专业运动员脊柱脊髓损伤后重返赛场的研究进展

doi:10.3969/j.issn.1006-9771.2020.10.007

Abstract

Abstract:

Spinal injuries caused by competitive sports are common. Spinal diseases are important issues that needs to be solved urgently in the fields of sports injury. Return to play recommendations are complicated due to a mix of medical factors, social pressures, and limited outcome data. This article reviewed the current situation of athletes return to play after spine and spinal cord injury based on disease classification, including cervical spine (cervical soft tissue injuries, cervical fracture and dislocation, cervical stenosis, cervical disk herniation, stingers and burners), thoracic spine (thoracic fracture), lumbar spine (lumbar strain, lumbar stenosis spondylolysis and spondylolisthesis, lumbar disk herniation), and spinal cord concussion and spinal cord injury. This article also analyzed the criteria for athletes to return to play after spine and spinal cord injuries. It may provide references for future clinical management and consensus/guidelines.

Key words: spine, spinal cord injury, sports, return to play, athletes, review

CLC Number:

R651.2

ZHANG Xin,LIU Hong-wei,SHEN Min-xin,YANG Ming-liang,GAO Feng,DU Liang-jie,LI Jian-jun. Advance in Return to Play after Spine and Spinal Cord Injury for Athletes (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(10): 1161-1166.

