An apparent reduction in the incidence and severity of spinal cord injuries in schoolboy rugby players in the Western Cape since 1990

dc.contributor.authorNoakes, Timothy
dc.contributor.authorJakoet, I
dc.contributor.authorBaalbergen, E
dc.date.accessioned2021-10-08T07:17:54Z
dc.date.available2021-10-08T07:17:54Z
dc.date.issued1999
dc.description.abstractOBJECTIVE: To determine the impact of the 1990 rugby law changes in South African schoolboy rugby on the number of schoolboys suffering paralysing spinal cord injuries in the subsequent eight rugby seasons (1990-1997) in the former Cape Province (now the Western Cape, but including Port Elizabeth and East London). METHODS: The study was a retrospective analysis of all patients with rugby-related spinal cord injuries admitted to the Conradie and Libertas Spinal Units, Cape Town, between 1990 and 1997. Data were initially collected annually from patient files. From 1993 patients were interviewed in hospital and a standardised questionnaire was completed. Data were collated and analysed. RESULTS: There were 67 spinal cord injuries in adult and schoolboy rugby players in the eight seasons studied. Fifty-four (80%) injuries were in adults and 13 (20%) in schoolboys, representing a 23% increase and a 46% reduction in the number of injured adults and schoolboys, respectively. Fifty-two per cent of those injuries for which the mechanism was recorded occurred in the tackle phase of the game; of these approximately equal numbers were due to vertex impact of the tackler's head with another object, or to illegal (high) tackles. Twenty-five per cent of injuries occurred in the ruck and maul and the remainder (23%) in the collapsed scrum. The only striking difference in the proportion of injuries occurring in the different phases of play was the absence of high-tackle injuries among schoolboys. The majority of injuries occurred at vertebral levels C4/5 (32%) and C5/6 (42%). Five players (8%) died, tetraplegia occurred in 48% and 35% recovered either fully or with minor residual disability. Playing position was recorded for half the injured players. Front-row forwards (props 33%, hookers 9%), locks (12%) wings and centres (21%) and loose forwards (15%), accounted for 90% of all injuries. CONCLUSIONS: Introduction of rugby law changes in South African schoolboy rugby in 1990 may have led to a 46% reduction in the number of spinal cord injuries in this group. In contrast, the number of these injuries in adult rugby players increased during the same time period due either to an increase in the number of adult players or to a real increase in the incidence of these injuries. More injured schoolboy than adult rugby players made total or near-complete recoveries from initially paralysing injuries (61% v. 28%). The reduced number of schoolboy injuries could not have resulted directly from the specific law changes introduced in 1990, which targeted scrum laws. Rather, the absence of illegal (high) tackle injuries among schoolboys appears to be the principal factor explaining fewer injuries in schoolboys, who suffered a higher proportion of injuries in the ruck and maul than did adult players. Accordingly we conclude that a further reduction in spinal cord injuries in adult and schoolboy rugby players in the Western Cape requires: (i) the elimination of injuries occurring in the ruck and maul, and to the tackler; (ii) the strict application of the high-tackle rule in adult rugby; and (iii) a continuing, high level of vigilance. Concern must be expressed about the continuing number of paralysing spinal cord injuries in adult rugby players.
