Return to sport possible after temporary paralysis

Athletes who have suffered spinal injuries severe enough to make them temporarily lose feeling in their limbs can sometimes safely return to their sport, research suggests.

These so-called transient spinal cord injuries, or TSCIs, are relatively uncommon but present one of the most difficult problems in the treatment of sidelined athletes.

Once the symptoms—including short-lived paralysis, numbness or weakness in the arms and legs—go away, many players want to know when they can get back in the game, according to Dr. Julian E. Bailes, chairman of neurosurgery at West Virginia University in Morgantown.

“It’s very troublesome,” he told Reuters Health, “because it’s hard for doctors, patients and families to tell what to do.”

In the Journal of Neurosurgery: Spine, Bailes reports on the long-term outcomes of ten high school, college and pro athletes who had suffered a TSCI. Most were football players who had been injured during tackling, but one wrestler and a gymnast were hurt when their heads hit a gym mat, and a baseball player was injured sliding into home plate.

Two athletes suffered paralysis in both arms and legs, while the other patients had numbness or weakness in their limbs. Their symptoms lasted anywhere from 15 minutes to 2 days, and some had recurrent symptoms for up to 3 years.

Overall, four of the athletes eventually returned to competition, and none, Bailes found, had a recurrent TSCI over an average of 40 months of follow-up.

According to Bailes, these findings and those for other groups of patients suggest that a single TSCI does not substantially raise an athlete’s risk of suffering a severe spinal injury in the future.

However, he said, transient paralysis needs to be taken seriously, and athletes who suffer such an injury probably have a slightly higher-than-average risk of a “catastrophic” trauma such as a broken neck.

Among the patients Bailes followed, MRI scans showed that in the area of the neck, three had lost the “cushion” of cerebrospinal fluid that bathes the spinal cord and brain. These patients were told to retire from contact sports.

In addition, there was some degree of spinal stenosis—a narrowing of the canal that surrounds the spinal cord—in all of the 10 patients with TSCI. Such narrowing in these young athletes, Bailes said, could be something they were born with or the result of the repetitive stress of contact sports.

Spinal stenosis, according to Bailes, should not necessarily preclude an injured athlete from returning to competition. The treatment of neurological injuries in sports is “highly individualized,” he said, and many factors go into the return-to-play decision.

SOURCE: Journal of Neurosurgery: Spine, January 2005. 

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