References 58

[1]	Kim K, Jang J Y, Moon G, et al. Experiences of the emergency department at the Pyeongchang Polyclinic During the 2018 PyeongChang Winter Olympic Games[J]. Yonsei Med J, 2019, 60(5):474-480. doi: 10.3349/ymj.2019.60.5.474
[2]	Weber C D, Horst K, Lefering R, et al. Major trauma in winter sports: an international trauma database analysis[J]. Eur J Trauma EmergSurg, 2016, 42(6):741-747.
[3]	Center N S C I S. Spinal Cord Injury Facts and Figures at a Glance[M]. Birmingham, AL: University of Alabama at Birmingham, 2019.
[4]	Liem B C, Olafsen N P, Harrast M A, et al. Final comment: return-to-play decision making: does level of competition make a difference?[J]. PM R, 2016, 8(3 Suppl):S139-143. doi: 10.1016/j.pmrj.2015.09.021
[5]	Sweeney E A, Daoud A K, Potter M N, et al. Association between flexibility and low back pain in female adolescent gymnasts[J]. Clin J Sport Med, 2019, 29(5):379-383. doi: 10.1097/JSM.0000000000000660 pmid: 31460951
[6]	France J C, Karsy M, Harrop J S, et al. Return to play after cervical spine injuries: a consensus of opinion[J]. Global Spine J, 2016, 6(8):792-797. doi: 10.1055/s-0036-1582394
[7]	Caine D J, Young K, Provance A J. Pediatric and adolescent injury in mountain biking[J]. Res Sports Med, 2018, 26(Supp1):71-90. doi: 10.1080/15438627.2018.1438284
[8]	Schroeder G D, Lynch T S, Gibbs D B, et al. The impact of a cervical spine diagnosis on the careers of National Football League athletes[J]. Spine (Phila Pa 1976), 2014, 39(12):947-952. doi: 10.1097/BRS.0000000000000321
[9]	Tator C H, Provvidenza C, Cassidy J D. Spinal injuries in Canadian ice hockey: an update to 2005[J]. Clin J Sport Med, 2009, 19(6):451-456. doi: 10.1097/JSM.0b013e3181bd0db6
[10]	Mall N A, Buchowski J, Zebala L, et al. Spine and axial skeleton injuries in the National Football League[J]. Am J Sports Med, 2012, 40(8):1755-1761. doi: 10.1177/0363546512448355
[11]	Brauge D, Sol J C, Djidjeli I, et al. Catastrophic return to play in rugby after double cervical arthrodesis[J]. Clin J Sport Med, 2020, 30(1):e8-e10.
[12]	Shigematsu H, Cheung J P, Mak K C, et al. Cervical spinal canal stenosis first presenting after spinal cord injury due to minor trauma: An insight into the value of preventive decompression[J]. J Orthop Sci, 2017, 22(1):22-26. doi: S0949-2658(16)30176-2 pmid: 27713009
[13]	Bailes J E. Experience with cervical stenosis and temporary paralysis in athletes[J]. J Neurosurg Spine, 2005, 2(1):11-16. doi: 10.3171/spi.2005.2.1.0011
[14]	Vaccaro A R, Klein G R, Ciccoti M, et al. Return to play criteria for the athlete with cervical spine injuries resulting in stinger and transient quadriplegia/paresis[J]. Spine J, 2002, 2(5):351-356. doi: 10.1016/S1529-9430(02)00202-4
[15]	Yamaguchi J T, Hsu W K. Intervertebral disc herniation in elite athletes[J]. IntOrthop, 2019, 43(4):833-840.
[16]	Hsu W K. Outcomes following nonoperative and operative treatment for cervical disc herniations in National Football League athletes[J]. Spine (Phila Pa 1976), 2011, 36(10):800-805. doi: 10.1097/BRS.0b013e3181e50651
[17]	McAnany S J, Overley S, Andelman S, et al. Return to play in elite contact athletes after anterior cervical discectomy and fusion: a meta-analysis[J]. Global Spine J, 2017, 7(6):552-559. doi: 10.1177/2192568217700112
[18]	Watkins R G T, Chang D, Watkins R G, 3rd. Return to play after anterior cervical discectomy and fusion in professional athletes[J]. Orthop J Sports Med, 2018, 6(6):2325967118779672.
[19]	Molinari R W, Pagarigan K, Dettori J R, et al. Return to play in athletes receiving cervical surgery: a systematic review[J]. Global Spine J, 2016, 6(1):89-96. doi: 10.1055/s-0035-1570460
[20]	Mai H T, Burgmeier R J, Mitchell S M, et al. Does the level of cervical disc herniation surgery affect performance-based outcomes in National Football League athletes?[J]. Spine (Phila Pa 1976), 2016, 41(23):1785-1789. doi: 10.1097/BRS.0000000000001868
