|
Print
Version
Of
all injuries that occur in football, possibly the most feared is
the neck injury. As
we all are aware, most neck injuries are quite minor and cause
minimal discomfort and debilitation.
But it is the severe neck injury, one with caustic and
long-term neurological and musculoskeletal sequelae, that is the
focus of much concern in the field of sports medicine.
Lets
start with a brief survey of neck anatomy.
The framework of the neck is seven vertebrae that form
the cervical spine. The
spinal cord runs through a canal formed by the vertebrae.
Ligaments and tendons attach at various places to the
vertebral column. Many
different muscles and other structures lie on, in and around the
cervical framework.
Nerve
roots exit the sides of the vertebrae in an intricate and
predictable pattern. The
nerve roots that come off of the spinal cord in the cervical
segment go primarily to the upper extremities.
Shortly after exiting the spinal column, many of the
nerves coalesce and form a structure know as the brachial
plexus. Each
brachial plexus goes to the shoulder and then to the arm to
provide innervation to the upper extremity.
The
cervical spine has a natural curve to it.
This natural architecture is called a lordotic curve and
allows for maximal biomechanical advantage and protection. With flexion (chin down) and extension (chin up) of the neck,
this curve can be diminished, neutralized or exaggerated.
Virtually
all neck injuries involve trauma to the head or neck. Football, diving and other sports provide ample trauma to
cause minor to severe neck injuries.
In fact, sports and recreation are the fourth most common
cause of spine fracture and the second most frequent cause of
sustaining associated paralysis.
Injuries
to the cervical spine are not at all uncommon, especially in
football and diving, and must be promptly recognized and treated
to minimize the long-term consequences of injury.
The
most common mechanism of fracture in the cervical spine is axial
loading of the spine when the natural curve is neutralized.
In other words, the neck is slightly flexed and a force
is applied directly to the top of the head.
For a mental picture of this, think of an illegal
spearing call in a football game.
The
spearing mechanism aligns the vertebrae in a straight column
and creates the perfect situation for a burst fracture.
Other
mechanisms of fracture include hyperextension, hyper flexion and
shearing/twisting. But,
with recent innovations in football helmet design and athlete
conditioning, the relative number of fractures due to these
mechanisms has been significantly reduced.
Aside
from fractures of the spinal column, the soft tissues that help
to support and move the neck and head can be easily injured.
Though these can be quite painful and uncomfortable,
there is rarely any lasting effect of soft tissue injury.
|
