Cervical spinal stenosis and sports-related cervical cord neurapraxia in children.
METHODS
Congenital spinal stenosis has been demonstrated to contribute to cervical cord neurapraxia after cervical spinal cord injury in adult athletes. A sagittal canal diameter <14 mm and/or a Torg ratio (sagittal diameter of the spinal canal: midcervical sagittal vertebral body diameter) of <0.8 are indicative of significant cervical spinal stenosis. Although sports-related cervical spine injuries are common in children, the role of congenital cervical stenosis in the etiology of these injuries remains unclear.


OBJECTIVE
The authors measured the sagittal canal diameter and the Torg ratio in children presenting with cervical cord neurapraxia resulting from sports-related cervical spinal cord injuries to determine the presence of congenital spinal stenosis.


METHODS
A total of 13 children (9 male, 4 female) presented with cervical cord neurapraxia after a sports-related cervical spinal cord injury. Age ranged from 7 to 15 years (mean +/- SD, 11.5 +/- 2.7 years). The sports involved were football (n = 4), wrestling (n = 2), hockey (n = 2), and soccer, gymnastics, baseball, kickball, and pogosticking (n = 1 each). Lateral cervical spine radiographs were used to determine the sagittal canal diameter and the Torg ratio at C4.


RESULTS
The sagittal canal diameter (mean +/- SD, 17.58 +/- 1.63 mm) and the Torg ratio (mean +/- SD, 1.20 +/- 0.24) were normal in all of these children.


CONCLUSIONS
Using the sagittal canal diameter and the Torg ratio as a measurement of congenital spinal stenosis, the authors did not find evidence of congenital cervical spinal stenosis in a group of children with sports-related cervical spinal cord neurapraxia. The occurrence of cervical cord neurapraxia in pediatric patients can be attributed to the mobility of the pediatric spine rather than to congenital cervical spinal stenosis.
Boockvar
J A
JA
Division of Neurosurgery, Children's Hospital of Philadelphia and University of Pennsylvania Medical Center, USA. boockvar@hotmail.com
Durham
S R
SR
Sun
P P
PP
D000293:Adolescent; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000628:therapy*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009431:Neural Conduction / Q000502:physiology; D011859:Radiography; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000628:therapy*; D013130:Spinal Stenosis / Q000151:congenital* / Q000000981:diagnostic imaging