Cervical Spine Conditions in Football

Cervical spine injuries, and specifically spinal cord injuries (SCI), represent a small fraction of the pathologies that occur within football. Though infrequent, appropriate recognition and proper management reduce the likelihood of progression of a neurological injury and improve chances of recovery. Therefore, we will introduce cervical spine injuries in football first by understanding their incidence and how they have been affected by specific rule changes. It is then pertinent for the treating provider of a football player with a suspected SCI to understand the essential on-field assessment, further detailed evaluation, and management that should be performed. We will then review some basic tenants of common cervical spine pathologies and provide an overview of general return-to-play guidelines in these athletes. Lastly, we will attempt to tackle the conundrum that exists for counseling athletes found to have incidental cervical spine processes such as cervical stenosis, Klippel-Feil syndrome, and Chiari malformation.