P Bernard (Mérignac)
Rugby is the second team sports after football in France. It is a high-energy collision sport played without any protective equipment for the musculoskeletal system. Since the onset of professionalism in 1995, the amount of injuries progressively increased essentially due to more numerous impacts in heavier, faster and more powerful players. Chronic intensive rugby practice has proven to frequently induce developmental cervical canal stenosis, especially on spines whose growth is not over yet. Workload during training sessions also notably increased, favouring both acute and chronic lesions in a very young population. We will describe the therapeutic options in this specific population and more specifically cervical surgery that is often necessary. In most cases, a cervical surgery history stays compatible with rugby practice at an elite level.
Associating collision sports to cervical canal stenosis exposes to an additional spinal risk which needs to be assessed case by case as scientifically as possible before authorising a professional to play or to resume playing after a cervical injury or proven pathology. For its professional players, the French Federation of Rugby (Fédération Française de Rugby, F.F.R.) has adopted a 3-stage classification of cervical risks according to clinical and anatomic criteria obtained by systematic MRI screening. Generalising preventive imaging evaluations led to the discovery of numerous cervical canal stenoses, especially in front-row players. The F.F.R. has made the evaluation of cervical status mandatory. It can lead to the end of the sports career. Though, if the potential risk of rugby practice with a degenerative cervical pathology is now well documented, traumatic acute risk remains more unpredictable.