Nouvelle classification des lésions cervicales pour l'aptitude au rugby professionnel

Rugby union is a collision sport exposing to a medullar risk through trauma but also by early degenerative lesions. The prevalency of cervical pathologies has grown with the onset of professionalism. These lesions often happen on a developmental narrow cervical canal, which increases the risk of serious neurological complication. A first classification of criterias of aptitude for professional rugby practice had been adopted by the French Ligue Nationale de Rugby in the early years of professionalism. Since cervical imaging and screening became mandatory, numbers of narrow or very narrow cervical canals on asymptomatic players have been detected. Meanwhile, the initially used Torg index appeared to be imperfect. These elements led to a necessary evolution of this classification. The new decision-making tool enables a precise evaluation of neurologic risk with data given by clinical examination and cervical IRM, and if necessary, cervical X-rays. New classification has been introduced with four groups of risk and aptitude (group 0 [G0]: no cervical pathology; group 1 [G1]: pathology without contraindication for professional rugby practice; group 2 [G2]: relative contraindication [known higher risk, to be accepted by the player]; group 3 [G3]: absolute contraindication). This new classification is presented and discussed. Nevertheless, as the structural risk related to the rugby practice will persist, sharing responsibilities with the player by implicating him in decision-making process remains necessary.