Return to play in athletes with spinal cord concussion: a systematic literature review

Narihito Nagoshi, Lindsay Tetreault, Hiroaki Nakashima, Aria Nouri, Michael G. Fehlings

研究成果: Review article

4 引用 (Scopus)

抄録

Study Design This is a systematic review. Purpose The study aimed to evaluate whether spinal cord concussion (SCC) patients can safely return to play sports and if there are factors that can predict SCC recurrence or the development of a spinal cord injury (SCI). Background Context Although SCC is a reversible neurologic disturbance of spinal cord function, its management and the implications for return to play are controversial. Methods We conducted a systematic search of the literature using the keywords Cervical Spine AND Sports AND Injuries in six databases. We examined return to play in patients (1) without stenosis, (2) with stenosis, and (3) who underwent single-level anterior cervical discectomy and fusion (ACDF). We also investigated predictors for the risk of SCC recurrence or SCI. Results We identified 3,655 unique citations, 16 of which met our inclusion criteria. The included studies were case-control studies or case series and reports. Two studies reported on patients without stenosis: pediatric cases returned without recurrence, whereas an adult case experienced recurrent SCC after returning to play. Seven studies described patients with stenosis. These studies included cases with and without recurrence after return to play, as well as patients who suffered SCI with permanent neurologic deficits. Three studies reported on patients who underwent an ACDF. Although some patients played after surgery without problems, several patients experienced recurrent SCC due to herniation at levels adjacent to the surgical sites. With respect to important predictors, a greater frequency of patients who experienced recurrence of symptoms or SCI following return to play had a “long” duration of symptoms (>24 hours; 36.36%) compared with those who were problem-free (11.11%; p=.0311). Conclusions There is limited evidence on current practice standards for return to play following SCC and important risk factors for SCC recurrence or SCI. Because of small sample sizes, future prospective multicenter studies are needed to determine important predictive factors of poor outcomes following return to play after SCC.

元の言語English
ページ(範囲)291-302
ページ数12
ジャーナルSpine Journal
17
発行部数2
DOI
出版物ステータスPublished - 2017 2 1

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Athletes
Spinal Cord
Spinal Cord Injuries
Recurrence
Pathologic Constriction
Diskectomy
Return to Sport
Athletic Injuries
Neurologic Manifestations
Sample Size
Nervous System
Multicenter Studies
Case-Control Studies
Spine
Databases
Prospective Studies
Pediatrics

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

これを引用

Return to play in athletes with spinal cord concussion : a systematic literature review. / Nagoshi, Narihito; Tetreault, Lindsay; Nakashima, Hiroaki; Nouri, Aria; Fehlings, Michael G.

:: Spine Journal, 巻 17, 番号 2, 01.02.2017, p. 291-302.

研究成果: Review article

Nagoshi, Narihito ; Tetreault, Lindsay ; Nakashima, Hiroaki ; Nouri, Aria ; Fehlings, Michael G. / Return to play in athletes with spinal cord concussion : a systematic literature review. :: Spine Journal. 2017 ; 巻 17, 番号 2. pp. 291-302.
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abstract = "Study Design This is a systematic review. Purpose The study aimed to evaluate whether spinal cord concussion (SCC) patients can safely return to play sports and if there are factors that can predict SCC recurrence or the development of a spinal cord injury (SCI). Background Context Although SCC is a reversible neurologic disturbance of spinal cord function, its management and the implications for return to play are controversial. Methods We conducted a systematic search of the literature using the keywords Cervical Spine AND Sports AND Injuries in six databases. We examined return to play in patients (1) without stenosis, (2) with stenosis, and (3) who underwent single-level anterior cervical discectomy and fusion (ACDF). We also investigated predictors for the risk of SCC recurrence or SCI. Results We identified 3,655 unique citations, 16 of which met our inclusion criteria. The included studies were case-control studies or case series and reports. Two studies reported on patients without stenosis: pediatric cases returned without recurrence, whereas an adult case experienced recurrent SCC after returning to play. Seven studies described patients with stenosis. These studies included cases with and without recurrence after return to play, as well as patients who suffered SCI with permanent neurologic deficits. Three studies reported on patients who underwent an ACDF. Although some patients played after surgery without problems, several patients experienced recurrent SCC due to herniation at levels adjacent to the surgical sites. With respect to important predictors, a greater frequency of patients who experienced recurrence of symptoms or SCI following return to play had a “long” duration of symptoms (>24 hours; 36.36{\%}) compared with those who were problem-free (11.11{\%}; p=.0311). Conclusions There is limited evidence on current practice standards for return to play following SCC and important risk factors for SCC recurrence or SCI. Because of small sample sizes, future prospective multicenter studies are needed to determine important predictive factors of poor outcomes following return to play after SCC.",
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