The Brain, Spine and Nerves in Sports

 

The definitive text on the diagnosis and treatment of sports-related neurological injuries

Although musculoskeletal injuries are by far the most common injuries seen in sports, neurological injuries are often the most serious and potentially devastating. The Brain, Spine and Nerves in Sports is a comprehensive textbook edited by neurosurgeons Nicholas Theodore and Russell R. Lonser, internationally renowned experts in sports-related brain and spine trauma. The book covers intricacies associated with the diagnosis and treatment of sports-related neurological injuries, with firsthand, collaborative insights from a who's who of multidisciplinary neurological experts in sports injury medicine.

The book is organized into four sections and 40 thoughtfully curated chapters covering diagnosis, surgical and nonsurgical approaches, and management of traumatic brain injuries, concussions, spinal cord injuries, and peripheral nerve injuries. The final chapter focuses on leveraging concussion data to improve the safety of American football. Each chapter blends theoretical knowledge, evidence-based practices, case studies, and practical insights derived from the authors' extensive clinical experience.

Key Features:

Contributions and pearls from leading authorities in the fields of neurosurgery, spine surgery, sports medicine, and rehabilitation

The latest advancements, techniques, and best practices for managing neurological conditions in athletes, presented in a succinct, easy-to-digest format, with short videos

Detailed, critical overviews of sports-related neurological injuries in American football, soccer, cycling, baseball, skiing, combat sports, ice hockey, rugby, and more

A wealth of tables and assessment tools to enhance management of challenging, often time-sensitive situations, including complex return-to-play issues

This definitive textbook will help neurosurgeons, orthopedic surgeons, neurologists, trainers, sports medicine physicians, and pain management physicians optimize patient outcomes, enhance performance, and promote the overall well-being of athletes at all levels of competition.

 

Table of Contents:

 

Section I Brain

1 Sports-Related Head Injury

1.1 Traumatic Brain Injury Overview

1.1.1 Classification

1.1.2 Epidemiology

1.1.3 Pathophysiology

1.2 Management Principles

1.2.1 Workup and Treatment

1.2.2 Complications

1.3 Clinical Pearls

1.4 References

2 Imaging of Sports-Related Neurological Injuries

2.1 Basic Anatomy and Pathophysiology of the Spine

2.2 Specific Injuries

2.2.1 Craniocervical Junction Injuries

2.2.2 Subaxial Cervical Spine

2.2.3 Thoracolumbar Spine

2.3 Imaging of Spine Trauma

2.3.1 Radiographs and Computed Tomography (CT)

2.3.2 Magnetic Resonance Imaging (MRI)

2.4 Imaging of Cranial Trauma

2.4.1 Initial Evaluation

2.4.2 Computed Tomography

2.4.3 Magnetic Resonance Imaging

2.4.4 Advanced Imaging

2.5 Clinical Pearls

2.6 Disclosure Statement

2.7 References

3 Management of Sports-Related Head Injury in the Athlete

3.1 Recognize and Remove

3.2 Re-evaluate

3.3 Rehabilitation

3.4 Refer

3.5 Recovery

3.6 Return to Sport (RTS) and Return to Learn (RTL)

3.7 Reconsider—Potential Long-term Effects

3.8 Retire

3.9 Risk Reduction

3.10 Refine—Para Sport and Pediatric Considerations

3.11 Clinical Pearls

3.12 References

4 Post-concussion Syndrome Management

4.1 Post-concussion Syndrome

4.2 Management of PCS

4.3 Evaluation of PPCS

4.3.1 Subthreshold Exercise

4.3.2 Neuropsychological Evaluation

4.3.3 Oculomotor and Vestibular Assessment

4.4 Treatment of PCS

4.4.1 Subthreshold Exercise

4.4.2 Oculomotor, Vestibular, and Cervical Rehabilitation

4.4.3 Pharmacological Management

4.4.4 Psychological Interventions

4.5 Clinical Pearls

4.6 Conflicts of Interest/Financial Disclosures

4.7 References

5 Congenital Cranial Anomalies and Implications for Athletics

5.1 Introduction

5.2 Hydrocephalus

5.3 Craniosynostosis

5.4 Chiari Malformations

5.5 Epilepsy

5.6 Arachnoid Cysts

5.7 Intracranial Vascular Pathologies

5.7.1 Arteriovenous Malformations

5.7.2 Moyamoya Syndrome and Disease

5.8 Prior Craniotomy

5.9 Conclusions

5.10 Clinical Pearls

5.11 References

6 Considerations for the Child with Sports-Related Head Injury

6.1 Introduction

6.2 SCAT6/SCOAT6

6.3 Treatment and Management of Concussion in Youth

6.4 Return to School

6.5 Returning the Youth Athlete to Sport

6.6 References

7 Concussion: Long-term Sequelae

7.1 Introduction

7.2 History

7.3 Epidemiology

7.4 Pathologic Features

7.4.1 Gross Findings

7.4.2 Histologic Features

7.5 Clinical Syndrome

7.6 Diagnostic Modalities

7.6.1 Imaging

7.6.2 Molecular Biomarkers

7.7 Treatment

7.8 Conclusion

7.9 Clinical Pearls

7.10 Disclosure Statement

7.11 References

Section II Spine

8 Sports-Related Spine Injuries

8.1 Introduction

8.2 Association of Sports with Spine Injuries

8.3 Spine Anatomy and Properties

8.4 Sports-Related Spine Injuries

8.4.1 Cervical Spine Injuries

8.4.2 Thoracic and Lumbar Spine Injuries

8.4.3 Back Pain

8.4.4 Spinal Cord Injuries

8.5 Injury Classification and Scoring Systems

8.6 Conclusion

8.7 Clinical Pearls

8.8 References

9 Biomechanics of the Head and Spine in Sports

9.1 Introduction

9.2 Fundamental Brain Biomechanics

9.2.1 Translational Kinematics

9.2.2 Rotational Kinematics

9.3 Direct versus Indirect Loads

9.4 Techniques to Determine Injury Thresholds

9.4.1 Physical Reconstructions

9.4.2 Head Impact Sensors

9.4.3 Computational Models

9.5 Role of Impact Direction

9.6 Biomechanics of Injury Prevention

9.7 Prevention of Long-term Consequences of Repetitive Head Impacts

9.8 Biomechanics of Spinal Injury in Sport

9.9 Clinical Pearls

9.10 References

10 Nonsurgical Treatment of Spinal Injuries

10.1 Introduction

10.2 General Considerations and Initial Assessment

10.3 Cervical Spine

10.3.1 Epidemiology

10.3.2 Strain and Sprain

10.3.3 Ligamentous Injuries

10.3.4 Disk Bulge and Herniation

10.3.5 Definition of Cervical Stenosis

10.3.6 Neuropraxia, Stingers, and Burners

10.3.7 Fractures without SCI

10.3.8 Return-to-Play Recommendations

10.4 Thoracic Injuries

10.4.1 Epidemiology

10.4.2 Strain and Sprain

10.4.3 Ligamentous Injuries

10.4.4 Disk Bulge and Herniation

10.4.5 Neuropraxia

10.4.6 Fractures without SCI

10.4.7 Return-to-Play Recommendations

10.5 Lumbar Injuries

10.5.1 Epidemiology

10.5.2 Strain and Sprain

10.5.3 Ligamentous Injuries

10.5.4 Disk Bulge and Herniation

10.5.5 Spondylolysis and Spondylolisthesis

10.5.6 Definition of Spinal Stenosis

10.5.7 Fractures without Instability

10.5.8 Return-to-Play Recommendations

10.6 Conclusion

10.7 Clinical Pearls

10.8 Disclosures

10.9 Acknowledgments

10.10 References

11 Emergent Management of the Athlete with Spinal Cord Injury

11.1 Introduction

11.2 Pregame Planning

11.3 Initiating Spinal Precautions

11.4 On-Field Management

11.5 In-Hospital Management

11.6 Additional Treatment Options

11.7 Conclusion

11.8 Clinical Pearls

11.9 Disclosures

11.10 References

12 Physical Examination of the Athletic Spine

12.1 Introduction

12.2 The Spine Examination

12.3 Phases of the Physical Examination of the Spine and Corresponding Pathologies

12.3.1 Cervical Spine

12.3.2 Thoracic Spine

12.3.3 Lumbar Spine

12.3.4 Shoulder, Hip, and Sacroiliac Joints

12.4 Clinical Pearls

12.5 References

13 Rehabilitation of Athletic Spinal Injuries

13.1 Introduction

13.2 General Rehabilitation Overview

13.3 Acute Phase

13.4 Therapeutic Modalities

13.5 Biomechanics

13.6 Core Stabilization

13.7 Spine Mobility

13.8 Muscle Activation and Motor Control

13.9 Adaptive Progression

13.10 Aerobic Excercise

13.11 Aquatic Rehabilitation

13.12 Rehabilitation Progression

13.13 Clinical Pearls

13.14 References

14 Spinal Manipulation

14.1 Introduction

14.2 Introduction to Chiropractic

14.3 Indications for Spinal Manipulation

14.3.1 Pain

14.3.2 Decreased Range of Motion

14.3.3 Posture

14.3.4 Neurological or Nerve Root Entrapment

14.3.5 Sacroiliac (SI) Disorders

14.3.6 Headaches

14.3.7 Vertigo, Equilibrium, and Balance Problems

14.3.8 Whiplash

14.3.9 Concussion

14.3.10 Degenerative Disk Disease (DDD)

14.3.11 Degenerative Joint Disease (DJD)

14.3.12 Extremity Injuries

14.3.13 Overall Performance

14.3.14 Proactive Care

14.4 Contraindications for Spinal Manipulation

14.5 What is an Adjustment?

14.5.1 Practice Pearl

14.6 The Effects of Spinal Misalignments

14.7 Commonly Utilized Chiropractic Techniques ▶ [615]

14.8 References

15 Surgery: Anterior Cervical Diskectomy and Fusion

15.1 Introduction

15.2 Preoperative Assessment

15.3 Surgical Technique

15.3.1 Positioning

15.3.2 Dissection

15.3.3 Diskectomy and Fusion

15.3.4 Postoperative Care

15.4 Return to Play after ACDF

15.5 Clinical Pearls

15.6 References

16 Surgery: Cervical Arthroplasty

16.1 Introduction

16.2 Preoperative Assessment

16.3 Surgical Technique

16.3.1 Operating Room Setup

16.3.2 Positioning

16.3.3 Decompression of the Segment

16.3.4 Placement of the Arthroplasty Device

16.4 Complication Avoidance

16.5 Return to Play

16.6 Conclusion

16.7 Clinical Pearls

16.8 Disclosures

16.9 Acknowledgments

16.10 References

17 Surgery: Posterior Cervical Foraminotomy

17.1 Introduction

17.2 Indications for PCF

17.3 Diagnostics

17.4 Nonoperative Management

17.5 Pertinent Anatomy

17.6 Operative Procedure

17.7 Complications

17.8 Postoperative Care

17.9 Conclusion

17.10 Clinical Pearls

17.11 Disclosures

17.12 Acknowledgments

17.13 References

18 Surgery: Posterior Lumbar Decompression and Fusion

18.1 Introduction

18.2 Indications

18.3 Preoperative Assessment

18.4 Surgical Technique

18.4.1 Operating Room Setup

18.4.2 Instrumentation of the Spine

18.4.3 Decompression of the Neural Elements

18.4.4 Placement of the Interbody

18.5 Complication Avoidance

18.6 Conclusion

18.7 Clinical Pearls

18.8 Disclosures

18.9 Acknowledgments

18.10 References

19 Surgery: Direct Pars Repair for Spondylolysis

19.1 Introduction

19.2 Spondylolysis

19.2.1 Presentation

19.2.2 Diagnosis

19.2.3 Management Options

19.3 Direct Pars Repair

19.3.1 Indications

19.3.2 Techniques

19.3.3 Outcomes

19.3.4 Case Presentation

19.4 Clinical Pearls

19.5 Summary

19.6 References

20 Return to Play after Spinal Injury

20.1 Introduction

20.2 Lack of Consensus

20.3 Considerations for RTP Guidelines

20.4 Spine Injury Biomechanics

20.5 Cervical Spinal Cord

20.5.1 Cervical Disk Herniation

20.5.2 Cervical Cord Neurapraxia

20.6 Lumbar Spine Injuries

20.6.1 Lumbar Disk Herniation

20.6.2 Spondylolisthesis

20.7 Surgical Considerations

20.7.1 Anterior Cervical Diskectomy and Fusion

20.7.2 Percutaneous Nucleotomy

20.7.3 Lumbar Diskectomy

20.8 Clinical Pearls

20.9 Disclosures

20.10 References

21 Congenital Spinal Anomalies and Implications for Athletics

21.1 Introduction

21.2 Spina Bifida

21.3 Klippel-Feil Syndrome

21.4 Os Odontoideum

21.5 Atlanto-Occipital Fusion

21.6 Atlantoaxial Instability in Down Syndrome

21.7 Hemivertebra

21.8 Adolescent Idiopathic Scoliosis

21.9 Conclusions

21.10 Clinical Pearls

21.11 References

Section III Peripheral Nerves

22 Anatomy and Physical Examination of the Peripheral Nerves

22.1 Scapula

22.2 Shoulder

22.3 Elbow

22.4 Wrist

22.5 Thumb

22.6 Fingers

22.7 Hip

22.8 Knee

22.9 Ankle

22.10 Foot

22.11 Provocative Tests

22.12 Clinical Pearls

22.13 References

23 Common Peripheral Nerve Problems in Athletes: Diagnosis and Management

23.1 Introduction

23.2 Burners and Stingers

23.3 Upper Extremity Nerve Injuries

23.3.1 Thoracic Outlet Syndrome

23.3.2 Other Nerve Injuries about the Shoulder: Suprascapular Nerve, Long Thoracic Nerve, and Axillary Nerve

23.3.3 Musculocutaneous Nerve

23.3.4 Median Nerve

23.3.5 Ulnar Nerve

23.3.6 Radial Nerve

23.4 Lower Extremity

23.4.1 Sciatic Nerve and Piriformis Syndrome

23.4.2 Pudendal Nerve

23.4.3 Lateral Femoral Cutaneous Nerve

23.4.4 Femoral Nerve

23.4.5 Fibular Nerve

23.4.6 Tibial Nerve

23.4.7 Morton’s Neuroma

23.5 Conclusions

23.6 Clinical Pearls

23.7 References

Section IV Sports

24 American Football

24.1 Introduction

