Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Updated: May 30 2019

[Blocked from Release] Cervical Stenosis - shows torg ratio small.jpg
  • Cervical stenosis may be 
    • congenital
    • acquired (traumatic, degenerative)
  • Associated conditions
    • Spear tackler's spine
      • a syndrome of cervical stenosis caused by repetitive microtrauma and improper tackling techniques
      • is considered a contraindication to return to play
  • Prognosis
    • cervical stenosis places a patient at increased risk for  radiculopathy/myelopathy/SCI even from minor trauma or cervical spondylosis
      • therefore congenital cervical stenosis is an important consideration in the athlete
  • Absolute cervical stenosis
    • defined as canal diameter < 10mm
  • Relative cervical stenosis
    • defined as canal diameter of 10-13mm
  • Radiographs
    • recommended views
      • ap, lateral, flexion/extension views of cervical spine
    • radiographic risk factors for neurologic involvement on lateral radiograph include
      • canal diameter of < 13mm (normal is ~17mm)
      • Torg-Pavlov ratio (canal/vertebral body width) of < 0.8 (normal is 1.0)  
        • Torg ratio is technique dependent, not predictive, and not accurate in large athletes
  • MRI
    • study of choice to evaluate soft tissue anatomy and neural impingement
  • Somatosensory evoked potentials
    • may help identify cord compromise in absolute stenosis
  • Nonoperative
    • observation with possible activity restrictions
      • indications
        • patients without neurologic symptoms
      • contraindications to return to play (controversial)
        • loss of the CSF around the cord or deformation of the spinal cord documented by MRI
          • especially with
            • history of multiple episodes of transient quadriparesis
            • bilateral extremity symptoms 
        • spear tackler's spine
        • Torg ratio of <0.8 alone is not considered a contraindication to return to play 
  • Operative
    • surgical decompression and stabilization
      • indications
        • radiculopathy
        • myelopathy
        • in some cases surgery may be indicated as a prophylactic measure
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options