Injury to the cervical spine and associated structures as a result of participation in competitive athletics and recreational activities is not uncommon. It appears that the frequency of these various injuries is inversely proportional to their severity. Albright et al<sup>1 Albright J.P., Moses J.M., Feldich H.G. , e al. Non-fatal cervical spine injuries in interscholastic football JAMA 1976 ;  236 : 1243-1245

Cliccare qui per andare alla sezione Riferimenti</sup> have reported that 32% of college football recruits sustained “moderate” injuries while in high school, whereas catastrophic injuries with associated quadriplegia occur in less than 1 in 100,000 participants per season at the high school level.<sup>17 Torg J.S., Vegso J.J., Sennett B. The National Football Head and Neck Injury Registry; 14 year report on cervical quadriplegia, 1971 through 1985 JAMA 1985 ;  254 : 3439-3443

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The variety of possible lesions involving the cervical spine is considerable and the severity variable. The literature dealing with the diagnosis and treatment of these problems is considerable. Conspicuously absent, however, are comprehensive criteria for permitting or prohibiting participation in collision activities (boxing, football, ice hockey, lacrosse, rugby, and wrestling) for those with congenital or developmental problems or following injury to the cervical spinal structures. The explanation for this void appears to be twofold. First, the combination of a litigious society and the potential for great harm should things go wrong makes “no” the easiest and perhaps most reasonable advice. Second, and perhaps most important, with the exception of transient quadriplegia, credible data pertaining to postinjury risk factors are lacking. Nevertheless, this report will attempt to establish management guidelines to assist the clinician in the decision-making process.