Case study of a rugby player who recovered after cervical anterior and posterior surgery.

The patient was a 26-year old rugby prop player in Japan's Top League. Left hand numbness and motor weakness appeared after a match game. At the time of consultation, we noticed the muscular strength of his left arm had decreased and that his tendon reflection of the lower-limb increased bilaterally. We diagnosed cervical myelopathy and incomplete cervical spinal cord injury and applied a neck collar. The assessment level from manual muscle testing was from 3 to 4 and muscular strength was still declining a month after injury. X ray revealed kyphosis of the cervical spine and magnetic resonance imaging revealed intervertebral disc degeneration and spinal cord compression. We conducted an operation to perform anterior decompression and fusion and posterior laminoplasty to correct local kyphotic alignment and decompress the cord. He recovered just after the operation and restarted training with a neck collar. He returned to match games within six months of the operation. Acute cervical trauma occurs frequently in rugby, and the cervical spines of some prop players develop kyphosis. It is thought that this degeneration is induced by repetitive flexion and axial stress as well as through physical contact and collision. There have been some reports of rugby players returning to competition after cervical operation, but their return after anterior and posterior decompression is rare. Because of the determination of our patient and his recovery from partial paralysis, he returned early to match games and continues competition with no symptoms at the present (24 months postop). Because we believe that the discs adjacent to the fusion may degenerate, careful follow-up is necessary. [ABSTRACT FROM AUTHOR]