Review Question - QID 3499

During collision sports, such as football, the most common type of traumatic neck injury involves fracture, dislocation, or ligamentous disruption of the subaxial cervical spine. These are typically due to axial loading mechanisms which, in football, most commonly occur during spear tackling by defensive backs.

Boden et al retrospectively reviewed 196 incidents of catastrophic high school and collegiate football neck injuries over a 13 year period. The events resulted in fracture, dislocation, or major ligamentous injury at a subaxial cervical level in 95 athletes, at the C1 or C2 level (or both) in 9 athletes, at combined upper and lower levels in 7 athletes, and at an unknown level in 41 athletes. In addition, 43 athletes were diagnosed with cervical cord neurapraxia, and 1 athlete had a cervical nerve root avulsion. Playing the defensive back position and spear tackling were shown to be the greatest risk factors for these fracture and dislocation type neck injuries.

Incorrect Answers:
2: Traction injury leading to nerve-root avulsion from arm tackling describes Neurotmesis of a nerve and would be considered the most severe form of "stinger" and can result in permanent nerve damage.
3: Excessive lateral bending from high impact shoulder tackling does not confer a high risk for cervical spine injury.
4:Flexion-distraction injuries due to a whiplash mechanism during cut blocking certainly can injure the cervical spine including cervical fractures and facet dislocations. However, it is not the most common etiology of catastrophic neck injury in football players.
5: Rotational injuries from pulling on the face mask during a tackle can result in severe injury but is not the most common manner of injury in football players.