Spinal Stenosis in Football | Dr. Rey Bosita, Spine Surgeon at Texas Back Institute


My name is Rey Bosita. I am a spine surgeon
at Texas Back Institute. Spinal stenosis is any condition that causes narrowing in the
spinal canal. When the patient has spinal stenosis, there’s not enough room for the
spinal cord within the spinal canal. And some people are born with it, and some people can
develop this from injuries, and other people can have disc herniations or arthritis that
cause this condition. And specifically for athletes, spinal stenosis in the cervical
spine can be a big problem. Oftentimes people will have stingers, with a transient pain
or numbness in one or both of their arms. Some patients can even have transient quadriplegia,
where their whole body kind of stops working and then has to wake itself up after a while,
and those patients are at high risk for further injury, and even becoming paralyzed. Spinal
stenosis in the cervical spine can go undetected because people don’t feel symptoms. When people
are hitting in grade school and in high school, it’s not with the same velocity, speed, and
aggressiveness as in the college or in the pros, so the same hit delivered in high or
grade school will not cause enough force at the time of impact to cause any symptoms,
but as the collisions get more violent and the athletes get bigger, the trauma to the
spine can be such that the patient will feel symptoms. There are two phases of treatment.
In the acute phase if the patient has stingers or transient quadriplegia, the first thing
to make sure is that there’s no disc herniation, there’s no cervical spine fracture, and there’s no instability. So, at the time the injury occurs, the patient is kept in very, very
careful spine precautions. Patients are log-rolled, the helmet and the shoulder pads remain on
until they get to the hospital, and only in a controlled environment under the care of
a spine surgeon or an ER doctor and trauma surgeon will they start to take off the helmet
and the shoulder pads. And then once the physical examination is done, and initial X-Ray, CT
scan, and even the MRI are completed, at that point we’ll start to figure out what caused
this problem, and whether it was a fracture, sometimes they need surgery, if it’s a disc
herniation, again, sometimes they’ll need acute surgery too, but if it really does fall
into the category of a transient spinal cord injury with congenital spinal stenosis, we
watch those patients very carefully and rehab them. The second phase of treatment is in
the chronic phase. That’s actually probably more difficult from a personal standpoint,
because a lot of these kids still want to play, and it’s very hard to tell some kids,
“You shouldn’t play, and you have to give up something that you really enjoy, because
you could potentially get paralyzed if you continue to do it.” And the linebacker from
Florida and other people from other colleges, you hear about stories like this a couple
of times a year where a really high-performing athlete will give up a career because of either
a spinal stenosis like this or head injuries, and unfortunately it’s more common probably
than we want it to be, but still, hopefully with changes to the safety equipment and the
rules, we can try and reduce the incidences of these problems.

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