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Classification of Injury

Cervical spine injuries can be classified, as described previously, as either catastrophic or noncatastrophic. The vast majority of injuries are noncatastrophic. Catastrophic cervical spine injuries include unstable fractures and dislocations, transient quadriplegia, and acute central disc herniation.

Additionally, some congenital spinal anomalies can place an athlete at increased risk for injury. All these conditions typically produce neurological symptoms and signs that involve the extremities in a bilateral distribution.

As mentioned, only a very small percentage of football and hockey players sustain a catastrophic cervical spine injury. Most cervical spine injuries and injury patterns associated with collision sports do not involve spinal cord injury. In contrast to catastrophic injuries, these common syndromes usually do not affect the extremities in a bilateral fashion.

Most neck-injured athletes display clinical findings in a single upper extremity,  the neck and arm, or the neck only. These syndromes include neuropraxia of the cervical root or brachial plexus (the “stinger” or “burner”), paracentral intervertebral disc herniation, stable fractures, spinal ligament injury, or intervertebral disc injury.

The sports medicine physician’s initial evaluation of an injured athlete’s signs and symptoms may help to distinguish between catastrophic and noncatastrophic injuries on the basis of the structural patterns of injury.

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