[21]	Bigdon S F, Gewiess J, Hoppe S, et al. Spinal injury in alpine winter sports: a review[J]. Scand J Trauma Resusc Emerg Med, 2019, 27(1):69. doi: 10.1186/s13049-019-0645-z
[22]	Schouten R, Lewkonia P, Noonan V K, et al. Expectations of recovery and functional outcomes following thoracolumbar trauma: an evidence-based medicine process to determine what surgeons should be telling their patients[J]. J Neurosurg Spine, 2015, 22(1):101-111. doi: 10.3171/2014.9.SPINE13849
[23]	李树达, 丁宇. 临沂大学竞技体操运动员脊柱损伤的情况调查[J]. 运动, 2018(19):44-45.
	Li S D, Ding Y. Investigation on the spine injuries of competitive gymnasts in Linyi University[J]. Sport, 2018(19):44-45.
[24]	张宏俊, 王莹, 胡鑫, 等. 我国优秀蹦床运动员脊柱腰段损伤致伤机制研究[J]. 福建体育科技, 2016, 35(6):32-34.
	Zhang H J, Wang Y, Hu X, et al. The excellent trampoline athletes injury of lumbar spine injury mechanism research[J]. Fujian Sports Sci Technol, 2016, 35(6):32-34.
[25]	Ramkumar P N, Farber J, Arnouk J, et al. Injuries in a professional ballet dance company: a 10-year retrospective study[J]. J Dance Med Sci, 2016, 20(1):30-37. doi: 10.12678/1089-313X.20.1.30
[26]	Warner W C, de MEndonca R G M. Adolescent spondylolysis: management and return to play[J]. Instr Course Lect, 2017, 66:409-413.
[27]	Crawford C H 3rd, Ledonio C G, Bess R S, et al. Current evidence regarding the etiology, prevalence, natural history, and prognosis of pediatric lumbar spondylolysis: a report from the Scoliosis Research Society Evidence-Based Medicine Committee[J]. Spine Deform, 2015, 3(1):12-29. doi: S2212-134X(14)00082-3 pmid: 27927448
[28]	Selhorst M, Fischer A, Macdonald J. Prevalence of spondylolysis in symptomatic adolescent athletes: an assessment of sport risk in nonelite athletes[J]. Clin J Sport Med, 2019, 29(5):421-425.
[29]	Drazin D, Shirzadi A, Jeswani S, et al. Direct surgical repair of spondylolysis in athletes: indications, techniques, and outcomes[J]. Neurosurg Focus, 2011, 31(5):E9.
[30]	Menga E N, Kebaish K M, Jain A, et al. Clinical results and functional outcomes after direct intralaminar screw repair of spondylolysis[J]. Spine (Phila Pa 1976), 2014, 39(1):104-110. doi: 10.1097/BRS.0000000000000043
[31]	Sutton J H, Guin P D, Theiss S M. Acute lumbar spondylolysis in intercollegiate athletes[J]. J Spinal Disord Tech, 2012, 25(8):422-425. doi: 10.1097/BSD.0b013e318236ba6c
[32]	Overley S C, Mcanany S J, Andelman S, et al. Return to play in adolescent athletes with symptomatic spondylolysis without lisjournal: a meta-analysis[J]. Global Spine J, 2018, 8(2):190-197. doi: 10.1177/2192568217734520
[33]	Reiman M P, Sylvain J, Loudon J K, et al. Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta-analysis[J]. Br J Sports Med, 2016, 50(4):221-230. doi: 10.1136/bjsports-2015-094691
[34]	Overley S C, Mcanany S J, Andelman S, et al. Return to play in elite athletes after lumbar microdiscectomy: a meta-analysis[J]. Spine (Phila Pa 1976), 2016, 41(8):713-718. doi: 10.1097/BRS.0000000000001325
[35]	Tencone F, Minetto M A, Tomaello L, et al. Return to competition after surgery for herniated lumbar disc in professional football players[J]. Clin J Sport Med, 30(5):e127-e129.
[36]	Nair R, Kahlenberg C A, Hsu W K. Outcomes of lumbar discectomy in elite athletes: the need for high-level evidence[J]. Clin Orthop Relat Res, 2015, 473(6):1971-1977. doi: 10.1007/s11999-014-3762-z
[37]	Watkins R T, Hanna R, Chang D, et al. Return-to-play outcomes after microscopic lumbar diskectomy in professional athletes[J]. Am J Sports Med, 2012, 40(11):2530-2535. doi: 10.1177/0363546512458570 pmid: 22986297
[38]	吴清英. 超声波联合牵引治疗对跳水运动员腰椎间盘突出症的疗效观察[J]. 中国体育科技, 2018, 54(2):121-124.
	Wu Q Y. Effect of ultrasound combined with traction in treatment of the diving athletes with lumbar intervertebral disc protrusion[J]. Chin Sport Sci Technol, 2018, 54(2):121-124.
