Catastrophic spine injuries in American football, 1977-2001

Neurosurgery. 2003 Aug;53(2):358-62; discussion 362-3. doi: 10.1227/01.neu.0000073422.01886.88.


Objective: Cervical spinal cord injuries have been the most common catastrophic football injury and the second leading direct cause of death attributable to football skills. This study looks at the 25-year (1977-2001) experience with catastrophic neck injuries and examines not only the incidence but also the cause of injury and variables that have either increased or decreased these injuries.

Methods: Data were collected on a national level from all organized football programs, including public school, college, professional, and youth programs, through personal contact and questionnaires on each catastrophic football injury. Funded by the National Collegiate Athletic Association, the National Federation of State High School Associations, and the American Football Coaches Association, data were collected by the National Center for Catastrophic Sports Injury Research, University of North Carolina at Chapel Hill (Frederick O. Mueller, Director, and Robert C. Cantu, Medical Director).

Results: Teaching the fundamental techniques of the game, equipment standards, and improved medical care both on and off the playing field have led to a 270% reduction in permanent spinal cord injury from a peak of 20 per year during the period 1971 to 1975 to 7.2 per year during the past 10 years.

Conclusion: The type of injury, activity at the time of injury, level of play, and whether the injury was incurred in a game or practice are presented. On the basis of the data, recommendations are given for reducing catastrophic cervical spine injury in football.

MeSH terms

  • Adolescent
  • Adult
  • Catastrophic Illness / epidemiology*
  • Cervical Vertebrae / injuries*
  • Child
  • Football / injuries*
  • Football / statistics & numerical data
  • Head Protective Devices
  • Humans
  • Incidence
  • Spinal Cord Injuries / epidemiology*
  • Time Factors
  • Trauma Severity Indices
  • United States / epidemiology