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Cervical Stenosis in theĀ Elite Athlete

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Spinal Conditions in the Athlete

Abstract

There is limited evidence available on treating the elite athlete with cervical stenosis. While many of the treatment principles from the general population can be applied to the elite athlete, the rigors of their sport require a nuanced, case-by-case approach. The presentation of cervical stenosis can range from an asymptomatic radiographic finding to quadriparesis. Return to play (RTP) for professional athletes with cervical stenosis is a controversial topic. Clinical history, physical exam, imaging characteristics, and sport played are the four critical factors to consider when providing recommendation to the elite athlete with CS. Most athletes can successfully RTP after a single-level anterior cervical discectomy and fusion (ACDF), and players have also RTP after multilevel procedures.

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References

  1. Vaccaro AR, Watkins B, Albert TJ, Pfaff WL, Klein GR, Silber JS. Cervical spine injuries in athletes: current return-to-play criteria. Orthopedics. 2001;24(7):699ā€“703.

    CASĀ  PubMedĀ  Google ScholarĀ 

  2. Hecht AC, editor. Spine injuries in athletes. Philadelphia: Wolters Kluwer; 2017.

    Google ScholarĀ 

  3. Hsu WK. Outcomes following nonoperative and operative treatment for cervical disc herniations in National Football League athletes. Spine. 2011;36(10):800ā€“5.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  4. Pollard H, Hansen L, Hoskins W. Cervical stenosis in a professional rugby league football player: a case report. Chiropr Osteopat. 2005;13:15.

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  5. Schroeder GD, Lynch TS, Gibbs DB, et al. The impact of a cervical spine diagnosis on the careers of National Football League athletes. Spine. 2014;39(12):947ā€“52.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  6. Aebli N, Ruegg TB, Wicki AG, Petrou N, Krebs J. Predicting the risk and severity of acute spinal cord injury after a minor trauma to the cervical spine. Spine J: Off J N Am Spine Soc. 2013;13(6):597ā€“604.

    ArticleĀ  Google ScholarĀ 

  7. Brigham CD, Capo J. Cervical spinal cord contusion in professional athletes: a case series with implications for return to play. Spine. 2013;38(4):315ā€“23.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  8. Dailey A, Harrop JS, France JC. High-energy contact sports and cervical spine neuropraxia injuries: what are the criteria for return to participation? Spine. 2010;35(21 Suppl):S193ā€“201.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  9. Torg JS, Ramsey-Emrhein JA. Suggested management guidelines for participation in collision activities with congenital, developmental, or postinjury lesions involving the cervical spine. Med Sci Sports Exerc. 1997;29(7 Suppl):S256ā€“72.

    CASĀ  PubMedĀ  Google ScholarĀ 

  10. Kepler CK, Vaccaro AR. Injuries and abnormalities of the cervical spine and return to play criteria. Clin Sports Med. 2012;31(3):499ā€“508.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  11. Grant TT, Puffer J. Cervical stenosis: a developmental anomaly with quadriparesis during football. Am J Sports Med. 1976;4(5):219ā€“21.

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  12. Bailes JE. Experience with cervical stenosis and temporary paralysis in athletes. J Neurosurg Spine. 2005;2(1):11ā€“6.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  13. Torg JS. Cervical spinal stenosis with cord neurapraxia: evaluations and decisions regarding participation in athletics. Curr Sports Med Rep. 2002;1(1):43ā€“6.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  14. Cantu RC. Stingers, transient quadriplegia, and cervical spinal stenosis: return to play criteria. Med Sci Sports Exerc. 1997;29(7 Suppl):S233ā€“5.

    CASĀ  Google ScholarĀ 

  15. Torg JS, Pavlov H, Genuario SE, et al. Neurapraxia of the cervical spinal cord with transient quadriplegia. J Bone Joint Surg Am. 1986;68(9):1354ā€“70.

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  16. Cantu RC. Functional cervical spinal stenosis: a contraindication to participation in contact sports. Med Sci Sports Exerc. 1993;25(3):316ā€“7.

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  17. Fagan K. Transient quadriplegia and return-to-play criteria. Clin Sports Med. 2004;23(3):409ā€“19.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  18. Ladd AL, Scranton PE. Congenital cervical stenosis presenting as transient quadriplegia in athletes. Report of two cases. J Bone Joint Surg Am. 1986;68(9):1371ā€“4.

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  19. Chang D, Bosco JA. Cervical spine injuries in the athlete. Bull NYU Hosp Jt Dis. 2006;64(3ā€“4):119ā€“29.

    Google ScholarĀ 

  20. Bailes JE, Petschauer M, Guskiewicz KM, Marano G. Management of cervical spine injuries in athletes. J Athl Train. 2007;42(1):126ā€“34.

    PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  21. Schroeder GD, Vaccaro AR. Cervical spine injuries in the athlete. J Am Acad Orthop Surg. 2016;24(9):e122ā€“33.

    ArticleĀ  Google ScholarĀ 

  22. Jenkins TJ, Mai HT, Burgmeier RJ, Savage JW, Patel AA, Hsu WK. The triangle model of congenital cervical stenosis. Spine. 2016;41(5):E242ā€“7.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  23. Triantafillou KM, Lauerman W, Kalantar SB. Degenerative disease of the cervical spine and its relationship to athletes. Clin Sports Med. 2012;31(3):509ā€“20.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  24. Huang P, Anissipour A, McGee W, Lemak L. Return-to-play recommendations after cervical, thoracic, and lumbar spine injuries: a comprehensive review. Sports health. 2016;8(1):19ā€“25.