[39]	Torg J S, Guille J T, Jaffe S. Injuries to the cervical spine in American football players[J]. J Bone Joint Surg Am, 2002, 84(1):112-122. doi: 10.2106/00004623-200201000-00017
[40]	Torg J S, Corcoran T A, Thibault L E, et al. Cervical cord neurapraxia: classification, pathomechanics, morbidity, and management guidelines[J]. J Neurosurg, 1997, 87(6):843-850. pmid: 9384393
[41]	Brigham C D, Capo J. Cervical spinal cord contusion in professional athletes: a case series with implications for return to play[J]. Spine (Phila Pa 1976), 2013, 38(4):315-323. doi: 10.1097/BRS.0b013e31827973f6
[42]	Nalliah R P, Anderson I M, Lee M K, et al. Epidemiology of hospital-based emergency department visits due to sports injuries[J]. Pediatr Emerg Care, 2014, 30(8):511-515. doi: 10.1097/PEC.0000000000000180 pmid: 25062295
[43]	Center N S C I S. 2018 Annual Statistical Report for the Spinal Cord Injury Model Systems[M]. Birmingham, AL: University of Alabama at Birmingham, 2018.
[44]	Chan C W, Eng J J, Tator C H, et al. Epidemiology of sport-related spinal cord injuries: a systematic review[J]. J Spinal Cord Med, 2016, 39(3):255-264. doi: 10.1080/10790268.2016.1138601
[45]	Huang P, Anissipour A, McGee W, et al. Return-to-play recommendations after cervical, thoracic, and lumbar spine injuries: a comprehensive review[J]. Sports Health, 2016, 8(1):19-25. doi: 10.1177/1941738115610753
[46]	Rosenthal B D, Boody B S, Hsu W K. Return to play for athletes[J]. Neurosurg Clin N Am, 2017, 28(1):163-171. doi: S1042-3680(16)30046-8 pmid: 27886878
[47]	Canty G, Nilan L. Return to play[J]. Pediatr Rev, 2015, 36(10):438-446; quiz 447. doi: 10.1542/pir.36-10-438 pmid: 26430204
[48]	Eddy D, Congeni J, Loud K. A review of spine injuries and return to play[J]. Clin J Sport Med, 2005, 15(6):453-458. doi: 10.1097/01.jsm.0000186681.13416.0c
[49]	Tempel Z J, Bost J W, Norwig J A, et al. Significance of T₂ hyperintensity on magnetic resonance imaging after cervical cord injury and return to play in professional athletes[J]. Neurosurgery, 2015, 77(1):23-30; discussion 30-31. doi: 10.1227/NEU.0000000000000728
[50]	Reinke A, Behr M, Preuss A, et al. Return to sports after cervical total disc replacement[J]. World Neurosurg, 2017(97):241-246.
[51]	Kepler C K, Vaccaro A R. Injuries and abnormalities of the cervical spine and return to play criteria[J]. Clin Sports Med, 2012, 31(3):499-508. doi: 10.1016/j.csm.2012.03.005
[52]	Cook R W, Hsu W K. Return to play after lumbar spine surgery[J]. Clin Sports Med, 2016, 35(4):609-619. doi: 10.1016/j.csm.2016.05.006
[53]	Ball J R, Harris C B, Lee J, et al. Lumbar spine injuries in sports: review of the literature and current treatment recommendations[J]. Sports Med Open, 2019, 5(1):26. doi: 10.1186/s40798-019-0199-7
[54]	Low M, Burgess L C, Wainwright T W. A critical analysis of the exercise prescription and return to activity advice that is provided in patient information leaflets following lumbar spine surgery[J]. Medicina (Kaunas), 2019, 55(7):347.
[55]	Nagoshi N, Tetreault L, Nakashima H, et al. Return to play in athletes with spinal cord concussion: a systematic literature review[J]. Spine J, 2017, 17(2):291-302. doi: 10.1016/j.spinee.2016.09.013
[56]	Sindelar B, Bailes J E. Neurosurgical emergencies in sport[J]. Neurol Clin, 2017, 35(3):451-472. doi: S0733-8619(17)30028-2 pmid: 28673409
[57]	Huang H, Young W, Skaper S, et al. Clinical Neurorestorative Therapeutic Guidelines for Spinal Cord Injury (IANR/CANR version 2019)[J]. J Orthop Translat, 2019, 20:14-24. doi: 10.1016/j.jot.2019.10.006
[58]	Fan B, Wei Z, Yao X, et al. Microenvironment imbalance of spinal cord injury[J]. Cell Transplant, 2018, 27(6):853-866. doi: 10.1177/0963689718755778

Advance in Return to Play after Spine and Spinal Cord Injury for Athletes (review)

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