144 Sports Participation and Sports-Related Neurologic Injuries in Pediatric Patients With Chiari I Malformation

Abstract

INTRODUCTION: Currently, there is no consensus recommendation regarding the safety of sports participation for pediatric patients with Chiari I malformation (CM-I). METHODS: A prospectively administered survey was given to 744 pediatric neurosurgery clinic patients at the University of Michigan between December 2010 and December 2021. Data were recorded on demographic information, imaging characteristics, treatment, sports participation, and presence of sports-related neurologic injury. Patients with incomplete survey data were called. Two hundred and seven patients completed at least 1 subsequent survey and were prospectively followed for a mean of 1.56 years. A season was defined as 3 months of sports play. RESULTS: Of the 744 patients with completed surveys, 462 patients participated in sports. Patients who participated in sports were more likely to be older at presentation (p < 0.001) and have rounded cerebellar tonsil morphology (p < 0.001). A cumulative total of 6,854.67 seasons of sports were played (5,918.67 prior to CM-I decompression (CMD) and 936 after). There were 84 sports-related concussions among 55 patients; 79 prior to CMD and 5 after CMD. The concussion rate was 12.25 per 1,000 seasons of all sports, 9.16 per 1,000 seasons of limited-contact sports and 13.76 per 1,000 of contact sports. The concussion rate after CMD was 5.34 per 1,000 seasons of all sports, 9.19 per 1,000 seasons of limited-contact sports and 7.09 per 1,000 seasons of contact sports. There were no reports of long-lasting neurologic issues post-concussion or of permanent spinal cord injury. CONCLUSIONS: There were no permanent or catastrophic sports-associated neurologic injuries reported in this study. The concussion rate in CM-1 patients before and after CMD were low and therefore sports participation in this population should not be counseled against.