title: Catastrophic Cervical Spine Injuries in Contact Sports.
abstract: Study DesignSystematic review.ObjectivesTo determine the incidence of catastrophic cervical spine injuries (CCSIs) among elite athletes participating in contact team sports and whether the incidence varies depending on the use of protective gear or by player position.MethodsElectronic databases and reference lists of key articles published from January 1, 2000, to January 29, 2016, were searched.ResultsFourteen studies were included that reported CCSI in rugby (n= 10), American football (n= 3), and Irish hurling (n= 1). Among Rugby Union players, incidence of CCSI was 4.1 per 100,000 player-hours. Among National Football League players, the CCSI rate was 0.6 per 100,000 player-exposures. At the collegiate level, the CCSI rate ranged from 1.1 to 4.7 per 100,000 player-years. Mixed populations of elite and recreational rugby players in four studies report a CCSI rate of 1.4 to 7.2 per 100,000 player-years. In this same population, the scrum accounted for 30 to 51% of total reported CCSIs in Rugby Union versus 0 to 4% in Rugby League. The tackle accounted for 29 to 39% of injuries in Rugby Union and 78 to 100% of injuries in Rugby League. Making a tackle was responsible for 29 to 80% of injuries in American football.ConclusionCCSIs are infrequent among elite athletes. There is insufficient evidence to determine the effect of protective gear (e.g., helmets, padding) on CCSI incidence. Scrum and tackle in rugby and tackling in American football account for the majority of CCSIs in each respective sport.
authors: Department of Spine Surgery, Princess Elisabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, Devon, United Kingdom.
authors: Michael James
authors: MJ
authors: Hutton
authors: Department of Orthopedics, University of Mississippi Medical Center, Jackson, Mississippi, United States.
authors: Robert A
authors: RA
authors: McGuire
authors: Department of Orthopaedic Surgery, University of Cape Town, Cape Town, South Africa.
authors: Robert
authors: R
authors: Dunn
authors: Department of Orthopaedics, Queensland University, Brisbane, Australia.
authors: Richard
authors: R
authors: Williams
authors: Department of Orthopaedics, Auckland City Hospital, Grafton, Auckland, New Zealand.
authors: Peter
authors: P
authors: Robertson
authors: Department of Orthopaedic Trauma, Auckland City Hospital, Grafton, Auckland, New Zealand.
authors: Bruce
authors: B
authors: Twaddle
authors: Sports Surgery Clinic, Dublin, Ireland.
authors: Patrick
authors: P
authors: Kiely
authors: Department of Orthopaedics, Middlemore Hospital, Auckland, New Zealand.
authors: Andrew
authors: A
authors: Clarke
authors: Pediatric Orthopaedic Department, Robert Debré Hospital, Paris, France.
authors: Keyvan
authors: K
authors: Mazda
authors: Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff, United Kingdom.
authors: Paul
authors: P
authors: Davies
authors: Spectrum Research, Inc., Tacoma, Washington, United States.
authors: Krystle T
authors: KT
authors: Pagarigan
authors: Spectrum Research, Inc., Tacoma, Washington, United States.
authors: Joseph R
authors: JR
authors: Dettori
keywords: American football; cervical spinal cord injury; contact sport; hurling; quadriplegia; rugby