Declining Incidence of Catastrophic Cervical Spine Injuries in French Rugby 1996-2006

Purpose: To investigate the incidence and the risk factors of catastrophic cervical spine injuries in French rugby. Study Design: Descriptive epidemiology study. Methods: The patients included had cervical spine injuries causing neurological disorder classified from the ASIA scale, grade A to D. A retrospective review of all cases that occurred between the 1996-1997 and the 2005-2006 seasons was made. Circumstances of the injuries and of the clinical outcome were collected by interview. Results: There were 37 cases of catastrophic cervical spine injuries in French rugby for the last 10 years. The incidence of the cervical spine injuries decreased during this period. The rates of injury were 2.1 per 100 000 players per year during the 1996-1997 season and 1.4 during the 2005-2006 season (P < .01). The scrum was a major cause of injury, accounting for 51.3% (19/37). The forwards represented 89.2% (33/37) of the injured players. The hookers were involved in 37.8% (14/37) of the cases. The measures of prevention with the modification of the rules of scrum and the creation of a medical certificate required for players to play in the front row must have been successful. Conclusion: The incidence of disabling cervical spine injuries in French rugby has decreased for the last 10 years, which is linked to the decreasing incidence of injuries in the scrum. This epidemiological study shows the effectiveness of the preventive measures on cervical spine injuries in French rugby players. A national register of catastrophic cervical spine injuries extends our epidemiological observations.