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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Sports with degenerative changes in the cervical spine - How high is the risk of a spinal contusion during a cervical trauma?

Sport mit degenerativen Veränderungen im Bereich der Halswirbelsäule – die Contusio Spinalis. Welche Gefahr besteht für das Rückenmark im Fall einer HWS-Distorsion?

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  • corresponding author Markus Knöringer - Neurochirurgische Klinik und Poliklinik der Technischen Universität München, Klinikum rechts der Isar, Ismaningerstr. 22, 81675 München
  • R. Kestlmeier - Neurochirurgische Klinik und Poliklinik der Technischen Universität München, Klinikum rechts der Isar, Ismaningerstr. 22, 81675 München
  • M. Schröder - Neurochirurgische Klinik und Poliklinik der Technischen Universität München, Klinikum rechts der Isar, Ismaningerstr. 22, 81675 München
  • R. Jaeger - Neurochirurgische Klinik und Poliklinik der Technischen Universität München, Klinikum rechts der Isar, Ismaningerstr. 22, 81675 München
  • F. X. Weinzierl - Neurochirurgische Klinik und Poliklinik der Technischen Universität München, Klinikum rechts der Isar, Ismaningerstr. 22, 81675 München
  • A. E. Trappe - Neurochirurgische Klinik und Poliklinik der Technischen Universität München, Klinikum rechts der Isar, Ismaningerstr. 22, 81675 München

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.13.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0131.shtml

Published: April 23, 2004

© 2004 Knöringer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

The number of middle age people who are regularly involved in sporting activities is growing rapidly. With a preexisting cervical spondylosis, and narrowing of the spinal canal they are at a high risk of receiving a major lesion of the spinal cord during a distortion of the cervical spine. Do we know enough to predict the risk of a spinal contusion? Would it be possible to develop recommendations for our patients?

Methods

We present an overview of the literature and discuss the anatomical and biomechanical aspects, epidemiology and treatment options. In addition, the case of a 35 year old man receiving a tetraplegia after a cervical distortion during snowboarding is reported.

Results

We provide a current standpoint concerning the biomechanical and anatomical risk factors for the spinal contusion. Predisposed levels are C3-6. Patients with a spinal canal <10mm have a very high risk, and patients with a spinal canal < 13mm, have a high risk of a lesion of the spinal cord. The different existing recommendations regarding therapy are presented. Operative treatment is reserved for cases with mass effect. MPSS infusions protocols like the Fehling (NASCIS 2001) for acute no penetration SCI are the standard treatment. The dosage depends on time gap between accident and first MPSS donation.

Conclusions

Patients with preexisting degenerative changes in the cervical spine have a high risk of getting a spinal contusion with a severe neurological deficit. We list the sporting activities with the highest numbers of spinal contusion.