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We present a case of multilevel lumbar transverse process fracture in a professional association football player, incurred after a fall from height during competitive play. Traditionally associated with high impact trauma in the general population, this injury is relatively rare in the context of professional football where it is more likely to be associated with lower impact trauma. We outline our experience of mechanism of injury, treatment options and recovery time serving as a guide for fellow clinicians when treating this condition in practice. In this particular case, the return to play time was 68 days.

The frontal N100 difference wave (N100d) between cortical evoked potentials to frequent and infrequent tones was compared before and during hypnosis in subjects with high and low hypnotic susceptibility (n = 10,11). This was to test putative alterations in attention, novelty detection in particular, modulated by anterior functions including the anterior cingulate to auditory stimuli extraneous to hypnosis. Susceptibility was measured with the HGSHS:A and validated with a laboratory scale during the experiment. Results showed that in the highly susceptible participants the N100d was clearly manifested in the pre‐hypnosis control condition, was later attenuated following instructions of hypnosis and was virtually absent after further hypnosis. The effect was due to attenuated responding to the infrequent stimulus, without change to the frequent stimulus. This compromise extended to the later frontal P300 wave whose amplitude was reduced by 50% with hypnosis and was negligible by the end of hypnosis. The parietal P300 was reduced in both hypnosis conditions to a similar degree. These results were consistent with a progressive reduction throughout the hypnotic induction in focused attention to stimuli incidental to hypnosis capable of frontal modulation and frontal activation to the novel stimulus. In contrast the participants with low susceptibility showed an opposite pattern of change in the N100d. Though absent before hypnosis there was a progressive increase in the N100d from the first to the second hypnosis recording. This was underpinned by changes in response amplitudes to both frequent and infrequent stimuli, without systematic changes to the P300. Their results supported a dispersion of attentional resources and an absence of frontal activation in the pre‐hypnosis baseline, compatible with a lack of focused attention and engagement of frontal functions theorized to be necessary for hypnosis. Furthermore subjects with low hypnotizability showed a longer P300 latency at the central parietal peak compatible with more prolonged processing of the rare stimulus, in keeping with a more posterior bias in processing. This may militate against the induction of hypnosis, theorized to require initial engagement of anterior processes, and here supported by the results in the highly hypnotizable participants. Copyright © 2002 British Society of Experimental and Clinical Hypnosis

The results suggest serial administration of the RT test does not produce a practice or learning effect. Clinicians, however, should be cautious as the results do provide evidence patients may demonstrate improved scores when testing occurs on repetitive days after initial exposure to the test.

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