Last Thursday, this 18 yo senior Varsity lacrosse player at local school had a severe blow to his head while checking another player in his chest, using his head and shoulder (possible “spearing” injury).
He had immediate severe pain and numbness and some weakness in left upper extremity, and came off the field.
His arm pain and numbness down into middle 3 fingers continued post-injury, but he did not complain of neck pain.
X-Rays of cervical spine were normal.
Physical exam showed sensory deficit in L hand in middle 3 fingers, and weakness in L triceps.
MRI showed possible facet fracture on L C67 with foraminal nerve root encroachment, but no spinal cord injury.
MRI flow through the adjacent vertebral artery was normal, although there was fracture of bone around artery.
CT Scan, shown here shows the facet fracture with foraminal narrowing.
He presents today for surgery, for C67 foraminotomy, to remove the broken bone fragments pressing on the nerve, followed by C67 plate fusion with a small titanium plate and screws, and bone grafting using local bone. An intra-operative photo, showing the plate and bone graft is shown.
Surgical time 1 hr 50 minutes.
Estimated Blood Loss 25 cc.
He will spend the night in hospital with his family, here at Duke Raleigh Hospital and go home tomorrow.

LEARNING/LESSONS: Lacrosse coaches, trainers and players should seek to prevent spearing injuries, which can cause severe cervical spine fractures, and spinal cord / nerve root injury. “Spearing” occurs when the head is driven into another football or lacrosse player, and then the cervical spine buckles under the high load, causing fracture and possible disclocation with cord and nerve root injuries common. Spearing has been outlawed in football, but is less well known in lacrosse and other sports.

Fortunately this young gentleman should have complete recovery.
He just woke up from anesthesia, and is moving his arms and legs well.

Lloyd A. Hey, MD MS
https://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA