Molinari Robert, Molinari William J
University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY 14642, USA.
J Spinal Cord Med. 2010;33(2):163-7. doi: 10.1080/10790268.2010.11689692.
BACKGROUND/OBJECTIVE: Serious cervical spinal injuries in organized youth football are rare. Cervical fracture with neurologic injury is rarely reported in organized youth football players with no pre-existing risk fractures for transient tetraplegia.
Case report and literature review.
After being improperly tackled by an opponent of significantly larger body size, a player sustained a C7 posterior cervical fracture with transient tetraplegia. He was immobilized in a cervical collar and sent to a level 1 trauma center for evaluation. Initial examination showed bilateral paresthesia of the limbs with normal motor function (ASIA D). Initial radiographs of the cervical spine showed a displaced extension-compression fracture of the C7 spinous process. Magnetic resonance imaging of the cervical spine showed edema in the spinal cord in the region of the injury along with significant posterior injury. Imaging studies showed normal volumetric measurements of the spinal canal and no pre-existing risk factors for spinal stenosis or spinal cord injury. Radiographs showed that cervical fracture was healed at 9-month follow-up examination. At 1-year follow-up, the patient was asymptomatic. Radiographs showed healed fracture with no residual instability and full range of cervical spine motion on flexion-extension views.
This case underscores the potential for serious cervical spinal injuries in organized youth sports when players are physically overmatched, and improper tackling technique is used.
背景/目的：在有组织的青少年足球运动中，严重的颈椎损伤很少见。在没有既往短暂性四肢瘫痪风险骨折的有组织青少年足球运动员中，颈椎骨折伴神经损伤的情况鲜有报道。
病例报告及文献综述。
一名球员被体型明显更大的对手不当铲球后，发生了C7颈椎后柱骨折并伴有短暂性四肢瘫痪。他被用颈托固定，并被送往一级创伤中心进行评估。初始检查显示四肢双侧感觉异常但运动功能正常（美国脊髓损伤协会D级）。颈椎的初始X线片显示C7棘突有移位的伸展压缩性骨折。颈椎磁共振成像显示损伤区域脊髓水肿以及严重的后部损伤。影像学检查显示椎管容积测量正常，且无既往存在的椎管狭窄或脊髓损伤风险因素。X线片显示在9个月的随访检查中颈椎骨折已愈合。在1年随访时，患者无症状。X线片显示骨折已愈合，无残余不稳定，屈伸位片上颈椎活动范围正常。
该病例强调了在有组织的青少年体育运动中，当运动员身体条件不匹配且使用不当铲球技术时，发生严重颈椎损伤的可能性。
