Spinal Injuries in the Overhead Athlete

Review

. 2022 Sep 29.


doi: 10.1007/s12178-022-09791-2.


Online ahead of print.

Affiliations

Item in Clipboard

Review

Robert G Watkins 4th et al.


Curr Rev Musculoskelet Med.


.

Abstract


Purpose of review:

Treatment of overhead athletes requires a systematic approach that will make an accurate diagnosis, deliver effective treatment, and make timely and safe return to sport.


Recent findings:

New data has shown success rates and return to play effectiveness after different types of cervical and lumbar surgery. Cervical foraminotomy has been shown to have the highest rate and fastest return to play, but with the highest incidence of need for revision surgery. Cervical artificial disc replacement has shown promising results in the general population and is being done more commonly in elite athletes, but has an unknown risk for failure. Cervical fusion is a well-established and effective treatment, but has the longest healing time and risk for adjacent level pathology. In the lumbar spine, discectomy has a long and proven track record, fusion is rarely performed but can be effective, and artificial disc replacement is extremely rare in an elite athlete. An effective and comprehensive approach can diagnose, treat, and return overhead athletes to competitive play.


Keywords:

Athlete; Cervical; Lumbar; Overhead; Spine; Sport.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Watkins RG IV, Watkins RG III. Cervical disc herniations, radiculopathy, and myelopathy. Clin Sports Med. 2021;40(3):513–39. https://doi.org/10.1016/j.csm.2021.03.006 .



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    1. Levine MJ, Albert TJ, Smith MD. Cervical radiculopathy: diagnosis and nonoperative management. J Am Acad Orthop Surg. 1996;4(6):305–16. https://doi.org/10.5435/00124635-199611000-00003 .



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      PubMed

    1. Vallée JN, Feydy A, Carlier RY, Mutschler C, Mompoint D, Vallée CA. Chronic cervical radiculopathy: lateral-approach periradicular corticosteroid injection. Radiology. 2001;218(3):886–92. https://doi.org/10.1148/radiology.218.3.r01mr17886 .



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      PubMed

    1. Rhee JM, Yoon T, Riew KD. Cervical radiculopathy. J Am Acad Orthop Surg. 2007;15:486–94. https://doi.org/10.5435/00124635-200708000-00005 .



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      PubMed

    1. Boden SD, McCowin PR, Davis DO, et al. Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;72:1178–84.



      DOI

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