Despite the high prevalence of musculoskeletal disorders seen by primary care physicians, numerous studies have demonstrated deficiencies in the adequacy of musculoskeletal education at multiple stages of medical education. The aim of this study was to assess a newly developed undergraduate module in musculoskeletal medicine.

Introduction: Haematogenous pyogenic spinal infection encompasses spondylodiskitis, septic discitis, vertebral osteomyelitis and epidural abscess. Management of pyogenic spinal infection can involve conservative methods and surgical intervention. We carried out a retrospective review of 48 cases of pyogenic vertebral osteomyelitis presenting over a twelve-year period to the National Spinal Injuries Unit of the Republic Of Ireland. Our objective was to analyze the presentation, aetiology, management and outcome of 48 cases of non-tuberculous pyogenic spinal infection.

Methods: Both the Hospital Inpatient Enquiry (HIPE) System and the National Spinal Injuries Unit Database were used to identify our study cohort. The medical records, blood results, radiologic imaging and bacteriology results of all patients identified were reviewed.

Results: The average age of presentation was 59 years with an almost even distribution between males and females. Most patients took between three and six weeks to present to hospital. Diagnosis was confirmed by serological testing of inflammatory markers and radiological imaging. The most frequently isolated pathogen was Staph. aureus (75% of cases). 94% of cases were managed by conservative measures alone, including antibiotic therapy and spinal bracing. However, in 6% of cases surgical intervention was required due to neurological compromise or mechanical instability.

Conclusions: With this large cohort of non-tuberculous, pyogenic spinal infections from the NSIU, we conclude that Staph. aureus is the predominent pathogen. In the vast majority, conservative management with antibiotic therapy and spinal bracing is very successful. However in 6% of cases surgical intervention is warranted and referral to a specialist centre is appropriate.

Aims: Rugby is a popular sport in Ireland, with over 100,000 players registered with the Irish Rugby Football Union (IRFU) at all levels. We report a 10 year series of spinal injuries presenting to the National Spinal Injuries Unit (NSIU) at the Mater Misericordiae University Hospital.

Methods: A large series of spinal injuries in rugby players was isolated utilizing the NSIU database, HIPE and data from the IRFU. An extensive chart review and telephone interview was performed in all cases to determine age, mechanism of injury, possible aetiological factors, anatomic location of injury, American Spinal Injuries Association (ASIA) scores, current level of activity and response to rehabilitation.

Results: From 1994 to 2004, 22 rugby players with spinal injuries necessitated admission to the NSIU. Twelve patients (54%) presented with neurology. The average age at time of injury was 21.1 years (range 14 – 44 years) and all patients were male. The average length of hospital stay was 10.1 days (range 1 – 45 days). Twenty patients had cervical spine injuries. The most common mechanism of injury was hyperflexion of the cervical spine, with C5/C6 most commonly injured. Fifteen injuries occurred at adult level, the remainder at schoolboy level. Seventeen (77%) players were injured whilst playing First Team rugby. Eleven (50%) players were injured in the Backs, the remainder in the Forwards. 68% of injuries occurred in the tackle situation and 32% in the scrums, rucks and mauls. Winger, Full Back and Hooker were the playing positions at greatest risk.

Nine (41%) patients underwent surgery and 11 (50%) required rehabilitation in the National Rehabilitation Centre, Dun Laoghaire, with an average length of inpatient stay of 9.22 months (range 5 – 14 months). Eight (36%) patients felt that their injury was preventable. Of those patients without neurology, 60% have returned to playing rugby.

Conclusion: Rugby as a sporting pastime is not without risk. During the ten year period under review, 8 players suffered permanent disability as a direct result of participation in competitive rugby. Serious spinal injuries continue to occur and recent rule changes have had little effect in reducing their incidence.

Aims: Rugby is a popular sport in Ireland, with over 90,000 players registered with the Irish Rugby Football Union (IRFU) at all levels. We report a 10 year series of spinal injuries presenting to the National Spinal Injuries Unit (NSIU) at the Mater Misericordiae University Hospital.

Methods: A large series of spinal injuries in rugby players was isolated utilizing the NSIU database, HIPE and data from the IRFU. An extensive chart review and telephone interview was performed in all cases to determine age, mechanism of injury, possible aetiological factors, anatomic location of injury, American Spinal Injuries Association (ASIA) scores, current level of activity and response to rehabilitation.

Results: From 1994 to 2004, 22 rugby players with spinal injuries necessitated admission to the NSIU. Twelve patients (54%) presented with neurology. The average age at time of injury was 21.1 years (range 14 – 44 years) and all patients were male. The average length of hospital stay was 10.1 days (range 1 – 45 days). Twenty patients had cervical spine injuries. The most common mechanism of injury was hyperflexion of the cervical spine, with C5/C6 most commonly injured. Fifteen injuries occurred at adult level, the remainder at schoolboy level. Seventeen (77%) players were injured whilst playing First Team rugby. Eleven (50%) players were injured in the Backs, the remainder in the Forwards. 68% of injuries occurred in the tackle situation and 32% in the scrums, rucks and mauls. Winger, Full Back and Hooker were the playing positions at greatest risk.

Nine (41%) patients underwent surgery and 11 (50%) required rehabilitation in the National Rehabilitation Centre, Dun Laoghaire, with an average length of inpatient stay of 9.22 months (range 5 – 14 months). Eight (36%) patients felt that their injury was preventable. Of those patients without neurology, 60% have returned to playing rugby.

Conclusion: Rugby as a sporting pastime is not without risk. During the ten year period under review, 8 players suffered permanent disability as a direct result of participation in competitive rugby. Serious spinal injuries continue to occur and recent rule changes have had little effect in reducing their incidence.