Cervical Spine and Brachial Plexus Injuries: Return-to-Play Recommendations.

Great care is required in managing cervical spine and brachial plexus injuries. Athletes who suffer one or more burners (transient brachial plexus injuries) may return to contact activity when they are asymptomatic and neurologically normal and have full cervical motion. A vertebra displaced horizontally more than 3.5 mm or rotated more than 11 degrees is an absolute contraindication to contact sports. Cervical cord neurapraxia is generally benign, but patients should be counseled about the probability of recurrence, depending on the spinal canal/vertebral body ratio. Unresolved spear tackler's spine is an absolute contraindication to collision sports, as are axial-load teardrop fracture and cervical spine fusion of more than three levels. Spinal cord resuscitation can include blood pressure maintenance and timely methylprednisolone.