Cervical Cord Neurapraxia

Cervical cord neurapraxia is characterized by an acute, transient sensory or motor change, or both, to more than one extremity. Symptoms include burning pain, numbness, and tingling with or without paresis or complete paralysis. Transient quadriplegia is a type of neurapraxia characterized by temporary paralysis and loss of motor function in all four limbs (Torg et al., 1986). Burning hands syndrome is characterized by burning dysesthesias of the hands and associated upper extremity weakness (Maroon, 1977). Episodes of cervical cord neurapraxia usually resolve within 10 to 15 minutes, although gradual resolution may take more than 24 to 48 hours.

Congenital or degenerative narrowing of the anteroposte-rior (AP) diameter of the cervical spinal canal is an established risk factor for cervical cord neurapraxia (Torg et al., 1997). Athletes with an episode of cord neurapraxia should be held from competition and undergo radiographic evaluation and MRI. Return to play after an episode of cervical cord neurapraxia is a highly controversial area in sports medicine. Several cases of permanent neurologic injury following cervical cord neurapraxia associated with cervical spinal stenosis have been reported (Brigham and Adamson, 2003; Cantu, 1993, 2000). Functional spinal stenosis on advanced imaging in an athlete with a history of cervical cord neurapraxia is an absolute contraindication to return to play in contact and collision sports (Cantu, 2000).

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