~1.2 million hs / 200,000 college & pro athletes largest number of sports-related injuries...
TRANSCRIPT
![Page 1: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/1.jpg)
~1.2 million HS / 200,000 college & pro athletes
Largest number of sports-related injuries among organized team sports in the United States
Spinal injuries in American football: Helmet to helmet Helmet contact with another body part Helmet to ground contact
Most studied sport
![Page 2: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/2.jpg)
196 HS and college spinal injuries 1989-2002
Incidence: 1.10 / 100,000 high school 4.72 / 100,000 college
Quadriplegia in 76 (38.8%) patients 5.85 /100,000 per year
“Spear” tackling predominant activity resulting in quadriplegia
Axial loading > hyperflexion and hyperextension
Boden BP, et al. Catastrophic cervical spine injuries in high school and college football players. Am J Sports Med 2006; 34(8): 1223-1232
![Page 3: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/3.jpg)
National Football Head and Neck Injury Registry > 1300 documented cervical spine
injuriesAnti-spearing rules established in 1976
88% reduction of spinal injuries by 1994 Anti-spearing rule coupled with better
coaching of blocking and tackling techniques has reduced football-related spinal injuries
Mueller FO. Fatalities from brain and cervical spine injuries in tackle football: 54 years' experience. Neurologic Athletic Head and Spine Injuries. Philadelphia, PA: WB Saunders; 2000:242–251.
![Page 4: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/4.jpg)
Vertebral artery injury
![Page 5: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/5.jpg)
![Page 6: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/6.jpg)
![Page 7: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/7.jpg)
~ 6500 pts / year in US Emergency Depts High risk of long-term morbidity and
mortality Male teenagers and young adults >50% of injuries occur in <4 ft of water 1.2-21% of all spinal cord injuries thought
to be due to diving related injuries Cervical spine is almost always involved
![Page 8: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/8.jpg)
Almost always axial loading Neck is flexed slightly +/- hyperflexion
Body weight generates axial load 70% are C5–C7 Flexion teardrop/burst fractures
~60%
![Page 9: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/9.jpg)
Jefferson FractureJefferson Fracture*
![Page 10: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/10.jpg)
![Page 11: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/11.jpg)
*
![Page 12: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/12.jpg)
![Page 13: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/13.jpg)
*
![Page 14: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/14.jpg)
![Page 15: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/15.jpg)
Articular facet fracture
Vertebral artery injury
![Page 16: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/16.jpg)
Gravity Gravity and and
collisions!collisions!
![Page 17: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/17.jpg)
Jefferson FractureJefferson Fracture
*
![Page 18: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/18.jpg)
57 yo diving accident 18 yo skiing accident
![Page 19: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/19.jpg)
Initial CT
![Page 20: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/20.jpg)
![Page 21: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/21.jpg)
![Page 22: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/22.jpg)
Type III Odontoid and C7 Spinous Process Fractures
![Page 23: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/23.jpg)
![Page 24: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/24.jpg)
![Page 25: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/25.jpg)
![Page 26: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/26.jpg)
C1-C2 rotatory subluxation
![Page 27: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/27.jpg)
Sports-related spinal injuries are a significant source of long-term morbidity and mortality
Mechanism of injury Injury pattern CT = primary imaging modality for the
evaluation of the potentially injured spine
Diagnostic work-up same as for other more common blunt mechanisms
![Page 28: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/28.jpg)
What is the estimated pooled sensitivity of radiography for the detection of cervical spine fractures?
A. 32% B. 52% C. 72% D. 92%
Holmes et al 2005 Meta-analysis Calculated pooled sensitivity
Radiography = 52% CT = 98% Holmes et al. Computed
tomography versus plain radiography to screen for cervical spine injury: a meta-analysis. J Trauma 2005;58(5):902-905
![Page 29: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/29.jpg)
What is the most common mechanism of injury for patients with cervical spine fractures following a shallow water diving injury?
A. Axial loading B. Axial loading with hyperflexion C. Hyperflexion D. Rotation E. Hyperextension
![Page 30: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/30.jpg)
What is the most common fracture pattern involving C2?
A. Hyperflexion burst B. Hangman fracture C. Odontoid fracture D. Articular pillar fracture E. Hyperextension teardrop
![Page 31: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/31.jpg)
What is the incidence of spinal cord injuries in the setting of hyperflexion burst fractures?
A. 65% B. 75% C. 85% D. 95%
![Page 32: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/32.jpg)
![Page 33: ~1.2 million HS / 200,000 college & pro athletes Largest number of sports-related injuries among organized team sports in the United States Spinal](https://reader038.vdocument.in/reader038/viewer/2022110402/56649e385503460f94b28d28/html5/thumbnails/33.jpg)