Department of Rehabilitation Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, New York.
Department of Biological Sciences, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York.
Clin J Sport Med. 2024 Jan 1;34(1):25-29. doi: 10.1097/JSM.0000000000001179. Epub 2023 Jul 17.
Previous research, including high-quality systematic reviews, has found that cervical injury, which often accompanies concussive head injury, can delay recovery from concussion. One pilot randomized controlled trial found that focused cervical assessment and appropriate intervention in children and young adults with persisting postconcussive symptoms (PPCS) improved recovery outcomes. Our sports medicine clinics adopted this approach early (within 2 weeks) in children (aged 10-18 years) after concussion. This study describes our clinical management protocol and compares the recovery trajectories in children after concussion with and without a concomitant cervical injury.
Prospective cohort study.
Three university-affiliated outpatient sports medicine clinics from September 2016 to December 2019.
One-hundred thirty-four concussed children with cervical impairment (mean age 14.9 years, 65% male, and 6.2 days since concussion) were compared with 130 concussed children without cervical impairment (mean age 14.9 years, 57% male, and 6.0 days since concussion).
Examination findings related to the cervical spine (range of motion, cervical spasm, and cervical tenderness).
Recovery time (measured in days), concussion symptom burden (Postconcussion Symptom Scale), and incidence of PPCS.
Children with cervical impairment reported a higher initial symptom burden; however, there were no differences in recovery time (33.65 [28.20-39.09] days vs 35.98 [27.50-44.45] days, P = 0.651) or incidence of PPCS (40.0% vs 34.3%, P = 0.340).
We conclude that within this pediatric population, early identification and management of cervical injuries concomitant with concussion may reduce the risk of delayed recovery.
包括高质量系统评价在内的既往研究发现，常伴随脑震荡的颈椎损伤可能会延迟脑震荡的恢复。一项初步随机对照试验发现，在持续性脑震荡后症状（PPCS）的儿童和年轻成人中，对颈椎进行集中评估和适当干预可改善恢复结果。我们的运动医学诊所早在脑震荡后 2 周内（10-18 岁）就采用了这种方法。本研究介绍了我们的临床管理方案，并比较了伴有和不伴有颈椎损伤的脑震荡儿童的恢复轨迹。
前瞻性队列研究。
2016 年 9 月至 2019 年 12 月期间，三家附属大学门诊运动医学诊所。
134 名伴有颈椎损伤的脑震荡患儿（平均年龄 14.9 岁，65%为男性，脑震荡后 6.2 天）与 130 名无颈椎损伤的脑震荡患儿（平均年龄 14.9 岁，57%为男性，脑震荡后 6.0 天）进行比较。
与颈椎相关的检查结果（活动范围、颈肌痉挛和颈椎压痛）。
恢复时间（以天为单位）、脑震荡症状负担（脑震荡后症状量表）和 PPCS 的发生率。
伴有颈椎损伤的患儿初始症状负担较高；然而，两组的恢复时间（33.65[28.20-39.09]天 vs 35.98[27.50-44.45]天，P=0.651）或 PPCS 的发生率（40.0% vs 34.3%，P=0.340）均无差异。
我们的结论是，在这个儿科人群中，早期识别和处理与脑震荡同时发生的颈椎损伤可能会降低恢复延迟的风险。
