Last week, Pittsburgh Steelers’ linebacker, Ryan Shazier, attempted to tackle an opposing player with his head down. This position transmitted sudden pressure from the brain to the spinal canal and resulted in paralysis. This type of non-penetrating spinal trauma is also known as a spinal concussion.
A concussion is a syndrome of immediate and transient neurologic impairment that results from a biomechanics force being applied to the nervous system.
Although the term has become synonymous with a brain injury, it can also be applied to the spinal cord.
The spinal cord contains an extensive network of nerve tracts that provide sensory and motor function to the extremities. It is divided into the cervical, thoracic, lumbar and sacral levels. The uppermost cervical level contains fibers extending to both the upper and lower extremities.
Like brain concussion, spinal concussion is the mildest form of trauma when considering a range that extends to penetrating trauma as the most severe form. Mild injuries typically do not produce any changes on CT scans or other imaging studies.
The pathology involved in this type of trauma is typically severe inflammation and swelling. There is a response to cellular injury where electrolytes that typically reside outside the cell rush inward through a breech in the nerve cell membrane causing swelling within the cell and eventual cell death.
Typical symptoms are immediate sensory loss and paralysis of the affected limbs. Careful positioning and stabilization of the spine are critical on the field, followed by ambulance transport to a hospital. Hospital care includes imaging with CT or MRI and may include treatment with steroids to reduce swelling.
Fortunately, most spinal concussions, like brain concussions, can fully resolve with little to no permanent damage. Hopefully, this is also the case for Shazier.
Editor’s note: The Steelers placed Shazier on injured reserve on Tuesday. The 25-year-old Shazier underwent spinal stabilization surgery last week and remains in the hospital.
Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at firstname.lastname@example.org