dc.identifier.apacitationNoakes, T., Jakoet, I., & Baalbergen, E. (1999). An apparent reduction in the incidence and severity of spinal cord injuries in schoolboy rugby players in the Western Cape since 1990. <i>South African Medical Journal</i>, 89(5), 540 - 545. http://hdl.handle.net/11427/34858en_ZA
dc.identifier.chicagocitationNoakes, Timothy, I Jakoet, and E Baalbergen "An apparent reduction in the incidence and severity of spinal cord injuries in schoolboy rugby players in the Western Cape since 1990." <i>South African Medical Journal</i> 89, 5. (1999): 540 - 545. http://hdl.handle.net/11427/34858en_ZA
dc.identifier.citationNoakes, T., Jakoet, I. & Baalbergen, E. 1999. An apparent reduction in the incidence and severity of spinal cord injuries in schoolboy rugby players in the Western Cape since 1990. <i>South African Medical Journal.</i> 89(5):540 - 545. http://hdl.handle.net/11427/34858en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Noakes, Timothy AU - Jakoet, I AU - Baalbergen, E AB - OBJECTIVE: To determine the impact of the 1990 rugby law changes in South African schoolboy rugby on the number of schoolboys suffering paralysing spinal cord injuries in the subsequent eight rugby seasons (1990-1997) in the former Cape Province (now the Western Cape, but including Port Elizabeth and East London). METHODS: The study was a retrospective analysis of all patients with rugby-related spinal cord injuries admitted to the Conradie and Libertas Spinal Units, Cape Town, between 1990 and 1997. Data were initially collected annually from patient files. From 1993 patients were interviewed in hospital and a standardised questionnaire was completed. Data were collated and analysed. RESULTS: There were 67 spinal cord injuries in adult and schoolboy rugby players in the eight seasons studied. Fifty-four (80%) injuries were in adults and 13 (20%) in schoolboys, representing a 23% increase and a 46% reduction in the number of injured adults and schoolboys, respectively. Fifty-two per cent of those injuries for which the mechanism was recorded occurred in the tackle phase of the game; of these approximately equal numbers were due to vertex impact of the tackler's head with another object, or to illegal (high) tackles. Twenty-five per cent of injuries occurred in the ruck and maul and the remainder (23%) in the collapsed scrum. The only striking difference in the proportion of injuries occurring in the different phases of play was the absence of high-tackle injuries among schoolboys. The majority of injuries occurred at vertebral levels C4/5 (32%) and C5/6 (42%). Five players (8%) died, tetraplegia occurred in 48% and 35% recovered either fully or with minor residual disability. Playing position was recorded for half the injured players. Front-row forwards (props 33%, hookers 9%), locks (12%) wings and centres (21%) and loose forwards (15%), accounted for 90% of all injuries. CONCLUSIONS: Introduction of rugby law changes in South African schoolboy rugby in 1990 may have led to a 46% reduction in the number of spinal cord injuries in this group. In contrast, the number of these injuries in adult rugby players increased during the same time period due either to an increase in the number of adult players or to a real increase in the incidence of these injuries. More injured schoolboy than adult rugby players made total or near-complete recoveries from initially paralysing injuries (61% v. 28%). The reduced number of schoolboy injuries could not have resulted directly from the specific law changes introduced in 1990, which targeted scrum laws. Rather, the absence of illegal (high) tackle injuries among schoolboys appears to be the principal factor explaining fewer injuries in schoolboys, who suffered a higher proportion of injuries in the ruck and maul than did adult players. Accordingly we conclude that a further reduction in spinal cord injuries in adult and schoolboy rugby players in the Western Cape requires: (i) the elimination of injuries occurring in the ruck and maul, and to the tackler; (ii) the strict application of the high-tackle rule in adult rugby; and (iii) a continuing, high level of vigilance. Concern must be expressed about the continuing number of paralysing spinal cord injuries in adult rugby players. DA - 1999 DB - OpenUCT DP - University of Cape Town IS - 5 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 1999 SM - 0038-2469 T1 - An apparent reduction in the incidence and severity of spinal cord injuries in schoolboy rugby players in the Western Cape since 1990 TI - An apparent reduction in the incidence and severity of spinal cord injuries in schoolboy rugby players in the Western Cape since 1990 UR - http://hdl.handle.net/11427/34858 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34858
dc.identifier.vancouvercitationNoakes T, Jakoet I, Baalbergen E. An apparent reduction in the incidence and severity of spinal cord injuries in schoolboy rugby players in the Western Cape since 1990. South African Medical Journal. 1999;89(5):540 - 545. http://hdl.handle.net/11427/34858.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Exercise Science and Sports Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue5
dc.source.journalvolume89
dc.source.pagination540 - 545
dc.source.urihttps://dx.doi.org/10.7196/sajs.718
dc.subject.otherTrauma
dc.subject.otherSport
dc.subject.otherSpinal cord
dc.subject.otherRugby
dc.subject.otherChild
dc.subject.otherSchool age
dc.subject.otherEpidemiology
dc.subject.otherQuestionnaire
dc.subject.otherSouth Africa(Republic)
dc.subject.otherHuman
dc.subject.otherNervous system diseases
dc.subject.otherSpinal cord disease
dc.subject.otherAfrica
dc.subject.otherTraumatisme
dc.subject.otherMoelle épinière
dc.subject.otherEnfant
dc.subject.otherAge scolaire
dc.subject.otherEpidémiologie
dc.subject.otherRépublique Sud Africaine
dc.subject.otherHomme
dc.subject.otherSystème nerveux pathologie
dc.subject.otherMoelle épinière pathologie
dc.titleAn apparent reduction in the incidence and severity of spinal cord injuries in schoolboy rugby players in the Western Cape since 1990
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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