Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.
Chicago Medical School at Rosalind and Franklin University of Medicine and Science, Chicago, IL.
Spine (Phila Pa 1976). 2021 Jul 1;46(13):886-892. doi: 10.1097/BRS.0000000000003931.
Literature-based review.
We sought to evaluate clinical and case studies related to return to play (RTP) after cervical spine injuries in elite American football athletes and to formulate guidelines to help health care practitioners manage these conditions.
American football athletes are at unique risk of cervical spine injury and appropriate case-by-case management of cervical spine injuries is necessary for these athletes. Despite this need, no standardized guidelines exist for RTP after cervical spine injury.
Observational or case-based articles relating to RTP after cervical spine injury in American football athletes were curated from PubMed/EMBASE databases. Primary literature published before December 1, 2019 involving National Football League (NFL) or National Collegiate Athletic Association (NCAA) athletes met inclusion criteria.
The data acquisition process yielded 28 studies addressing cervical spine injuries and RTP in American football athletes. Stingers/burners were the most common injury and placed athletes at higher risk of a more severe re-injury. Transient quadriplegia, cervical stenosis, cervical disc herniation (CDH), and cervical fractures have a more significant impact on the long-term health and career longevity of the American football athlete. As such, the literature offers some guidance for management of these athletes, including average time for RTP in patients treated nonoperatively, thresholds involving cervical stenosis, and postoperative recommendations after spinal decompression and/or fusion surgery.
Elite American football athletes are at high risk for cervical spine injury due to the nature of their sport. The decision to allow these athletes to return to play should involve an understanding of the average RTP time, the potential risks of recurrence or re-injury, and individual characteristics such as position played and pathology on imaging.Level of Evidence: 3.
文献回顾。
我们旨在评估与精英美式足球运动员颈椎损伤后重返赛场（RTP）相关的临床和病例研究，并制定指导方针，以帮助医疗保健从业者管理这些情况。
美式足球运动员面临颈椎损伤的独特风险，需要对颈椎损伤进行个案管理。尽管有这种需求，但颈椎损伤后 RTP 尚无标准化指南。
从 PubMed/EMBASE 数据库中精选出与美式足球运动员颈椎损伤后 RTP 相关的观察性或基于病例的文章。主要文献为 2019 年 12 月 1 日之前发表的涉及国家橄榄球联盟（NFL）或全国大学生体育协会（NCAA）运动员的文献，符合纳入标准。
数据获取过程共产生了 28 篇研究文章，涉及美式足球运动员的颈椎损伤和 RTP。刺痛/灼伤是最常见的损伤，使运动员面临更高的再次严重损伤风险。一过性四肢瘫痪、颈椎狭窄、颈椎间盘突出症（CDH）和颈椎骨折对美式足球运动员的长期健康和职业寿命有更重大的影响。因此，文献为这些运动员的管理提供了一些指导，包括非手术治疗患者的 RTP 平均时间、涉及颈椎狭窄的阈值以及脊柱减压和/或融合手术后的术后建议。
由于运动性质的原因，精英美式足球运动员颈椎损伤的风险较高。允许这些运动员重返赛场的决定应涉及对平均 RTP 时间、复发或再损伤的潜在风险以及个人特征（如所扮演的位置和影像学上的病理学）的理解。
3 级。
