables were abstracted from 1980 through 2015. RESULTS The PubMed search yielded 65 articles with 153 patients (mean age 44.7 years; range 14–85 years) who underwent anterior spinal surgery and sustained esophageal perforation, either during surgery or in a delayed fashion. The most common indications for initial anterior cervical spine surgery in these cases were vertebral fracture/dislocation (n = 77), spondylotic myelopathy (n = 15), and nucleus pulposus herniation (n = 10). The most commonly involved spinal levels were C5–6 (n = 51) and C6–7 (n = 39). The most common presenting symptoms included dysphagia (n =63), fever (n = 24), neck swelling (n = 23), and wound leakage (n = 18). The etiology of esophageal perforation included hardware failure (n = 31), hardware erosion (n = 23), and intraoperative injury (n = 14). The imaging modalities used to identify the esophageal perforations included modified contrast dye swallow studies, CT, endoscopy, plain radiography, and MRI. Esophageal repair was most commonly achieved using a modified muscle flap, as well as with primary closure. Outcomes measured in the literature were often defined by the time to oral intake following esophageal repair. Complications included pneumonia (n = 6), mediastinitis (n = 4), osteomyelitis (n = 3), sepsis (n = 3), acute respiratory distress syndrome (n = 2), and recurrent laryngeal nerve damage (n = 1). The mortality rate of esophageal perforation in the analysis was 3.92% (6 of 153 reported patients). CONCLUSIONS Esophageal perforation after anterior cervical spine surgery is a rare complication. This systematic review demonstrates that these perforations can be stratified into 3 categories based on the timing of symptomatic onset: intraoperative, early postoperative (within 30 days of anterior spinal surgery), and delayed. The most common source of esophageal injury is hardware erosion or migration, each of which may vary in their time to symptomatic manifestation.

scholarly journals Effect of perioperative steroids on dysphagia after anterior cervical spine surgery: A systematic review

10.14444/4009 ◽  
2017 ◽  
Vol 11 (2) ◽  
pp. 9 ◽  
Author(s):  
Abidemi S. Adenikinju ◽  
Sameer H. Halani ◽  
Rima S. Rindler ◽  
Matthew F. Gary ◽  
Keith W. Michael ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

scholarly journals Prone Positioning of Patients with Cervical Spine Pathology

2019 ◽  
Vol 07 (02) ◽  
pp. 070-076
Author(s):  
Sarah L. Boyle ◽  
Zoe Unger ◽  
Vinay Kulkarni ◽  
Eric M. Massicotte ◽  
Lashmi Venkatraghavan
Keyword(s):  
Cervical Spine ◽  
Prone Position ◽  
Spine Surgery ◽  
Good Alternative ◽  
Neurological Injury ◽  
Prone Positioning ◽  
Cervical Spine Surgery ◽  
Advantages And Disadvantages ◽  
Flexion Extension ◽  
Spine Pathology

AbstractPatients with cervical trauma or degenerative disease often require surgical decompression and stabilization in the prone position and are at the risk of secondary neurological injury during this transfer. This review aims to explore the current literature on different methods of positioning patients prone and to identify the safest technique to achieve prone positioning in patients with an unstable cervical spine undergoing posterior cervical spine surgery. We searched the Embase, Medline, and Medline-in Process databases for literature in English related to prone positioning patients with cervical spine pathology undergoing spine surgery. Seventy-three citations were identified as relevant and reviewed in detail with 20 articles being identified as answering the clinical questions posed. Our literature review identified three methods of prone positioning patients with cervical pathology: logroll with manual in-line stabilization (MILS), rotating the patient on a specialized spinal table using a “sandwich and flip” technique, and awake prone positioning. Each of these methods has its own advantages and disadvantages. When comparing the degree of neck movement between positioning techniques, “sandwich and flip” rotation was associated with over 50% reduction in both flexion–extension and axial–lateral rotation as compared to logroll with MILS. Awake self-positioning of a patient is another alternative that allows for rapid neurological assessment after repositioning. A “sandwich and flip” is the safest way to turn a patient with cervical pathology into a prone position for surgery. For cooperative patients, who are physically capable, awake self-positioning is a good alternative.

scholarly journals Oblique Sagittal Images Prevent Underestimation of the Neuroforaminal Stenosis Grade Caused by Disc Herniation in Cervical Spine MRI

2018 ◽  
Vol 190 (10) ◽  
pp. 946-954 ◽  
Author(s):  
Laurent Kintzelé ◽  
Christoph Rehnitz ◽  
Hans-Ulrich Kauczor ◽  
Marc-André Weber
Keyword(s):  
Cervical Spine ◽  
Disc Herniation ◽  
Sagittal Plane ◽  
Cervical Disc ◽  
Cervical Spine Surgery ◽  
Valuable Adjunct ◽  
Significant Difference ◽  
Disc Herniations ◽  
Oblique Images ◽  
Spine Mri

Purpose To identify whether standard sagittal MRI images result in underestimation of the neuroforaminal stenosis grade compared to oblique sagittal MRI images in patients with cervical spine disc herniation. Materials and Methods 74 patients with a total of 104 cervical disc herniations compromising the corresponding nerve root were evaluated. Neuroforaminal stenosis grades were evaluated in standard and oblique sagittal images by one senior and one resident radiologist experienced in musculoskeletal imaging. Oblique images were angled 30° towards the standard sagittal plane. Neuroforaminal stenosis grades were classified from 0 (no stenosis) to 3 (high grade stenosis). Results Average neuroforaminal stenosis grades of both readers were significantly lower in standard compared to oblique sagittal images (p < 0.001). For 47.1 % of the cases, one or both readers reported a stenosis grade, which was at least 1 grade lower in standard compared to oblique sagittal images. There was also a significant difference when looking at patients who had neurological symptoms (p = 0.002) or underwent cervical spine surgery subsequently (p = 0.004). Interreader reliability, as measured by kappa value, and accordance rates were better for oblique sagittal images (0.94 vs. 0.88 and 99 % vs. 93 %). Conclusion Standard sagittal images tend to underestimate neuroforaminal stenosis grades compared to oblique sagittal images and are less reliable in the evaluation of disc herniations within the cervical spine MRI. In order to assess the potential therapeutic consequence, oblique images should therefore be considered as a valuable adjunct to the standard MRI protocol for patients with a radiculopathy. Key Points  Citation Format

Mild Cervical Spine Trauma Showing Symptomatic Calcified Cervical Disc Herniation in a Child

Spine ◽  
2003 ◽  
Vol 28 (5) ◽  
pp. E93-E94 ◽  
Author(s):  
Klaus-D. Schaser ◽  
John F. Stover ◽  
Max J. Kaeaeb ◽  
N. P. Haas ◽  
Thomas Mittlmeier
Keyword(s):  
Cervical Spine ◽  
Disc Herniation ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Spine Trauma ◽  
Spine Trauma
Sign in / Sign up

Export Citation Format

Share Document