![]() ![]() 1 Major CSIs, although rare compared with sprain and strain injuries to the extremities, are troubling because of mortality rates and the potential permanent loss of neural function. This is evidenced by a multiprofessional task force effort initiated by the National Athletic Trainers' Association to establish general guidelines for the acute care of the spine-injured athlete. Injury biomechanics in the cervical spine are complex, and much can still be learned about mechanisms of the cervical spine injury specific to sports.īecause of the potentially catastrophic and life-altering nature of cervical spine injury (CSI), much concern exists regarding the prehospital management of the cervical spine–injured athlete. However, the cervical spine is unique in its normal kinematics compared with joints of the extremities. Impact location and head orientation affect the degree and level of resultant injury.Ĭonclusions/Recommendations: As with any joint of the body, our understanding of the mechanisms of cervical spine injury will ultimately serve to reduce their occurrence and increase the likelihood of recognition and immediate care. The reaction of the cervical spine to an axial-load impact has been investigated using cadaver specimens and demonstrates a buckling effect. Furthermore, vertebral movement in 1 plane often requires contributed movement in 1 or 2 other planes. Instead, individual vertebrae may experience a reversal of motion while traveling through a single plane of movement. The movement into a single plane is not the product of equal and summative movement between and among all cervical vertebrae. Alternate methods of impairment evaluation should be developed that are more specific for individuals with true functional impairment and that account for age-related differences in spinal motion.Objective: To provide a foundation of knowledge concerning the functional anatomy, kinematic response, and mechanisms involved in axial-compression cervical spine injury as they relate to sport injury.ĭata Sources: We conducted literature searches through the Index Medicus, SPORT Discus, and PubMed databases and the Library of Congress from 1975–2003 using the key phrases cervical spine injury, biomechanics of cervical spine, football spinal injuries, kinematics of the cervical spine, and axial load.ĭata Synthesis: Research on normal kinematics and minor and major injury mechanisms to the cervical spine reveals the complex nature of movement in this segment. Impairment may be overestimated by up to 38%. The current method of impairment determination based on spinal motion may not accurately reflect impairment in many patients. The level of impairment increased with age for cervical, lumbar, and total impairment percentages (p = 0.0001). Based on the AMA criteria, all of the normal subjects were noted to have some degree of impairment ranging from 2 to 38.5%, with a mean value of 10.8%. Ninety-five individual measurements of cervical and lumbar spine motion were performed on each of 81 healthy subjects by two examiners using the double-inclinometer method. The purpose of this investigation was to test the validity of this concept by determining spinal impairment in normal subjects using one of the more popular rating systems, the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment. The validity of using spinal motion as the primary variable for impairment ratings must be questioned because of the large spectrum of age-related changes in motion in a normal population. Spinal range of motion is a major determinant of impairment in many disability rating schedules used today. ![]()
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