24.2 Cervical Spine Injuries in Football Players

24.2.1 Epidemiology and Pathogenesis

24.2.2 Diagnosis

24.2.3 Management

24.3 Thoracolumbar Spine Injuries in Football Players

24.3.1 Epidemiology and Pathogenesis

24.3.2 Diagnosis

24.3.3 Management

24.4 Return to Play

24.5 Clinical Pearls

24.6 Disclosures

24.7 Acknowledgments

24.8 References

25 Soccer

25.1 Introduction

25.2 Brain Injury

25.2.1 Concussion

25.2.2 Subconcussive Heading, Neuropsychological Changes and Controversies

25.2.3 Neurodegenerative Disease and Controversies

25.2.4 Intracerebral Hemorrhages

25.3 Spine Injury

25.3.1 Spinal Degenerative Changes

25.3.2 Spinal Cord Injury

25.4 Peripheral Nerve Injuries

25.4.1 Facial Nerve (Cranial Nerve VII) Injury

25.4.2 Brachial Plexus Injury

25.4.3 Sciatic Nerve Branches (Fibular Nerve, Sural Nerve) Injury

25.5 Conclusions

25.6 Clinical Pearls

25.7 Disclosures

25.8 References

26 Golf

26.1 Introduction

26.2 Pathogenesis of Spinal Disease in Golf

26.2.1 Repetitive Traumatic Diskopathy

26.3 Treatment of Spinal Disease in Golf

26.3.1 Physical Therapy and Rehabilitation

26.3.2 Swing Modifications

26.4 Surgical Management and Return to Play Guidelines

26.5 Conclusions

26.6 Clinical Pearls

26.7 Disclosures

26.8 Acknowledgments

26.9 References

27 Cycling

27.1 Introduction

27.2 Brain

27.3 Spine

27.4 Peripheral Nerves

27.4.1 Ulnar Nerve

27.4.2 Median Nerve

27.4.3 Pudendal Nerve

27.5 Conclusions

27.6 Clinical Pearls

27.7 Disclosures

27.8 References

28 Rowing

28.1 Basic Technique

28.2 Common Spinal Injuries

28.3 Imaging

28.4 Prevention and Treatment

28.5 Clinical Pearls

28.6 References

29 Professional Motorsport Racing

29.1 Introduction

29.2 Different Types of Neurological Injury

29.2.1 Brain Injury

29.2.2 Spinal Cord Injury

29.2.3 Peripheral Nerve Injury

29.3 Safety Equipment for the Prevention of Neurological Injury

29.4 Conclusion

29.5 Clinical Pearls

29.6 References

30 Gymnastics

30.1 Introduction

30.2 Brain Injuries

30.2.1 Mechanism of Injury

30.2.2 Symptoms

30.2.3 Diagnosis

30.2.4 Treatment

30.3 Spine Injuries

30.3.1 Spondylolysis

30.3.2 Degenerative Disc Disease

30.3.3 Other Spinal Injuries

30.4 Prevention of Injury

30.5 Conclusions

30.6 Clinical Pearls

30.7 Disclosures

30.8 References

31 Equestrian

31.1 Introduction

31.2 Mechanism of Injury

31.3 Risk Factors

31.4 Brain Injuries

31.5 Spine Injuries

31.5.1 Vertebral Column Fractures

31.5.2 Spinal Cord Injury

31.6 Prevention and Protective Measures

31.7 Conclusion

31.8 Clinical Pearls

31.9 Disclosures

31.10 References

32 Baseball

32.1 Introduction

32.2 Biomechanics and Basic Technique

32.2.1 Pitching

32.2.2 Batting

32.3 Catastrophic Injuries in Baseball

32.4 Noncatastrophic Spine Injuries

32.4.1 Disc Herniation

32.4.2 Lumbar Spondylolysis

32.5 Traumatic Brain Injuries

32.6 Peripheral Nerve Injuries

32.6.1 Suprascapular Neuropathy

32.6.2 Ulnar Neuropathy

32.7 Prevention of Injuries

32.8 Disclosures

32.9 References

33 Skiing

33.1 Introduction

33.2 Spinal Injuries in Skiing

33.2.1 Epidemiology, Nature of Injury, and Biomechanics

33.3 Diagnosis

33.4 Treatment, Management, and Rehabilitation

33.5 Prevention

33.6 References

34 Combat Sports

34.1 Introduction

34.2 The Brain in Combat Sports

34.2.1 Common Brain Injury Forms in Combat Sports

