Direct competitive wrestling-related catastrophic lower cervical spine injuries

Jean Marie Vianney Hope¹*, Jean Claude Sane², Souleymane Diao¹, Joseph Davy Diouf¹, Francis Mugabo¹, Jean Paul Bitega⁴, Anselme Noaga Nikiema¹, Amadou Ndiassé Kassé1, El Hadji Souleymane Camara¹ and Mouhamadou Habib Sy¹

Received: September 22, 2018;   Published: October 09, 2018

DOI: 10.32474/OSMOAJ.2018.02.000127

Full Text PDF

To view the Full Article   Peer-reviewed Article PDF

Abstract

Background: Only wrestling-related catastrophic injuries in high school and collegiate wrestlers in the USA have been thorough undertaken. These injuries are either fatal, nonfatal or serious. In our environment, wrestling is now a national sport, exceeding even football in popularity. Therefore, studying the magnitude of wrestlers’ cervical spine injuries seemed needed.

Purpose: To describe the characteristics of direct competitive wrestling-related catastrophic lower cervical spine injuries and factors affecting management and outcome.

Study design: Case series; Level of evidence, 4.

Methods: This was a prospective study of 10 men professional wrestlers who sustained direct competitive wrestling-related catastrophic lower cervical spine injuries over a 5-year period. Torg for radiographic measurement, Argenson classification for lower cervical spinal injuries and the ASIA clinical scale for clinical evaluation have been used. All of the statistical calculations were performed using the SPSS.

Results: The mean age was 22.7 years (range, 17 - 28 years). A total of 10 direct catastrophic lower cervical spine injuries were identified. These are 2 fatalities, 4 nonfatal and 4 serious. The preoperative Torg value was below 8 in 9 cases and 1.2 in 1 case (mean, 0.6; range, 0.3 - 1.2). We have found 2 cases of burst fractures, 1 case of teardrop fracture, 1 case of severe sprain, 4 cases of bilateral facet fracture-dislocation and 1 case of traumatic cervical disc herniation. All cases underwent surgical management, and MPSS as adjuvant therapy was administered in 9 cases presenting with SCI. In terms of quality of life, at final follow-up, 4 cases returned in wrestling at the competitive level, 4 cases sustained permanent neurologic disabilities while 2 cases died.

Conclusion: Return to play after a direct competitive wrestling-related catastrophic lower cervical spine injury depends on clinical and radiological findings.

Keywords: Wrestling; Catastrophic Injury; Lower Cervical Spine; Return to Play

Abbreviations: NCCSIR: National Center for Catastrophic Sport Injury Research; TQ: Transient Quadriplegia; ASIA: American Spinal Injury Association; SCI: Spinal Cord Injury; SPSS: Statistical Package for Social Sciences; SD: Standard Deviation; MPSS: Methylprednisolone Sodium Succinate; CT: Computed Tomography MR: Magnetic Resonance; NASCIS: National Acute Spinal Cord Injury Study; RTP: Rate of Return to Play

Abstract| Materials and Methods| Results| Discussion| Conclusion| References|