Abstract
INTRODUCTION: Regular review [1, 2] of cervical injuries occurring in rugby players is an important step toward maximising the safety of the players. It is hoped that the recognition of recurring patterns of injury would lead to appropriate rule modification by the regulatory bodies of the sport. Serious cervical injuries in rugby have been reported to occur by a range of mechanisms, including those involved with scrummaging, tackling, rucking and mauling.
Spinal flexion is the commonest mechanism of injury and has been associated with scrum engagement, scrum collapse, rucking or mauling, and mistimed tackling. The second most common mechanism of cervical spinal injury is hyper-extension. This commonly occurs during tackling, particularly the ‘gang tackle’ involving several participants simultaneously, where sudden deceleration of a player’s head may lead to cervical hyperextension, focal spinal stenosis and potential damage to the spinal cord by a “pincer” mechanism.
The most commonly reported levels of injury are C5/6 and C4/5 [3].
METHODS: A retrospective review of neck injuries presenting to a major spinal injuries facility and resulting from all codes of football (rugby union, rugby league, soccer, indoor soccer and touch) was conducted and 38 cases identified.
RESULTS: Of the 38 patients, 14 were injured playing rugby union, 15 rugby league, three soccer, one indoor soccer, one touch football and four were playing an unidentified code. Six players were injured while scrummaging, five rugby union and one rugby league. 21 people were injured as tacklees, four as tacklers and two with unspecified involvement in a tackle. One person was injured whilst “heading” the ball, and three people were injured in a non-contact or unspecified action. At final follow-up, four people were found to be quadriplegic (ASIA A), 10 quadriparetic (ASIA B – 0 C –1 and D –9) and 24 recovered completely (ASIA E).
These abstracts were prepared by Dr Robert J. Moore. Correspondence should be addressed to him at Spine Society of Australia, Institute of Medical and Veterinary Science, The Adelaide Centre for Spinal Research, Frome Road, Adelaide, South Australia 5000.
REFERENCES:
1 Silver, J.R. and D. Stewart, The prevention of spinal injuries in rugby football. Paraplegia, 1994. 32(7): p. 442–53. Google Scholar
2 Silver, J.R., Rugby injuries. Lancet, 1995. 346(8968): p. 187–8. Google Scholar
3 Silver, J.R. and S. Gill, Injuries of the spine sustained during rugby. Sports Medicine, 1984. 5(5): p. 328–34. Google Scholar
