Recommendations for participation in contact sports in certain cervical spine conditions, part B

Condition	Contraindication to play
Condition	Absolute	Relative*	None*
Ligamentous injuries
Mild ligamentous sprain with no laxity			X
Ligamentous sprain with mild laxity (<3.5 mm anteroposterior displacement and 11 degrees rotation)		X
Ligamentous laxity (>3.5 mm anteroposterior displacement or 11 degrees rotation)	X
Fractures
Acute cervical fracture	X
Vertebral body fracture with a sagittal component	X
Vertebral body fracture with associated posterior arch fractures and/or ligamentous laxity	X
Vertebral body fracture with displacement into the spinal canal	X
Healed fractures with associated neurologic findings or symptoms, pain, or limitation of cervical range of motion	X
Healed, stable, mildly displaced vertebral body fracture without a sagittal component or neural ring involvement		X
Healed, stable, end-plate fracture			X
Healed stable compression fracture of vertebral body			X
Healed "clay-shoveler's" fracture			X
Healed, nondisplaced Jefferson fracture		X
Healed, stable neural ring fractures		X
Spinal fusion
Stable, one-level anterior or posterior surgical fusion			X
Stable, two-level anterior or posterior surgical fusion		X
Anterior or posterior fusion of three or more levels	X
Cervical disk conditions
Healed intervertebral disk bulge			X
Healed intervertebral disk herniation		X
Intervertebral disk herniation with neurologic signs or symptoms, pain, or limitation of cervical range of motion	X

Return_to_play_guidelines_B.htm

* Provided individual is asymptomatic and neurologically normal and has full range of pain-free cervical motion.

Adapted from Torg, JS, Ramsey-Emrhein, JA. Cervical spine and brachial plexus injuries: Return-to-play recommendations. Phys Sportsmed 1997;25.

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