Conservative Management for a Traumatic Cervical Spine Cycling Injury

Abstract

Competitive cycling holds an inherent risk of traumatic injury often resulting in fracture.  Questions regarding the probability of return to sport then arise. The purpose of this case report is to describe the treatment approach and likelihood of returning to cycling after traumatic fracture of the cervical spine and clavicle. This case report describes the use of an original combination of interventions for a C1 fracture with an associated open reduction internal fixation of a left clavicle fracture in a 39-year-old male cyclist.  The patient lost control of his bike while descending a slippery slope and was propelled over the handlebars landing head first.  The resultant cervical spine and clavicle fractures required twelve weeks in a cervical collar.  Physical therapy interventions focused on regaining strength and functional mobility of the cervical spine and shoulder.  Following treatment a minimal detectable change was seen for range of motion (>6%) of the cervical spine and shoulder, the Numerical Pain Rating Scale (3 point change), and the Disabilities of the Arm, Shoulder and Hand (29.2% change).  The patient returned to his prior level of function at home and work.  Medical clearance was received to return to training, with a hopeful prognosis of eventually returning to competition.