BOULDER, Colo. — At the International Extreme Sports Medicine Congress, a presenter discussed spinal injuries sustained in extreme sports athletes.
“[The] hardest part for me is keeping the athletes down,” Vikas Patel, MD, MA, BSME, a Spine Surgery Today Editorial Board member, said during his presentation. “These are typically high-energy athletes than want to push the limits, and the typical does not seem to apply to them. The importance of stabilizing the spine, giving the bones a chance to heal given the opportunity to stabilize first and then being aggressive about the [rehabilitation], I think for me is the take-home point.”
He explained cervical injuries can be flexion or extension injuries. Flexion, compression, distraction and extension shear-type injuries can lead to predictive patterns of injury and surgeons should at those patterns to treat and stabilize injuries.
“Water sports are more common than you would think,” he said. “Not only swimming and diving into the pool, but more [common] are the surfing and watersports at the beach type of activities, especially when the shore break is not clearly understood and you can tumble and hit the sand.”
Cervical injuries can also be caused by mountain biking, with over-the-handle type falls being the most common. Skiing injuries can be a combination of cervical, lumbar and thoracolumbar injuries, especially given the jumping and landing in the sport.
“[The] acute thoracolumbar injuries tend to be moving down the spine [and] tend to be more of those direct impact or hard landing types of injuries,” Patel said. “In this case, landing wrong and not absorbing the energy coming down directly on your spine can lead to significant fractures.”
Patel noted axial loading is probably the best-tolerated fracture except in cases in which it turns into a dislocation, which may lead to neurological or spinal injuries.
Rock climbing can also correlate with thoracolumbar injuries, and impact on the head that may cause head injuries and concussions can also cause similar stresses on the neck, he said. Patel also noted injuries with airborne sports, such as sky diving, stem from poor landings.
“The worst of the injuries are often the severe impact where you land and you dislocate between your pelvis and your spine,” he said. “The spinal pelvic disassociation or dislocation is when you have some of the worst neuro injuries, and that affects the sacral plexus with other types of injuries. They can be simple reconstructions or more complex reconstructions to stabilize the bones and give the nerves a chance to recover.” ‒ by Monica Jaramillo
Patel V. Spine injuries in the extreme sports athlete — Treating the tingling. Presented at: International Extreme Sports Medicine Annual Congress; June 10-11, 2016; Boulder, Colo.
Disclosures: Patel reports he is a board member of Aesculap; is a consultant for Aesculap and Si-Bone; receives grants from Medtronic, Si-Bone, Medicrea, Vertiflex, Orthofix and Aesculap; receives payment for lectures from Stryker; and receives royalties from Aesculap and Zimmer Biomet.