スポーツ外傷による頚髄損傷

―脊髄損傷の発生状況と現場での取り組みおよび診断, 治療のピットフォールと変遷―

抄録

  I reviewed the epidemiology and occurrence of traumatic cervical spine injuries of athletes in Japan and other countries, and noted the importance of initial assessment at the sports site, imaging diagnosis, and treatment of cervical spine injuries. From the global epidemiology of sports-related spinal cord injury, the frequency and cause of spinal cord injuries are different among countries, along with their respective characteristics. Taking prompt measures at the sports site is necessary to ensure safe patient handling and transport. However, as many people other than doctors are involved in sports events, the staff involved in these events should be prepared and practice emergency response measures. No major difference was found between athletes and non-athletes in regard to the treatment of cervical spine injury. However, athletes strongly hope for early return to active participation in their sport. Thus, surgical methods that are less invasive to soft tissues and involve strong fixation should be selected. However, further knowledge about evaluation and judgment for these athletes to return to their sport is needed. Many sports-related spinal cord injuries are preventable, and we must strive toward achieving zero incidence of spinal cord injuries. Thus, physicians attending to sports-related spinal cord injuries should both communicate more actively and supervise players of the team.