II. Symptoms and signs
-
Neuropraxia with or without Transient Quadriplegia
- Mild: Motor changes (i.e. Muscle Weakness)
- Severe: Complete paralysis
- Sensory changes or Paresthesias into extremities
- Burning pain
- Numbness
- Tingling
- Loss of Sensation
- Neck Pain usually absent
- Complete recovery in most cases
- Early: 10-15 minutes
- Delayed: 36 hours
III. Causes
- Narrowing of cervical spinal canal
- Associated other predisposing factors
- Congenital cervical fusions
- Ligamentous instability
- Intervertebral disc disease
IV. Radiology
-
C-Spine XRay (Inaccurate)
- Spinal canal diameter (varies with magnification)
- Normal >15 mm
- Absolute Stenosis <10 mm
- Torg ratio
- Stenosis: < 0.8
- High sensitivity but poor Specificity
- Spinal canal diameter (varies with magnification)
- C-Spine MRI (most accurate method)
V. Return to competition
- Contraindications to participation
- Disc Herniation
- Vertebral Fracture or dislocation
- Significant Congenital Anomaly
- Guidelines after Transient Quadriplegia
- Contact Sport participation indications
- Symptom-free
- No Cervical Spinal Stenosis by C-Spine MRI
- Patient accepts risk of future Quadriplegia
- Contact Sport participation contraindications
- True Cervical Spinal Stenosis by MRI
- Consider minimal to no Contact Sports
- Contact Sport participation indications