Torg J S, Ramsey-Emrhein J A
Allegheny University for Health Sciences, Philadelphia, PA, 19102-1192, USA.
Phys Sportsmed. 1997 Jul;25(7):61-88. doi: 10.3810/psm.1997.07.1487.
Great care is required in managing cervical spine and brachial plexus injuries. Athletes who suffer one or more burners (transient brachial plexus injuries) may return to contact activity when they are asymptomatic and neurologically normal and have full cervical motion. A vertebra displaced horizontally more than 3.5 mm or rotated more than 11 degrees is an absolute contraindication to contact sports. Cervical cord neurapraxia is generally benign, but patients should be counseled about the probability of recurrence, depending on the spinal canal/vertebral body ratio. Unresolved spear tackler's spine is an absolute contraindication to collision sports, as are axial-load teardrop fracture and cervical spine fusion of more than three levels. Spinal cord resuscitation can include blood pressure maintenance and timely methylprednisolone.
处理颈椎和臂丛神经损伤时需要格外小心。遭受一次或多次“烧灼样”损伤(短暂性臂丛神经损伤)的运动员,在无症状、神经功能正常且颈椎活动完全正常时,可恢复接触性运动。水平移位超过3.5毫米或旋转超过11度的椎体是接触性运动的绝对禁忌证。颈髓神经失用症一般为良性,但应根据椎管/椎体比值向患者说明复发的可能性。未解决的“擒抱者脊柱”是碰撞性运动的绝对禁忌证,轴向负荷泪滴形骨折和超过三个节段的颈椎融合也是如此。脊髓复苏可包括维持血压和及时使用甲基强的松龙。