Severe cervical spinal cord injuries related to rugby union and league football in New South Wales, 1984‐1996

Rotem, Tai; Lawson, James S.; Wilson, S; Engel, Scot; Rutkowski, Sue; Aisbett, C W

doi:10.5694/j.1326-5377.1998.tb138989.x

Cited by 32 publications

(17 citation statements)

References 4 publications

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“…While the current consensus statement for rugby injury data collection recognises the importance of calculating incidences for comparability across playing nations,20 it still does not include ‘near miss’ outcomes in the definition of catastrophic injury. The small difference between non-permanent and permanent outcomes, and therefore the epidemiological importance of including these outcomes, has been stated by various authors in the past3 24 and was clearly illustrated in a recent UK study of spinal injuries in junior players 25…”

Section: Discussionmentioning

confidence: 90%

The incidence of rugby-related catastrophic injuries (including cardiac events) in South Africa from 2008 to 2011: a cohort study

et al. 2013

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ObjectivesTo establish an accurate and comprehensive injury incidence registry of all rugby union-related catastrophic events in South Africa between 2008 and 2011. An additional aim was to investigate correlates associated with these injuries.DesignProspective.SettingThe South African amateur and professional rugby-playing population.ParticipantsAn estimated 529 483 Junior and 121 663 Senior rugby union (‘rugby’) players (population at risk).Outcome measuresAnnual average incidences of rugby-related catastrophic injuries by type (cardiac events, traumatic brain and acute spinal cord injuries (ASCIs)) and outcome (full recoveries—fatalities). Playing level (junior and senior levels), position and event (phase of play) were also assessed.ResultsThe average annual incidence of ASCIs and Traumatic Brain Injuries combined was 2.00 per 100 000 players (95% CI 0.91 to 3.08) from 2008 to 2011. The incidence of ASCIs with permanent outcomes was significantly higher at the Senior level (4.52 per 100 000 players, 95% CI 0.74 to 8.30) than the Junior level (0.24 per 100 000 players, 95% CI 0 to 0.65) during this period. The hooker position was associated with 46% (n=12 of 26) of all permanent ASCI outcomes, the majority of which (83%) occurred during the scrum phase of play.ConclusionsThe incidence of rugby-related catastrophic injuries in South Africa between 2008 and 2011 is comparable to that of other countries and to most other collision sports. The higher incidence rate of permanent ASCIs at the Senior level could be related to the different law variations or characteristics (eg, less regular training) compared with the Junior level. The hooker and scrum were associated with high proportions of permanent ASCIs. The BokSmart injury prevention programme should focus efforts on these areas (Senior level, hooker and scrum) and use this study as a reference point for the evaluation of the effectiveness of the programme.

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Section: Discussionmentioning

confidence: 90%

The incidence of rugby-related catastrophic injuries (including cardiac events) in South Africa from 2008 to 2011: a cohort study

et al. 2013

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“…The last of these injuries is the only one of limited significance, while the remaining 11 represent potentially catastrophic injuries or ‘near misses’ (figure 2). Previous authors have recognised the significance of near misses11 suggesting they can provide ‘collateral evidence of trends in frequency of serious injury’ 4. Williams and McKibbin12 proposed that a serious neck injury is one showing sufficient instability to damage the spinal cord or requires surgical stabilisation.…”

Section: Discussionmentioning

confidence: 99%

“…A recent review from South Africa15 has observed that players aged 17 years had the highest number of spinal cord injuries, although other reviews have suggested that the peak age is slightly older at 22–25 years 8 11 16…”

Section: Discussionmentioning

confidence: 99%

Serious neck injuries in U19 rugby union players: an audit of admissions to spinal injury units in Great Britain and Ireland

Maclean

Hutchison

2011

Br J Sports Med

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U19 rugby players continue to sustain serious neck injuries necessitating admission to spinal injury units with a low but persistent frequency. The recent rate of admission in Scotland is disproportionately high when the respective estimated playing populations are considered. While more injuries were sustained in the tackle, spinal cord injury was significantly more common in neck injury sustained in the scrum (p<0.001). No register of catastrophic neck injuries exists despite repeated calls over the past three decades, and a study such as this has not been reported before. Data collection of this serious category of injury is incomplete and very variable across the home unions, as a consequence a large proportion of the serious neck injuries that have occurred in U19 players over the past 14 years have not been analysed. Rigorous data collection and analysis have to be established so that problem areas of the game such as scrum engagement and the tackle can be made safer.

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“…[1][2][3][4][5][6][7][8] The most frequently injured vertebrae are C4 to C6. 1 7 Approximately half of all cervical spine injuries in rugby result in tetraplegia.…”

Section: Discussionmentioning

confidence: 99%

Paraplegia secondary to fracture-subluxation of the thoracic spine sustained playing rugby union football: Figure 1

Walsh

Shine²,

McManus³

2004

Br J Sports Med

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Fractures of the spinal column during rugby matches of all codes are rare but catastrophic, especially when associated with spinal cord injury. The cervical spine is vulnerable during trauma to the head and neck in contact sports. Spinal injuries reported during rugby matches have almost exclusively involved the cervical region, often with neurological sequelae. This is the first reported case of paraplegia caused by a fracture-dislocation of the thoracic spine resulting from a low velocity rugby union injury. CASE REPORTA 35 year old accountant, playing at wing forward, was admitted to our spinal injuries unit after an injury during a junior level rugby match. He had sustained a forced hyperflexion injury to his spine. The player was in a seated position, when a maul, in which he had just been involved, collapsed over him. He complained of instant severe thoracolumbar back pain associated with an immediate loss of all power and sensation from his lower abdomen distally.On examination in the emergency room, he had tenderness over his lower thoracic spine with palpable malalignment of the posterior elements at this level. A complete neurological injury with a sensory level at T12 was diagnosed. He had no associated injuries and was otherwise healthy. Of note, the patient had undergone lumbar spinal surgery 11 years previously. Anteroposterior ( fig 1A) and lateral (fig 1B) plain radiographs showed a fracture-subluxation of the T11/T12 vertebrae. The radiographs also showed previous bilateral fusions for spondylolysis of L3 and L4.The patient was nursed on a spinal bed and taken to the operating theatre. Reduction and stabilisation of the fracturedislocation with posterior instrumentation from T10 to L1 was carried out. Postoperative anteroposterior (fig 2A) and lateral ( fig 2B) radiographs showed adequate alignment of the thoracolumbar spine. The patient was subsequently transferred to a neurorehabilitation unit, but has since showed no significant neurological recovery. DISCUSSIONInjuries to the spine in rugby have been widely reported, with a high rate of cervical spine and spinal cord injury.

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Severe cervical spinal cord injuries related to rugby union and league football in New South Wales, 1984‐1996

Cited by 32 publications

References 4 publications

The incidence of rugby-related catastrophic injuries (including cardiac events) in South Africa from 2008 to 2011: a cohort study

The incidence of rugby-related catastrophic injuries (including cardiac events) in South Africa from 2008 to 2011: a cohort study

Serious neck injuries in U19 rugby union players: an audit of admissions to spinal injury units in Great Britain and Ireland

Paraplegia secondary to fracture-subluxation of the thoracic spine sustained playing rugby union football: Figure 1

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