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Overview of musculoskeletal neck injuries in the child or adolescent athlete

Jason E Decker, MD, FAAP
Albert C Hergenroeder, MD
Section Editors
Joseph Chorley, MD
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH


An overview of musculoskeletal injuries of the neck in the young athlete will be presented here. The anatomy of the cervical spine, the diagnostic approach to the athlete with neck pain or injury, the prehospital management of the athlete with an acute neck injury, and cervical spinal cord and peripheral nerve injuries are discussed separately. (See "Approach to the child or adolescent athlete with neck pain or injury" and "Field care and evaluation of the child or adolescent athlete with acute neck injury" and "Overview of cervical spinal cord and cervical peripheral nerve injuries in the child or adolescent athlete".)


Recreational and sports activities are important causes of spinal fractures associated with neurologic injury. (See "Approach to the child or adolescent athlete with neck pain or injury", section on 'Epidemiology'.)

In a review of 1447 spine fractures treated at two Canadian centers, 14 percent of the fractures, but 23 percent of the injuries with neurologic deficit, were sustained during sporting and recreational activities [1]. Among the 202 fractures that occurred during recreational activity, diving accounted for 21 percent, and snowmobiling, parachuting/skydiving, and equestrian events accounted for 10 percent each. Nearly one-fourth of the fractures were sustained in high-velocity winter sports (eg, snowmobiling, tobogganing, Alpine skiing, and ice hockey).

Atlas (C1) fractures — Axial loading of the cervical spine can cause two types of fractures of the atlas, known as Jefferson fractures: posterior arch fractures and burst fractures [2].

Posterior arch fractures are more common (image 1); with bracing, they typically heal well with fibrous or bony union.

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Literature review current through: Nov 2017. | This topic last updated: Aug 15, 2017.
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