Management of thoracic spinal cord injury in a professional American football athlete: illustrative case

J Neurosurg Case Lessons, 2021 · DOI: 10.3171/CASE21206 · Published: August 9, 2021

Spinal Cord Injury Orthopedics Rehabilitation

Simple Explanation

This paper describes the case of a professional football player who suffered a severe spinal cord injury in his upper back (thoracic spine) while playing. The injury was complicated by the fact that the player also had scoliosis, a curvature of the spine. Doctors used a combination of treatments, including surgery, cooling the body (hypothermia), steroids, hyperbaric oxygen therapy, and a high dose of omega-3 fatty acids in addition to rehabilitation to help the player recover. He regained the ability to run and jump. The authors suggest this case is unique due to the combination of a rare injury in football, scoliosis, and the aggressive treatment approach. It highlights the potential for recovery even in severe cases with multifaceted interventions.

Study Duration

Not specified

Participants

One professional American football player

Evidence Level

Level 4: Case Report

Key Findings

1
A professional football player sustained a T8 AIS A thoracic SCI in the setting of idiopathic scoliosis.
2
Prompt intensive intervention, including surgery for a secondary neurological deterioration and prolonged intensive rehabilitation, facilitated an optimal functional recovery.
3
The patient improved from T8 AIS A to T10 AIS D after aggressive treatment and rehabilitation, ultimately regaining the ability to run and jump.

Research Summary

This case report details the management of a severe thoracic spinal cord injury (SCI) in a professional American football player with pre-existing scoliosis. The patient received a multimodal treatment approach including methylprednisolone, hypothermia, surgical decompression and fusion, hyperbaric oxygen therapy, omega-3 fatty acids, and intensive rehabilitation. The patient achieved significant motor and sensory recovery, progressing from complete paraplegia (AIS A) to incomplete paraplegia (AIS D) and regaining the ability to run and jump with minimal residual spasticity.

Practical Implications

Aggressive Intervention

Early and aggressive medical and surgical intervention, combined with intensive rehabilitation, may lead to favorable outcomes in severe SCI cases, even those complicated by pre-existing conditions like scoliosis.

Multimodal Therapy

A multimodal approach including hypothermia, steroids, hyperbaric oxygen, omega-3 supplementation, and intensive rehabilitation may be considered for SCI in healthy athletes.

Scoliosis Awareness

Scoliosis may predispose individuals to spinal injuries at the apex of the curve, highlighting the need for awareness and potential preventative measures in athletes with spinal curvature disorders.

Study Limitations

1
Single case report limits generalizability.
2
Efficacy of individual therapeutic interventions is speculative and requires further study.
3
The patient's excellent recovery may be due to a combination of factors that are difficult to isolate.

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