Return-to-Sport Recommendations for Athletes With Congenital Cervical Spine Pathology: A Modified Delphi Consensus Survey of Expert Opinion.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zuckerman Scott L, Jo Jacob, Rigney Grant H, Bailes Julian E, Bonfield Christopher M, Cantu Robert C, Chan Patrick C H, Cordover Andrew M, Coric Domagoj, Feuer Hank, Gardocki Raymond J, Hecht Andrew C, Hsu Wellington K, Joseph Jacob R, Lehman Ronald A, Levi Allan D, Liew Susan M, Louie Philip K, Ludwig Steven C, Maroon Joseph, Miele Vincent J, Mullin Jeff, Nemani Venu M, Phillips Frank M, Qureshi Sheeraz, Riew K Daniel, Rogers Myron A, Sasso Rick C, Smith Gabriel A, Turner Jay D, Vaccaro Alexander R, Watkins Robert G, Theodore Nicholas, Okonkwo David O, Sills Allen K, Davis Gavin A
Аннотация
METHODS: A cross-sectional, modified Delphi consensus survey investigating RTS decisions in athletes with various types of congenital cervical spine pathology was undertaken. An international panel of neurosurgery/orthopedic spine surgeons with sport expertise was identified. The cervical spine pathologies studied were craniocervical anomalies, Klippel-Feil syndrome, os odontoideum, Chiari malformation, and congenital cervical stenosis. A 2 × 2 scheme was used to classify sport risk based on impact forces and frequency : low impact/low frequency, low impact/high frequency, high impact/low frequency, and high impact/high frequency. Consensus was a-priori defined at ≥70%. Descriptive statistics were performed.
RESULTS: Of the 34 sports spine surgeons invited (56% neurosurgeons and 44% orthopedic surgeons), survey completion was 100%. The following scenarios achieved ≥70% consensus to recommend athletes to return-to-play high impact/high frequency sports: C1 ring anomaly and no prior neurapraxic event, occipitalized C1, Klippel-Feil of 1 motion segment with/without kyphosis, and asymptomatic Chiari malformation without syrinx. Consensus was also achieved that an athlete with congenital stenosis who has experienced at least 2 neurapraxic events should be advised not to RTS. Although consensus was not achieved in other areas, notable findings are discussed.
CONCLUSION: The following scenarios reached ≥70% consensus recommending athletes to return to high impact/high frequency sports: C1 ring anomaly without a prior neurapraxic event, occipitalized C1, Klippel-Feil syndrome involving 1 motion segment, and asymptomatic Chiari malformation without a syrinx. In addition, consensus was reached advising athletes with congenital stenosis with 2 or more neurapraxic events not to RTS. Although consensus was not obtained in other areas, notable findings are discussed.