Evaluation and Management of Athletic Injuries of the Cervical Spine

Cervical spine injuries (CSIs) can be a serious and devastating occurrence in athletes. These injuries happen primarily to athletes involved in the contact sports of football, wrestling, and ice hockey, with football injuries constituting the largest number of cases. There are three types of cervical spinal cord injuries (SCIs) based on clinical and radiographic findings. Type I injuries range from immediate and complete paralysis below the level of injury to various patterns of incomplete SCI. All injuries within this category have demonstrable radiographic abnormalities consistent with the neurological deficit. Type II injuries consist of transient neurological symptoms and are radiographically occult. Type III injuries consist of radiographic abnormalities without neurological deficit. Decisions regarding return to play for athletes who suffer a CSI are made by expert opinion and consensus that has evolved primarily over the past two decades. The recommendations provided in the literature represent a conglomerate of the advice and experience of experts in the field of sport-related CSI.