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Epidemiology of cervical spine abnormalities in asymptomatic adult professional Rugby Union players using static and dynamic MRI protocols – 2002 to 2006.
  1. Bernard H Castinel (bcastinel{at}
  1. CAPIO-Clinique des Cedres, France
    1. Philippe Adam
    1. CAPIO-Clinique des Cedres, France
      1. Peter D Milburn
      1. School of Physiotherapy, University of Otago, New Zealand
        1. Aurelie Castinel
        1. CAPIO-Clinique des Cedres, France
          1. Kenneth L Quarrie
          1. Research & Injury Prevention, New Zealand Rugby Union, New Zealand
            1. Jean-Claude Peyrin
            1. Medical Commission of the French “Ligue Nationale de Rugby”, France
              1. John D Yeo
              1. Spinal Injuries Unit, Royal North Shore Hospital, Sydney, NSW, Australia


                Objective: To investigate the prevalence of abnormalities in the cervical spine of asymptomatic professional rugby players using both static and dynamic magnetic resonance imaging (MRI) in order to improve the detection of abnormalities and prevention of related injuries.

                Design: Prospective observational study. Setting: French professional rugby union clubs, between 2002 and 2006.

                Participants: 206 elite male adult players.

                Intervention: Static sagittal T2 and axial T2* FSE, and dynamic sagittal SSFSE weighted MRI scans of the C2-C7 region were examined for the presence of abnormalities. Participants’ spines were in supine neutral position for the static protocol but were allowed complete flexibility in a sagittal plane for the dynamic protocol.

                Main outcome measurements: The medulla-to-canal ratio (MCR) was measured at every vertebral disc level for both MRI methods. When observed, anatomical abnormalities were categorised.

                Results: Anatomical abnormalities mainly consisted of degenerative discopathy and were most frequently observed in players aged 21 years and older, as well as in players whose MCR was abnormally high based on medical expertise. Most MCRs that were initially assessed as intermediate with static MRI were subsequently assessed as abnormal with dynamic MRI assessment.

                Conclusions:Since dynamic MRI is more accurate than static techniques in examining the cervical spine, it contributes substantially to identifying the risk of spinal injuries in professional rugby players, and when used in association with clinical assessment, can assist in preventing spinal injury.

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