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Biomedical subjects

A T Scher

Publications and source records attributed to A T Scher.

At least 19 recordsLinked to original sources
PubMed1991

A retrospective study of spinal cord injuries in Cape Province rugby players, 1963-1989. Incidence, mechanisms and prevention.

A retrospective study was undertaken to determine aetiological factors for 117 catastrophic neck injuries in rugby players admitted to the Spinal Cord Unit, Conradie Hospital, Cape Town, between 1963 and 1989. Nineteen of these players were known to be dead; the files of another 10 were missing. Questionnaires were sent to the remaining 88 players and 52 responded (59%). Their data were supplemented with information obtained from the medical records of the patients who did not respond. The annual number of admissions increased dramatically after 1976 with 83% of all injuries occurring after that date. A further increase since 1984 contrasts with a falling incidence of these injuries in Britain, Australia and New Zealand. Increased risk of injury was related to the following factors: 98% of injuries occurred in matches and 81% were incurred by adults; 69% of injuries occurred in age-group A team or senior first team players; and 57% of injuries occurred in the tackle situation and 39% in scrums, rucks and mauls. Hooker, centre and flyhalf were the playing positions at greatest risk. Injuries were more common in early season matches and again after the mid-season break. This study confirmed that spinal cord injuries occur under predictable circumstances and are therefore foreseeable and preventable. The high incidence of these injuries in the Cape Province is as unacceptable today as it was when first reported in 1977.

Adolescent↗
PubMed1991

Paralysis due to the high tackle--a black spot in South African rugby.

The high tackle around the neck is illegal but still commonplace in South African rugby. An analysis of 40 rugby players who sustained spinal cord injury during the period 1985-1989 revealed that 8 were injured by a high tackle. The case histories and radiographs of these 8 players were analysed. The majority sustained flexion-rotation injuries after being tackled from the side. Another mechanism of injury was hyper-extension during a tackle from the rear. Disturbingly, 4 of the 8 players sustained complete permanent paralysis. This was consequent upon the orthopaedic injuries sustained--specifically facet dislocations or 'tear-drop' fractures, both injuries carrying with them a high risk of serious spinal cord injury. It is concluded that foul play in the form of the high tackle is still a major cause of serious spinal cord injury in South African rugby.

Adolescent↗
PubMed1991

Catastrophic rugby injuries of the spinal cord: changing patterns of injury.

In reports from the UK and New Zealand, it is noted that the incidence of rugby injuries to the cervical spinal cord has dropped and that the percentage of players injured in the tackle has similarly decreased. In contrast, this does not appear to be the pattern in South Africa and an analysis has therefore been made of 40 rugby players sustaining injuries to the spinal cord during the period 1985 to 1989. The radiological appearances on admission have been correlated with the circumstances of injury, associated orthopaedic injuries and neurological deficits. The tackle was responsible for the majority of injuries, causing more than the scrum. Tackles were also responsible for more cases of complete, permanent quadriplegia than the scrum. The commonest cause of injury in players being tackled was the high tackle around the neck, while the commonest cause of injury in players making the tackle was the dive tackle. This survey has shown that the tackle is now the major cause of spinal cord injury in South African rugby, in contrast to earlier analyses in which the scrum was identified as the most common cause.

Adolescent↗
PubMed1990

Premature onset of degenerative disease of the cervical spine in rugby players.

Rugby players and other individuals with the changes of degenerative disease of the cervical spine are at risk of spinal cord trauma after hyperextension injury. In an attempt to assess whether rugby players are prone to the development of premature degenerative disease, radiographs of the cervical spines of 150 rugby players were compared with a control group of 150 male hospital patients. The study revealed that rugby players showed premature and advanced changes of degenerative disease when compared with the control group. These changes were most marked in the cervical spines of the tight forwards. Rugby players so affected are therefore more likely to present with the symptoms and signs of cervical osteo-arthrosis and are at greater risk of hyperextension injury to the cervical spinal cord.

Adult↗
PubMed1990

Cervical vertebral dislocation in a rugby player with congenital vertebral fusion.

Congenital cervical vertebral fusion is an anomaly which decreases the normal range of spinal movement and predisposes to trauma. The case history of a rugby player with a congenital fusion who sustained permanent quadriplegia after dislocation of the lower cervical spine is presented. The mechanism of injury is discussed. A plea is made for routine radiographic examination of the cervical spines of all rugby players in order to detect the presence of vertebral fusion and other conditions which may predispose to spinal trauma.

Adult↗
PubMed1987

Rugby injuries of the spine and spinal cord.

This article analyzes the type and circumstances of injury in 50 rugby players who sustained cervical spinal cord injury with paralysis. Specific mechanisms of injury occurring during certain phases of the game are identified as being responsible for the majority of injuries. Each phase of the game is discussed in detail, emphasizing the vulnerability of the cervical spine to certain maneuvers, the dangers of illegal play, and the importance of preventive measures to decrease the incidence of these catastrophic injuries.

Athletic Injuries↗
PubMed1983

Rugby injuries of the upper cervical spine. Case reports.

Fractures and dislocations of the upper cervical spine (atlas and axis) differ markedly from those of the lower cervical spine (C3 - C7) because of the unique anatomy and function of these two vertebrae. Case reports of 4 rugby players who sustained serious injuries of the upper cervical spine are presented. The role of the high tackle in causing these injuries is described and the association of head and upper cervical spinal trauma is emphasized. The radiological management of the player with suspected injury is outlined.

Adult↗
PubMed1983

Radiological assessment of thoracolumbar spinal injuries.

The vertebrae of the thoracolumbar junction are extremely vulnerable to serious injury. Spontaneous reduction of these unstable fractures or dislocations often occurs, making radiological diagnosis of the full extent of these injuries difficult. The technique of radiological examination applicable is described, and important radiological signs are emphasized. The anatomical factors predisposing the thoracolumbar junction to trauma and the mechanism of injury are briefly described.

Fractures, Bone↗
PubMed1983

Associated sternal and spinal fractures. Case reports.

Fractures of the upper thoracic spine due to flexion-compression trauma may be associated with sternal injuries of a specific type. The sternal or spinal component of such injuries may easily be overlooked, as illustrated by the 2 case reports presented. Sternal injuries due to direct and indirect trauma are described with particular reference to the anatomy of the manubriosternal joint. The importance of routine radiographic examination of the thoracic spine in the presence of sternal injury --and vice versa--is emphasized.

Adolescent↗
PubMed1983

Hyperextension trauma in the elderly: an easily overlooked spinal injury.

The diagnosis of hyperextension injury to the cervical spinal cord after a fall is easily overlooked in the elderly. This is because the pattern of neurologic deficit, usually that of the 'central cord syndrome,' is complex and because no radiologic signs of trauma are present apart from changes of cervical spondylosis. The case history of a patient who had delayed onset of paralysis after a fall and in whom the correct diagnosis was initially overlooked is presented. In older patients hyperextension injuries may result in serious damage to the spinal cord due to preexisting weakness of the intervertebral discs, which are fragmented and fissured as a result of degeneration. In such patients, radiologic evidence of spondylosis and a posterior osteophyte at C4/C5 or C5/C6 often go unnoticed. This injury is usually caused by indirect cervical spine trauma resulting from head or face injury. A lateral X-ray view of the area with the patient supine is safe, quick, and inexpensive.

Cervical Vertebrae↗