34.2.2 Prevalent Brain Injuries and Return to Play Rules in Boxing

34.2.3 Prevalent Brain Injuries and Return to Play Rules in Judo

34.3 The Spine in Combat Sports

34.3.1 Common Spine Injuries in Combat Sports

34.3.2 Prevalent Spine Injuries and Return to Play Rules in Wrestling

34.3.3 Prevalent Spine Injuries in Boxing

34.4 The Nerves in Combat Sports

34.4.1 Common Nerve Injuries in Combat Sports

34.4.2 Prevalent Nerve Injuries in Boxing

34.4.3 Prevalent Nerve Injuries in Wrestling

34.4.4 Nerve Injury Imaging and Clinical Care

34.5 Preventative Measures and the Future Directions of Combat Sports

34.6 Clinical Pearls

34.7 Disclosures

34.8 References

35 Ice Hockey

35.1 Introduction

35.2 Brain

35.2.1 Symptoms

35.2.2 Diagnosis

35.2.3 Treatment

35.2.4 Prevention

35.3 Spine

35.3.1 Symptoms

35.3.2 Diagnosis

35.3.3 Treatment

35.3.4 Prevention

35.4 Peripheral Nerves

35.4.1 Burners

35.4.2 Axillary Nerve

35.4.3 Peroneal Nerve

35.5 Conclusion

35.6 Clinical Pearls

35.7 Disclosures

35.8 References

36 Weightlifting

36.1 Introduction

36.2 Pathophysiology of Weightlifting Injuries

36.2.1 Athlete Baseline Factors

36.2.2 Physiological Forces

36.2.3 Onset of Injury

36.3 Common Injuries Caused by Weightlifting

36.3.1 Spine

36.3.2 Peripheral Nerve

36.4 Conclusion

36.5 Clinical Pearls

36.6 Disclosures

36.7 References

37 Rugby

37.1 Rugby Basics

37.2 Historical Numbers

37.3 Plays Likely to Cause Neurotrauma

37.4 Most Neurotrauma by Position

37.5 Rule Changes

37.6 Clinical Pearls

37.7 References

38 Aquatic Sports

38.1 Introduction

38.2 Mechanisms of CNS Injuries in Common Aquatic Sports

38.2.1 Diving

38.2.2 Personal Watercraft Riding

38.2.3 Scuba Diving

38.2.4 Surfing

38.2.5 Swimming

38.2.6 Wave-Related Activities

38.3 Diagnosis and Treatment of Aquatic Injuries

38.3.1 Traumatic Spine Injuries

38.3.2 Traumatic Brain Injuries

38.3.3 Submersion Injuries

38.3.4 Decompression Injuries

38.4 Conclusion

38.5 Clinical Pearls

38.6 Disclosures

38.7 References

39 The Future of Traumatic Brain Injury

39.1 Overview

39.2 Imaging Biomarkers

39.3 Blood and Saliva Biomarkers

39.4 Pupillometry/Eye Tracking

39.5 Sports-Specific Tools

39.6 Conclusion

39.7 Clinical Pearls

39.8 Disclosures

39.9 References

40 Concussions in the National Football League: Using Data to Improve Game Safety

40.1 Introduction

40.2 Building the Data Source

40.2.1 The NFL Injury Analytics Database

40.2.2 Medical Data Optimization

40.2.3 Team Behind the Team

40.3 Concussion Detection, Diagnosis, and Return to Participation

40.3.1 Athletic Trainer (AT) Spotter Program

40.3.2 Unaffiliated Neurotrauma Consultant (UNC) Program

40.3.3 Pregame “60-Minute Meeting”

40.3.4 Gameday Technology and Injury Video Review System (IVRS)

40.3.5 Medical Tents

40.3.6 Player Education

40.3.7 Concussion Assessment

40.3.8 Return to Participation

40.4 Data-Driven Injury Prevention

40.4.1 Equipment-Related Changes

40.4.2 Changes to Game Play

40.5 Conclusions

40.6 Clinical Pearls

40.7 Conflicts of Interest and Source of Funding

40.8 References

Contributors

Index

Imprint/Access Code

 

An aparitie	3 sep 2024
Autor	Nicholas Theodore, Russell Lonser
Dimensiuni	216 x 279 mm
Editura	Thieme
ISBN	9781684201143
Limba	Engleza
Nr pag	272
Versiune digitala	DA