Cervical spinal cord injury in sumo wrestling: a case report

Return to Martial Arts after Surgical Treatment of the Cervical Spine: Case Report and Systematic Review of the Literature for an Evidence-Based Approach

Background: Cervical spine injuries are considered common in athlete populations, especially in those involved in high-contact sports. In some cases, surgical treatment can be necessary, and, therefore, return-to-play (RTP) after surgery represent a notable issue. Methods: We performed a systematic review of literature according to the PRISMA statement guidelines using the following search algorithm: (("ACDF") OR ("cervical spine surgery") OR ("neck surgery") OR ("cervical discectomy") OR ("foraminotomy") OR ("cervical disc replacement")) AND (("return to play") OR ("athlete") OR ("contact sports") OR ("martial arts")). The search was performed on 21 October 2022. We included only articles in which operative treatment for the cervical spine was performed and return to martial art activity was declared in the text. Results: Eight articles were selected, including 23 athletes who practice wrestling (n = 16), kickboxing (n = 1), sumo (n = 1) or other unspecified martial arts (n = 5). We also included the case of a young judoka who underwent anterior cervical discectomy and fusion (ACDF) at our hospital. About 88% (21 of 24 cases) of martial arts practitioners returned to play after cervical spine surgery, and no major complications were reported after RTP. Four patients (16.7%) returned in 0-3 months; 41.7% (10 of 24) returned in 3-6 months; 29.2% (7 of 24) returned after a period longer than 6 months. ACDF is the most used procedure. The level of evidence in the included articles is low: only case reports are available, including some single-case studies. Moreover, a small number of cases have been reported, and the examined data are very heterogeneous. Conclusions: Return to martial arts within one year after cervical spine surgery is generally safe, even if case-by-case evaluation is, however, necessary. Further studies are necessary to corroborate the present findings in a larger population.

Jones Fractures in Sumo Wrestlers: Three Case Reports

Jones fractures sometimes occur in athletes and are known to have complications, such as nonunion, delayed union, and recurrence, even with treatment. We describe three cases of Jones fractures in sumo wrestlers with treatment-related difficulties. All patients discontinued treatment at their own discretion. The two conservative cases had nonunion or delayed union, and the operative case had a broken screw. However, all patients continued sumo wrestling, with little impact on their careers. The risk factors of Jones fractures in sumo wrestling may be heavy weight, and training or competition characteristics unique to sumo wrestling. In cases of a complete Jones fracture, operative treatment is most commonly selected, as the risk for nonunion or refractures is less than that for conservative treatment. However, in the case of sumo wrestlers, there are risks of infection and problems with treatment compliance. As taking a rest may result in a lowered rank, completing a sufficient duration of treatment is difficult. Treatment is difficult and controversial in sumo wrestlers; all three patients discontinued treatment of their own accord. These cases suggest that it is important to thoroughly inform sumo wrestlers of the treatment options, and to decide the most appropriate treatment method for each patient.

lnjuries in wrestling: systematic review

OBJECTIVES

To identify all studies of injuries in wrestling, assess risk of bias and compute weighted average injury rates.

METHODS

17 online databases and nine grey literature resources were searched with no language/date limitations. Abstracts were assessed for inclusion and data abstracted independently by two reviewers.

RESULTS

Eleven studies of competitions, 27 databases, four surveys (699 wrestlers) and seventeen case reports (604 cases) were included. Studies provided varying completeness of data. Weighted average injury rates of 16.3/1000AE (AE = Athletic encounter) could be computed for 8/11 studies of competitions and 69.5/1000AE for 5/27 databases. Eleven of the databases focused on specific injuries. Weighted average injury rates by location for 8/11 competition studies and 7/16 databases were similar for the upper extremities (competitions 26%, databases 24%) and torso (15%, 12%), but dissimilar for head/neck (31%, 20%) and lower extremities (24%, 39%). Weighted average injury rates by injury type varied from 6/11 to 2/11 competition studies and 6/16 to 3/16 database studies. Percentages were similar for fractures (6%, 7%), dislocations/subluxations (6%, 6%), ligament tears/cartilage injuries (12%, 17%) and concussions/1000AE (2 competition studies, 1 database) in competitions (25%, 27%) and training (5.7%, 7.1%). Percentages were dissimilar for lacerations/abrasions/contusions (23%, 4%) and sprains/strains (38%, 26%). The differences may be due to the small number of databases providing specific data and the unknown proportion of training injuries. Databases extrapolating injuries to the national US level reported high annual numbers.

CONCLUSIONS

Average injury rates weighted by sample size are 16.3/1000AE for 8/11 competition studies and 69.5/1000AE for 5/27 databases. Competition data are likely to be accurate because they were observed by physicians, trainers and referees and the completeness and accuracy of database studies vary. Databases which extrapolated data to provide annual national rates estimated large numbers. Few studies provided data about the situations in which injuries occur and the causes of injuries.

Severity and pattern of injuries caused by Swiss wrestling (Schwingen): first retrospective study at a level I University Emergency Department in Switzerland

Background

This article addresses typical injury patterns related to the traditional Swiss folk wrestling, ‘Schwingen’. This is a fight between two competitors with its own rules, grips and throws. A variety of injuries have been occasionally reported. The aim of this study was to characterise all cases of Schwingen injuries treated in the University Hospital of Bern from January 2006 to July 2016.

Methods

To assess the frequency, type and outcome of Schwingen injuries, database search was performed of all inpatient and outpatient cases related to Schwingen that were admitted to Bern University Hospital from January 2006 to December 2016.

Results

A total of 32 such patients could be identified. Apart from a single woman, all patients were male. 31 of the 32 players were Swiss. One patient was admitted to the intermediate care unit, eight patients underwent surgery, two were hospitalised for further treatment and two were given a plaster. 17 other patients were given medications such as painkillers. One was dismissed without further treatment and another one left the hospital on his own. Typical injury patterns varied from simple lesions to distortions and fractures as well as head injuries and other neurological complications.

Conclusion

The majority of injuries caused by Schwingen are not life threatening. Nevertheless, there is always the potential of head injuries and neurological deficits. Apart from the economic loss due to treatment costs and sick leave, these injuries can be disabling for life. It should therefore be obligatory for all players to evaluate preventive measures.

Radiological Changes in the Cervical Spine in Freshman Collegiate Sumo Wrestlers

BACKGROUND

Sumo has long been a traditional sport in Japan and is rapidly attracting enthusiasts abroad. Sumo wrestling entails a risk of impact to the cervical spine during an initial charge. Few reports are available in the English-language literature regarding radiological changes in the cervical spine in sumo wrestlers.

PURPOSE

To examine radiological changes in the cervical spine in freshmen collegiate sumo wrestlers.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

A total of 53 freshmen sumo wrestlers (age, 18-19 years) who belonged to the Japan Sumo Federation underwent routine radiographic examination of the cervical spine and completed questionnaires on cervical symptoms.

RESULTS

Of the 53 wrestlers, 81% showed loss of lordosis, 45% showed osteophyte formation (mainly at C3-C4), 11% showed disc space narrowing (mainly at C5-C6), and 51% showed narrowing of the cervical nerve root foramina (mainly at C3-C4). Fifty-one percent had some cervical symptoms. A correlation was found between deformity of the cervical bodies (such as intervertebral disc ballooning) and cervical symptoms, but no correlation was found between cervical degenerative changes and cervical symptoms.

CONCLUSION

Our data suggest that loss of lordosis, osteophyte formation, and narrowing of the cervical nerve root foramina at C3-C4 were frequently present in freshmen wrestlers and may be due to the axial load incurred prior to their collegiate careers.

Indirect catastrophic injuries in olympic styles of wrestling in iran

Background:

Data on indirect catastrophic injuries in wrestling are scarce.

Objectives:

To develop a profile of indirect catastrophic injuries in international styles of wrestling and to describe possible risk factors.

Study Design:

Retrospective case series; Level of evidence, 3.

Methods:

Indirect catastrophic injuries that occurred in wrestling clubs in Iran from July 1998 to June 2005 were identified by contacting several sources. The cases were retrospectively reviewed.

Results:

The injuries included 9 indirect catastrophic injuries. The injury rate was 0.62 injuries per 100 000 wrestlers per year. The majority of indirect injuries were cardiovascular events in veteran groups of wrestlers.

Conclusions:

Indirect catastrophic wrestling injuries are rare and present most commonly in older athletes. Coronary artery disease was the main cause.