Citation

Ellis MJ, McDonald PJ, Olson A, Koenig J, Russell K. J. Head Trauma Rehabil. 2019; 34(2): 103-110.

Affiliation

Department of Surgery (Dr Ellis), Pediatrics and Child Health (Drs Ellis and Russell), Diagnostic Radiology (Dr Koenig), and Section of Neurosurgery (Dr Ellis), University of Manitoba, Winnipeg, Canada; Pan Am Concussion Program, Pan Am Clinic, Winnipeg, Canada (Drs Ellis and Koenig); Children's Hospital Research Institute of Manitoba, Winnipeg, Canada (Drs Ellis and Russell); Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada (Ms Olson); Canada North Concussion Network, Winnipeg, Manitoba (Drs Ellis, McDonald, and Russell); University of Manitoba, Winnipeg, Manitoba, Canada (Drs Ellis, Koenig, and Russell).

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000411

PMID

30045221

Abstract

OBJECTIVE: To examine the prevalence of cervical spine injuries among children and adolescents referred with suspected and diagnosed sports-related concussion (SRC); and evaluate the effect of cervical spine dysfunction (CSD) on physician-documented clinical recovery following SRC. SETTING: A multidisciplinary pediatric concussion program. PARTICIPANTS: A total of 266 patients (6-19 years) referred with suspected SRC.

DESIGN: A retrospective cohort study. MAIN MEASURES: CSD defined as neurological symptoms localized to the cervical spine or the presence of neck pain, headache, or dizziness and abnormal cervical spine examination findings; physician-documented clinical recovery.

RESULTS: One patient was diagnosed with a T1 compression fracture. Of the 246 patients diagnosed with SRC, 80 (32.5%) met the clinical criteria for CSD including 4 patients with central cord neuropraxia and 1 with a spinal cord injury without radiographic abnormality (SCIWORA). Excluding patients with central cord neuropraxia OR SCIWORA, patients with SRC with CSD took longer to achieve physician-documented clinical recovery (28.5 days vs 17 days, P <.0001) and were 3.95 times more likely to experience delayed physician-documented clinical recovery (>4 weeks postinjury) compared with those without CSD.

CONCLUSIONS: Patients with suspected and diagnosed SRC can present with a wide spectrum of coincident cervical spine injuries. Cervical spine dysfunction may be a risk factor for delayed clinical recovery.

Language: en