Division of Orthopaedic Surgery, Univeristy of Cape Town, South Africa.
S Afr Med J. 2010 Mar 30;100(4):235-8. doi: 10.7196/samj.3489.
To review the incidence of all rugby-associated cervical spine injuries in the Western Cape and identify risk factors.
We reviewed case notes and X-rays of 27 male patients with rugby-related cervical spine injuries treated in the acute spinal injury (ASCI) unit at Groote Schuur Hospital from April 2003 to June 2008, and followed up with telephone interviews. Patient profile, rugby profile, subsequent injury management from the field to definitive surgery and neurological status on admission, discharge and follow-up using the American Spinal Injury Association (ASIA) classification were assessed.
Average patient age was 25.3 years; 19% of them were scholars. The highest level of education among the adults was primary school in 70% of cases. Forwards and backs had the same injury rate. Most injuries occurred outside the metropole; more occurred in the tackling phase; 39% occurred during foul play; a third of players were not stabilised with a collar on the field; and 65% were taken to an inappropriate primary contact centre. A median of 10 hours elapsed before admission to the ASCI unit. Facet dislocations occurred in 59%; 8 presented neurologically complete and remained so; and 3 presented with residual sensation, with 2 improving to normal. Three presented as ASIA C improving to D, and all Ds improved to Es. Despite their injuries, 60% said they would advise their sons to play rugby. Only 22% regretted playing.
Despite a reduction in cervical spine injuries in rugby in the Western Cape, the latter mostly occur outside the metropole, where levels of education are lower, foul play is more often associated with the injury, and rapid access to medical care is generally unavailable.
回顾西开普省所有与橄榄球相关的颈椎损伤的发生率，并确定危险因素。
我们回顾了 2003 年 4 月至 2008 年 6 月期间在格罗特舒尔医院急性脊柱损伤（ASCI）病房接受治疗的 27 名男性橄榄球相关颈椎损伤患者的病历和 X 光片，并通过电话采访进行了随访。评估了患者特征、橄榄球特征、从现场到确定性手术的后续损伤管理以及入院、出院和随访时的美国脊柱损伤协会（ASIA）分类的神经状态。
平均患者年龄为 25.3 岁；19%的患者是学者。成年人中最高的教育水平是 70%的小学。前锋和后卫的受伤率相同。大多数损伤发生在大都市之外；更多发生在擒抱阶段；39%发生在犯规行为中；三分之一的球员在现场没有用颈托固定；65%的人被送往不适当的初级接触中心。中位数为 10 小时前被送往 ASCI 病房。小关节脱位发生率为 59%；8 例出现完全性神经损伤且保持不变；3 例出现残留感觉，其中 2 例改善至正常。3 例表现为 ASIA C 改善为 D，所有 D 改善为 E。尽管他们受伤了，但 60%的人表示他们会建议他们的儿子踢橄榄球。只有 22%的人后悔踢橄榄球。
尽管西开普省橄榄球的颈椎损伤有所减少，但后者主要发生在大都市之外，那里的教育水平较低，犯规行为更常与损伤相关，而且通常无法获得快速的医疗服务。