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  25. Cantu RC, Li YM, Abdulhamid M, Chin LS. Return to play after cervical spine injury in sports. Curr Sports Med Rep. 2013;12(1):14ā€“7.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  26. Maroon JC, El-Kadi H, Abla AA, et al. Cervical neurapraxia in elite athletes: evaluation and surgical treatment. Report of five cases. J Neurosurg Spine. 2007;6(4):356ā€“63.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  27. Paulus S, Kennedy DJ. Return to play considerations for cervical spine injuries in athletes. Phys Med Rehabil Clin N Am. 2014;25(4):723ā€“33.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  28. Davis G, Ugokwe K, Roger EP, et al. Clinics in neurology and neurosurgery of sport: asymptomatic cervical canal stenosis and transient quadriparesis. Br J Sports Med. 2009;43(14):1154ā€“8.

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  29. Chatley A, Kumar R, Jain VK, Behari S, Sahu RN. Effect of spinal cord signal intensity changes on clinical outcome after surgery for cervical spondylotic myelopathy. J Neurosurg Spine. 2009;11(5):562ā€“7.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  30. Zhou Y, Kim SD, Vo K, Riew KD. Prevalence of cervical myelomalacia in adult patients requiring a cervical magnetic resonance imaging. Spine. 2015;40(4):E248ā€“52.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  31. Meredith DS, Jones KJ, Barnes R, Rodeo SA, Cammisa FP, Warren RF. Operative and nonoperative treatment of cervical disc herniation in National Football League athletes. Am J Sports Med. 2013;41(9):2054ā€“8.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  32. Joaquim AF, Hsu WK, Patel AA. Cervical spine surgery in professional athletes: a systematic review. Neurosurg Focus. 2016;40(4):E10.

    ArticleĀ  Google ScholarĀ 

  33. Albright JP, Moses JM, Feldick HG, Dolan KD, Burmeister LF. Nonfatal cervical spine injuries in interscholastic football. JAMA. 1976;236(11):1243ā€“5.

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  34. Mai HT, Chun DS, Schneider AD, Hecht AC, Maroon JC, Hsu WK. The difference in clinical outcomes after anterior cervical fusion, disk replacement, and foraminotomy in professional athletes. Clin Spine Surg. 2018;31(1):E80ā€“4.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  35. Roberts DW, Roc GJ, Hsu WK. Outcomes of cervical and lumbar disk herniations in Major League Baseball pitchers. Orthopedics. 2011;34(8):602ā€“9.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  36. Maroon JC, Bost JW, Petraglia AL, et al. Outcomes after anterior cervical discectomy and fusion in professional athletes. Neurosurgery. 2013;73(1):103ā€“12; discussion 112.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  37. Molinari RW, Pagarigan K, Dettori JR, Molinari R Jr, Dehaven KE. Return to play in athletes receiving cervical surgery: a systematic review. Global spine journal. 2016;6(1):89ā€“96.

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  38. Andrews J, Jones A, Davies PR, Howes J, Ahuja S. Is return to professional rugby union likely after anterior cervical spinal surgery? J Bone Joint Surg. 2008;90(5):619ā€“21.

    ArticleĀ  CASĀ  Google ScholarĀ 

  39. Sasso RC, Smucker JD, Hacker RJ, Heller JG. Artificial disc versus fusion: a prospective, randomized study with 2-year follow-up on 99 patients. Spine. 2007;32(26):2933ā€“40.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  40. Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA. Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg Spine. 2007;6(3):198ā€“209.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  41. Murrey D, Janssen M, Delamarter R, et al. Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J: Off J N Am Spine Soc. 2009;9(4):275ā€“86.

    ArticleĀ  Google ScholarĀ 

  42. Kang DG, Anderson JC, Lehman RA Jr. Return to play after cervical disc surgery. Clin Sports Med. 2016;35(4):529ā€“43.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  43. Reinke A, Behr M, Preuss A, Villard J, Meyer B, Ringel F. Return to sports after cervical Total disc replacement. World Neurosurg. 2017;97:241ā€“6.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  44. Kang DG, Lehman RA, Tracey RW, Cody JP, Rosner MK, Bevevino AJ. Outcomes following cervical disc arthroplasty in an active duty military population. J Surg Orthop Adv. 2013;22(1):10ā€“5.

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  45. Cleveland A, Herzog J, Caram P. The occupational impact of single-level cervical disc arthroplasty in an active duty military population. Mil Med. 2015;180(11):1196ā€“8.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  46. Tumialan LM, Ponton RP, Garvin A, Gluf WM. Arthroplasty in the military: a preliminary experience with ProDisc-C and ProDisc-L. Neurosurg Focus. 2010;28(5):E18.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  47. Burnett MG, Sonntag VK. Return to contact sports after spinal surgery. Neurosurg Focus. 2006;21(4):E5.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  48. Torg JS. Cervical spine injuries and the return to football. Sports health. 2009;1(5):376ā€“83.

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  49. Tumialan LM, Ponton RP, Gluf WM. Management of unilateral cervical radiculopathy in the military: the cost effectiveness of posterior cervical foraminotomy compared with anterior cervical discectomy and fusion. Neurosurg Focus. 2010;28(5):E17.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

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Jenkins, T.J., Rhee, J.M., Heller, J.G. (2020). Cervical Stenosis in theĀ Elite Athlete. In: Hsu, W., Jenkins, T. (eds) Spinal Conditions in the Athlete. Springer, Cham. https://doi.org/10.1007/978-3-030-26207-5_12

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  • DOI: https://doi.org/10.1007/978-3-030-26207-5_12

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