Evaluation, Management, and Return-To-Sport Guidelines for Cervical Spine Injuries in Athletes: A Narrative Review.
- 1Department of Orthopedic Surgery, Brown University, Providence, RI, USA.
Abstract
Study DesignNarrative review.ObjectivesTo synthesize current evidence on the epidemiology, pathophysiology, classification, evaluation, and imaging of cervical spine injuries (CSI) in athletes and propose a practical framework for return-to-sport (RTS) decision-making.MethodsA review of the most recent and relevant published studies and consensus statements was performed, focusing on athletic cervical spine pathology. Key domains included on-field assessment, imaging modalities, clinical clearance criteria, and sport-specific risk considerations. All literature published in reputable journals, preferably available through well-regarded databases such as Scopus and PubMed, was eligible for inclusion, with preference given to the most recent publications related to any given topic.ResultsThe reviewed literature supports that RTS across CSI types requires resolution of symptoms, normal neurologic examination, restoration of painless cervical range of motion and strength, and radiographic evidence of healing or stability. MRI is consistently recommended for identifying high-risk features such as canal stenosis, cord signal change, or ligamentous disruption. Sport-specific risk stratification is supported by data showing higher reinjury rates in collision sports. Evidence remains heterogeneous, with substantial variation in specialist recommendations.ConclusionsSafe RTS after CSI requires comprehensive clinical and imaging assessment, recognition of sport-specific risks, and shared decision-making to prioritize athlete safety while avoiding unnecessary restrictions.
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BibTeX
@article{batrash2026evaluation,
title = {{Evaluation, Management, and Return-To-Sport Guidelines for Cervical Spine Injuries in Athletes: A Narrative Review.}},
author = {Firas Batrash and Nicolas L Carayannopoulos and Puru Sadh and Yasmeen Saeed and Michael J Farias and Joseph E Nassar and Jinseong Kim and Eren O Kuris and Stephen E Marcaccio and Nicholas Lemme and Brett Owens and Bryce A Basques and Alan H Daniels},
journal = {Global spine journal},
year = {2026},
month = oct,
doi = {10.1177/21925682261495104},
url = {https://europepmc.org/article/MED/42853117},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Evaluation, Management, and Return-To-Sport Guidelines for Cervical Spine Injuries in Athletes: A Narrative Review.
AU - Firas Batrash
AU - Nicolas L Carayannopoulos
AU - Puru Sadh
AU - Yasmeen Saeed
AU - Michael J Farias
AU - Joseph E Nassar
AU - Jinseong Kim
AU - Eren O Kuris
AU - Stephen E Marcaccio
AU - Nicholas Lemme
AU - Brett Owens
AU - Bryce A Basques
AU - Alan H Daniels
PY - 2026
DA - 2026/10/09
JO - Global spine journal
DO - 10.1177/21925682261495104
UR - https://europepmc.org/article/MED/42853117
AB - Study DesignNarrative review.ObjectivesTo synthesize current evidence on the epidemiology, pathophysiology, classification, evaluation, and imaging of cervical spine injuries (CSI) in athletes and propose a practical framework for return-to-sport (RTS) decision-making.MethodsA review of the most recent and relevant published studies and consensus statements was performed, focusing on athletic cervical spine pathology. Key domains included on-field assessment, imaging modalities, clinical clearance criteria, and sport-specific risk considerations. All literature published in reputable journals, preferably available through well-regarded databases such as Scopus and PubMed, was eligible for inclusion, with preference given to the most recent publications related to any given topic.ResultsThe reviewed literature supports that RTS across CSI types requires resolution of symptoms, normal neurologic examination, restoration of painless cervical range of motion and strength, and radiographic evidence of healing or stability. MRI is consistently recommended for identifying high-risk features such as canal stenosis, cord signal change, or ligamentous disruption. Sport-specific risk stratification is supported by data showing higher reinjury rates in collision sports. Evidence remains heterogeneous, with substantial variation in specialist recommendations.ConclusionsSafe RTS after CSI requires comprehensive clinical and imaging assessment, recognition of sport-specific risks, and shared decision-making to prioritize athlete safety while avoiding unnecessary restrictions.
SN - 2192-5682
SN - 2192-5690
ER -