Advertisement

Cervical Cord Neurapraxia

  • Frank H. ValoneIII
  • Kiehyun Daniel Riew
Chapter

Abstract

Cervical cord neurapraxia is a transient neurological deficit resulting from trauma to the cervical spine. Most symptoms resolve in adults within 15 min and, however, may last much longer in children. The association of cervical cord neurapraxia with cervical stenosis has been shown in many series in adults but has not been well demonstrated in children. Initial management should include immobilization, clinical exam, and radiographic evaluation. Adults that do return to their sport have at least a 50% risk of recurrence, whereas the risk of recurrence in children has not yet been established. We believe that absolute contraindications to return to play include instability or focal cord compression that cannot be resolved with surgical intervention as well as any residual weakness in a major motor group, imbalance, loss of dexterity, or other cord-related neurologic deficits.

Keywords

Cervical cord neurapraxia Transient paralysis Cervical stenosis Torg ratio Athlete Return to play 

References

  1. 1.
    Torg JS, et al. Cervical cord neurapraxia: classification, pathomechanics, morbidity, and management guidelines. J Neurosurg. 1997;87(6):843–50.CrossRefGoogle Scholar
  2. 2.
    Pavlov H, et al. Cervical spinal stenosis: determination with vertebral body ratio method. Radiology. 1987;164(3):771–5.CrossRefGoogle Scholar
  3. 3.
    Torg JS, et al. The Nicolas Andry award. The pathomechanics and pathophysiology of cervical spinal cord injury. Clin Orthop Relat Res. 1995;321:259–69.Google Scholar
  4. 4.
    Penning L. Some aspects of plain radiography of the cervical spine in chronic myelopathy. Neurology. 1962;12:513–9.CrossRefGoogle Scholar
  5. 5.
    Maroon JC, et al. Cervical neurapraxia in elite athletes: evaluation and surgical treatment. Report of five cases. J Neurosurg Spine. 2007;6(4):356–63.CrossRefGoogle Scholar
  6. 6.
    Page S, Guy JA. Neurapraxia, “stingers,” and spinal stenosis in athletes. South Med J. 2004;97(8):766–9.CrossRefGoogle Scholar
  7. 7.
    Torg JS, et al. Neurapraxia of the cervical spinal cord with transient quadriplegia. J Bone Joint Surg Am. 1986;68(9):1354–70.CrossRefGoogle Scholar
  8. 8.
    Boockvar JA, Durham SR, Sun PP. Cervical spinal stenosis and sports-related cervical cord neurapraxia in children. Spine (Phila Pa 1976). 2001;26(24):2709–12; discussion 2713.CrossRefGoogle Scholar
  9. 9.
    Torg JS, et al. The relationship of developmental narrowing of the cervical spinal canal to reversible and irreversible injury of the cervical spinal cord in football players. J Bone Joint Surg Am. 1996;78(9):1308–14.CrossRefGoogle Scholar
  10. 10.
    Bajwa NS, et al. Establishment of parameters for congenital stenosis of the cervical spine: an anatomic descriptive analysis of 1,066 cadaveric specimens. Eur Spine J. 2012;21(12):2467–74.CrossRefGoogle Scholar
  11. 11.
    Wolf BS, Khilnani M, Malis L. The sagittal diameter of the bony cervical spinal canal and its significance in cervical spondylosis. J Mt Sinai Hosp N Y. 1956;23(3):283–92.PubMedGoogle Scholar
  12. 12.
    Smith MG, et al. The prevalence of congenital cervical spinal stenosis in 262 college and high school football players. J Ky Med Assoc. 1993;91(7):273–5.PubMedGoogle Scholar
  13. 13.
    Cantu RC. Cervical spine injuries in the athlete. Semin Neurol. 2000;20(2):173–8.CrossRefGoogle Scholar
  14. 14.
    Cantu RC. Return to play guidelines after a head injury. Clin Sports Med. 1998;17(1):45–60.CrossRefGoogle Scholar
  15. 15.
    Morganti C, et al. Return to play after cervical spine injury. Spine (Phila Pa 1976). 2001;26(10):1131–6.CrossRefGoogle Scholar
  16. 16.
    Morganti C. Recommendations for return to sports following cervical spine injuries. Sports Med. 2003;33(8):563–73.CrossRefGoogle Scholar
  17. 17.
    Dailey A, Harrop JS, France JC. High-energy contact sports and cervical spine neuropraxia injuries: what are the criteria for return to participation? Spine (Phila Pa 1976). 2010;35(21 Suppl):S193–201.CrossRefGoogle Scholar
  18. 18.
    Bailes JE, et al. Management of athletic injuries of the cervical spine and spinal cord. Neurosurgery. 1991;29(4):491–7.CrossRefGoogle Scholar
  19. 19.
    Bailes JE. Experience with cervical stenosis and temporary paralysis in athletes. J Neurosurg Spine. 2005;2(1):11–6.CrossRefGoogle Scholar
  20. 20.
    Vaccaro AR, et al. Cervical spine injuries in athletes: current return-to-play criteria. Orthopedics. 2001;24(7):699–703; quiz 704–5.PubMedGoogle Scholar
  21. 21.
    Vaccaro AR, et al. Return to play criteria for the athlete with cervical spine injuries resulting in stinger and transient quadriplegia/paresis. Spine J. 2002;2(5):351–6.CrossRefGoogle Scholar
  22. 22.
    Tempel ZJ, et al. Significance of T2 hyperintensity on magnetic resonance imaging after cervical cord injury and return to play in professional athletes. Neurosurgery. 2015;77(1):23–30.CrossRefGoogle Scholar
  23. 23.
    Veidlinger OF, et al. Cervical myelopathy and its relationship to cervical stenosis. Spine (Phila Pa 1976). 1981;6(6):550–2.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Frank H. ValoneIII
    • 1
  • Kiehyun Daniel Riew
    • 2
  1. 1.Department of Orthopaedic SurgeryCalifornia Pacific Medical CenterSan FranciscoUSA
  2. 2.Department of Orthopedic SpineNew York Presbyterian/Columbia UniversityNew YorkUSA

Personalised recommendations