Cervical Spine Injuries in the Athlete - Health Assignment Help

Assignment Task:

Task:

Spinal pain, while common in the general population, is essentially universal in the athletic population. Certain specific positions and activities of a given sport inherently place athletes at a high risk for the develop- ment of low back or neck pain syndromes. As an example,  “stingers” occur more commonly in wrestlers, particularly with the take-down maneuver, and as well in football play- ers, especially for defensive backs and offensive linemen. Although low back and neck pain syndromes can be trauma related, this review will focus on the epidemiology, anatomy, prehospital care, imaging, prevention, and rehabilitation of the many types of cervical spine trauma commonly seen in athletes (Table 1) and will not cover complex cervical spine fractures.

Epidemiology
The vast majority of spinal cord injuries (SCIs) in athletes involve the cervical spine. Ghiselli and colleagues reported that the incidence of cervical spine injuries in sports is 1000 per year, mostly from diving and swimming (hitting the bottom of the pool).1 This is consistent with Maroon and Bailes, who note that cervical spine injuries in the athlete account for 10% of the 10,000 cervical spine injuries per year in the U.S.2 Many of these are incomplete injuries, meaning that some neurologic function is preserved.

Anatomy
There are seven specialized vertebrae in the cervical spine. The vertebral bodies are comparatively small and slightly concave on their superior surface. Within the transverse pro- cesses are the foramen transversarium, which transmit pas- sage of the vertebral arteries above the C7 level. The pedicles are oriented medially 15° to 40° and slightly cephalad. The inferior and superior articular surfaces of adjacent vertebrae form the facet joints, which are diarthrodial articulations and are oriented upward 30° to 45° from the horizontal.

Prehospital Care
Prehospital care begins in the field. The involved caretakers, EMTs (emergency medical technicians), and athletic train-ers, are pivotal and must be experienced in recognizing and addressing the cervical spine injured patient. Knowing the correct protocols of CPR (cardiopulmonary resuscitation) and ACLS (advanced cardiac life support) is paramount, as well as having and applying the correct equipment. Atten-tion to changes in the person’s ABCs (airway, breathing and circulation), neurological status, and level of consciousness all factor critically into initial management.

Imaging
The American College of Surgeons recommends in its ATLS (Advanced Trauma Life Support) guidelines that all patients with a traumatic injury above the clavicle have a cervical spine radiograph. However, the National Emergency X-Ray Use Study (NEXUS) found that patients who had no midline cervical tenderness, no focal neurological deficits, normal alertness, no intoxication, and no painful distracting injuries had a low probability of cervical spine injury. Therefore, fully conscious athletes who have cervical trauma can be cleared without radiographic studies provided the above criteria are met.

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