Severe spinal injuries in rugby are rare – but the consequences are considerable. This study presents a series of severe or catastrophic spinal injuries involving under-18 Scottish rugby players since 1992. Demographic and medical data were collected from records at the Queen Elizabeth National Spinal Injuries Unit for Scotland. The players were interviewed personally by the main author, using a questionnaire developed to expose risk factors contributing to injury.

All patients were male rugby union players, aged from 14-17. Twelve severe or catastrophic spinal injuries occurred between 1992 and 2009; 10/12 resulted in neurological dysfunction. Six players were forwards and 6 were backs. Three injuries occurred during scrums and 9 injuries resulted from tackles. Five players were injured during league games, 5 during ‘friendly’ games and 1 during a trial game for a regional team. All reported the playing conditions as good and 67% occurred in the second half of the game.

The rate of spinal injury was 1 every 3 years from 1992 to 2007. In the last 3 years of the study (2007 to 2010) 7 spinal injuries occurred (including 6 with neurological compromise). 6/12 players thought there was a mismatch between the teams, 3/12 were playing their first game for that team, 2/12 players changed position during the match and 3/12 players were playing above their age group. Overall, one of these four risk factors was present in 10/12 (82%) of cases. 7/12 players felt their injury was preventable.

This study demonstrates that the rate of severe spinal injuries in Scottish under-18 rugby had increased to an unacceptable level. Since these data were shared with the Scottish Rugby Union, safety measures have been implemented in an effort to reduce the rate of injuries in youth rugby.