Abstract
BackgroundThis paper describes a case of C7 radiculopathy in a professional rugby league player after repeated cervical spine trauma. The report outlines the management of the patient following an acute cervical hyperflexion injury with chiropractic manipulation and soft tissue therapies. It also presents a change in approach to include distractive techniques on presentation of a neurological deficit following re-injury. The clinical outcomes, while good, were very dependent upon the athlete restricting himself from further trauma during games, which is a challenge for a professional athlete.Case presentationA 30-year old male front row Australian rugby league player presented complaining of neck pain after a hyperflexion and compressive injury during a game. Repeated trauma over a four month period resulted in radicular pain. Radiographs revealed decreased disc height at the C5-C6 and C6-C7 levels and mild calcification within the anterior longitudinal ligament at the C6-C7 level. MRI revealed a right postero-lateral disc protrusion at the C6-C7 level causing a C7 nerve root compression.ConclusionRecommendations from the available literature at the present time suggest that conservative management of cervical discogenic pain and disc protrusion, including chiropractic manipulation and ancillary therapies, can be successful in the absence of progressive neurological deficit. The current case highlights the initial successful management of a football athlete, and the later unsuccessful management. This case highlights the issues involvement in the management of a collision sport athlete with a serious neck injury.
Highlights
This paper describes a case of C7 radiculopathy in a professional rugby league player after repeated cervical spine trauma
Recommendations from the available literature at the present time suggest that conservative management of cervical discogenic pain and disc protrusion, including chiropractic manipulation and ancillary therapies, can be successful in the absence of progressive neurological deficit
Effective cervical injury management requires an understanding of the pathomechanics of injury [1]
Summary
This case report has outlined the progression of cervical injury to a disc protrusion resulting in a C7 radiculopathy in a professional rugby league player, due to numerous blows to the cervical spine after a series of hyperflexion injuries. The patient suffered a severe forced flexion combined with left lateral flexion injury to the cervical spine and experienced sensory and motor changes in the right C7 nerve root distribution. When it became http://www.chiroandosteo.com/content/13/1/15 apparent that there was intervertebral foramen encroachment secondary to a disc protrusion the treatment protocol changed toward a more conservative approach. Further research is needed on the chiropractic management of acute athletic injuries to the spine and the long-term outcome for surgery versus conservative management of patients wishing to continue their athletic career. HP conceived of the study, participated in its design and helped to draft and edit the manuscript. WH helped to collect literature and draft the manuscript.
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