Sports-Related Cervical Spine Fracture and Spinal Cord Injury

A Review of Nationwide Pediatric Trends

Haddy Alas, BS; Katherine E. Pierce, BS; Avery Brown, BS; Cole Bortz, BA; Sara Naessig, BS; Waleed Ahmad, MS; Michael J. Moses, MD; Brooke O'Connell, MS; Constance Maglaras, PhD; Bassel G. Diebo, MD; Carl B. Paulino, MD; Aaron J. Buckland, MBBS, FRACS; Peter G. Passias, MD


Spine. 2021;46(1):22-28. 

In This Article


The present study investigated national trends in sports-related cervical spine injuries over the span of nearly a decade, and found that adolescent age increases risk for cervical spine fractures between C1–4 and subaxial (C5–7) segments, cervical dislocation, and cervical SCIWORA. Cervical SCIWORA was most associated with a concurrent TBI compared to other types of cervical injuries. American football injuries predicted greater odds of cervical SCIWORA compared to any other sport, whereas winter and water sports injuries were most associated with cervical fracture. The increased prevalence of cervical spine injury with age sheds light on the growing concern for youth sports played at a highly competitive level. Our findings support recently updated regulations aimed at decreasing life-threatening injuries in youth athletics and recreation.