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硬膜外类固醇注射治疗精英摔跤运动员的颈神经根病:病例系列及文献综述

Epidural steroid injections for the treatment of cervical radiculopathy in elite wrestlers: case series and literature review.

作者信息

Clark Randy, Doyle Matthew, Sybrowsky Christian, Rosenquist Richard

出版信息

Iowa Orthop J. 2012;32:207-14.

Abstract

BACKGROUND

Elite wrestlers place tremendous stress through their cervical spine. These athletes are at risk for cervical trauma and may develop radiculopathy from recurrent episodes of injury. Team physicians and athletic trainers are faced with the challenge of treating these injuries in such a way as to allow the athlete to safely and expeditiously return to competition. Epidural steroid injections can be a successful complement to a conservative treatment algorithm for these complex injuries.

STUDY DESIGN

Case Series.

METHODS

Five upper-level NCAA collegiate wrestlers who experienced symptomatic cervical radiculopathy were identified from an archival review. The majority of the athletes had MRI evidence of cervical disc disease, with corresponding subjective complaints and physical examination findings including pain and weakness that precluded continued competition. All athletes were treated conservatively with initial activity modification, strengthening, rehabilitation, NSAIDs, and, ultimately, cervical epidural steroid injections.

RESULTS

All five athletes successfully returned to competition without negative clinical sequelae or need for operative intervention. The athletes demonstrated subjective improvement in their symptoms and strength, and all were able to return to a high level of competition. The cervical epidural steroid injections were found to be safe, effective, and well tolerated in all of the athletes.

CONCLUSIONS

Elite wrestlers with cervical radiculopathy can be effectively and safely managed with a conservative regimen that includes cervical epidural steroid injections, which may allow them to continue to compete at a high level.

摘要

背景

精英摔跤运动员的颈椎承受着巨大压力。这些运动员有颈椎创伤的风险,且可能因反复受伤而患上神经根病。队医和运动训练师面临着以让运动员安全、迅速重返比赛的方式治疗这些损伤的挑战。硬膜外类固醇注射可以成为这些复杂损伤保守治疗方案的成功补充。

研究设计

病例系列。

方法

通过档案回顾确定了5名有症状性颈椎神经根病的美国大学体育协会(NCAA)高水平大学摔跤运动员。大多数运动员有颈椎间盘疾病的MRI证据,伴有相应的主观症状和体格检查发现,包括疼痛和无力,这使得他们无法继续比赛。所有运动员最初均接受保守治疗,包括调整活动、加强锻炼、康复训练、使用非甾体抗炎药(NSAIDs),最终进行颈椎硬膜外类固醇注射。

结果

所有5名运动员均成功重返比赛,无不良临床后遗症,也无需手术干预。运动员们的症状和力量有主观改善,所有人都能够重返高水平比赛。发现颈椎硬膜外类固醇注射在所有运动员中都是安全、有效的,且耐受性良好。

结论

患有颈椎神经根病的精英摔跤运动员可以通过包括颈椎硬膜外类固醇注射在内的保守方案进行有效且安全的管理,这可能使他们能够继续在高水平比赛中竞争。

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