Tim P. Trupiano is.
J Athl Train. 1997 Apr;32(2):159-62.
To present the case of a high school football player with a burst fracture of the ring of C1 resulting from a "spearing" tackle.
Cervical spine fractures are rare in collision sports, but their potentially grave consequences mean that they must be given special attention. Spearing was banned by the National Collegiate Athletic Association and the National Federation of High School Athletic Associations in 1976, and the number of cervical spine fractures in high school and college football players has fallen dramatically. However, cervical spine fractures do still occur, and they present a diagnostic challenge to sports medicine professionals.
Cervical sprain.
Treatment consists of halo-vest immobilization. Surgical fusion may be necessary for unstable C1-C2 fractures, although initial halo-vest treatment is usually attempted.
A 17-year-old defensive back attempted to make a tackle with his head lowered. He was struck on the superolateral aspect of the helmet by the opposing running back. He remained in the game for another play, but then left the field under his own power, complaining of neck stiffness and headache. Physical examination revealed upper trapezius and occiput tenderness, bilateral cervical muscle spasm, and pain at all extremes of voluntary cervical movement. He was alert and oriented, with a normal neurologic examination. Treatment with ice was attempted but was discontinued due to increased pain and stiffness. Heat resulted in decreased pain and stiffness, but his symptoms persisted, and he was trans- ported to the emergency room. Plain radiographs were read as negative, but a CT scan demonstrated a burst fracture of Cl. He was treated with halo-vest immobilization for 8 weeks and a rigid cervical collar for 8 additional weeks. Physical therapy was then initiated, and normal cervical range of motion and strength were restored within 6 weeks. The athlete competed in track 6 months after the injury and continues to play recreational sports without difficulty. At clinical follow-up 8 months after injury, he had full, painless cervical range of motion and a normal neurologic examination.
A potentially devastating cervical spine injury can present insidiously, without dramatic signs or symptoms. Therefore, sports medicine professionals must retain a high index of suspicion when evaluating athletes with cervical spine complaints.
报告一例因“刺球”而导致 C1 环爆裂骨折的高中橄榄球运动员病例。
颈椎骨折在碰撞性运动中较为罕见，但由于其潜在的严重后果，必须对其给予特别关注。1976 年，美国全国大学体育协会和全国高中体育协会禁止了“刺球”动作，此后，高中和大学橄榄球队员的颈椎骨折数量大幅下降。然而，颈椎骨折仍时有发生，这给运动医学专业人员带来了诊断挑战。
颈椎扭伤。
治疗方法包括使用头环背心进行固定。对于不稳定的 C1-C2 骨折，可能需要进行手术融合，但通常会先尝试初始的头环背心治疗。
一名 17 岁的防守后卫试图低头进行铲球。他的头盔外上侧被对方的跑卫撞击。他又在场上进行了一次比赛，然后自行离开场地，抱怨颈部僵硬和头痛。体格检查显示斜方肌上部和枕骨触痛，双侧颈肌痉挛，以及在所有主动颈椎活动范围内疼痛。他意识清醒，定向正常，神经检查正常。尝试了冰敷治疗，但因疼痛和僵硬加剧而停止。热敷减轻了疼痛和僵硬，但他的症状仍持续存在，随后被送往急诊室。平片检查结果为阴性，但 CT 扫描显示 C1 爆裂骨折。他接受了 8 周的头环背心固定治疗和 8 周的硬颈圈固定治疗。随后开始进行物理治疗，6 周内恢复了正常的颈椎活动范围和力量。受伤后 6 个月，该运动员参加了田径比赛，此后继续参加休闲运动而无困难。受伤后 8 个月的临床随访时，他的颈椎活动范围完全无痛且神经检查正常。
潜在的破坏性颈椎损伤可能表现得很隐匿，没有明显的症状或体征。因此，运动医学专业人员在评估有颈椎不适的运动员时，必须保持高度怀疑。
