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, 3 soccer, 1 indoor soccer, 1 touch football and 4 were playing an unidentified code. 6 players were injured while scrummaging, 5 rugby union and 1 rugby league. 21 people were injured as tacklees, 4 as tacklers and 2 with unspecified involvement in a tackle. 1 person was injured whilst “heading” the ball, and 3 people were injured in a non-contact or unspecified action. At final follow-up, 4 people were found to be quadriplegic (ASIA A), 10 quadriparetic (ASIA B – 0 C −1 and D –9) and 24 recovered completely (ASIA E).