1. Management of degenerative neck disease in sportsm M Taha, B Mathew
Hull Royal Infirmary, Hull, UK
Introduction:
Every spinal surgeon will be faced at some stage of his career with a sportsman suffering from acute or chronic cervical disc. Any type of treatment whether conservative or surgical will have a significant impact on sportsman’ future career.
Objective:
The aim of the study is to present our series and experience in this field and to do a literature search to see if there is any real evidence of how to treat this group of patients.
Methods:
Retrospective review of all cases of athletes with degenerative neck disease treated by the senior author over the last 5 years.
A medline search of neck injury/ disease in sportsmen/ athletes was carried out ( 1966 till now)
Results:
Our series
10 patients, all male
Age ( 46-23, mean: 33)
Rugby player(6, 3 retired), golfer(2) , footballer(1), and tennis player(1)
4 professional
Radiculopathy: 8
Radiculo-myelopathy: 1
Neck pain only: 1
6 patients treated with surgery and 4 non-operatively.
All patients had a good outcome, and majority return to play within 3 months
Literature search
Neck injuries: 36 articles
Cervical canal stenosis and stingers ( neuropraxia): 5
Degenerative cervical disc disease: 3 articles only.
Recommendation
Management similar to non-athletes
Conservative unless
- persistent, recurrent radicular
pain
- persistent, progressive deficit
- myelopathy
Surgery: always fusion
Return to play:
No neck pain or neurological symptoms
Full, and painless ROM of the neck
Evidence of fusion( op group)
Case 1
23, M , professional footballer.
3 weeks of acute neck and right arm pain.
O/E: - restricted neck ROM
- 4/5 power of R. triceps
- absent TJ
- reduced C7 sensation
No improvement with pain killer or physiotherapy
Patient operated
Good outcome, return to play
Case 2
28, M , Rugby league player
3/52 Gradual onset of left arm
Brachalgia after a tackle
O/E: - mild neck ROM
- slight weakness of wrist extension
- reduced C6 dermatome sensation
- reflexes intact
Conservative treatment,
good outcome
Return to play
REFERENCES: C.P.O’Brien: “Rugby Neck”: Cervical Degeneration in Two Front Row Rugby Union Players. Clinical Journal of Sport Medicine. 1996;6(1): S.C.Scherping, JR: Cervical Disc Disease in the Athlete. Clinics in Sports Medicine. 2002; 21(1): Katherine L. Dec: Non-operative Versus Operative Treatment of Acute Disc Injuries in Athletes. Current Sports Medicine Reports. 2002,1:35-42