Skimboarding: An Increasingly Recognized Cause of Life-Threatening Spinal Cord Injury

Abstract

Skimboarding is a sport that combines elements from aquatic and terrestrial sports and has gained popularity with increased riskier maneuvers. Spinal cord injuries associated with this sport have rarely been reported. Here we present a case of a previously healthy 44-year-old male with a life-threatening C2/C3 fracture and dislocation after a skimboarding fall. Traumatic facet dislocations in the cervical spine are usually consequent to high-energy transmission injuries, so it is difficult to explain the mechanism of injury in this clinical case. As this sport's practice continues to grow, our purpose is to emphasize that these injuries may occur with irreversible consequences as most of the damage occurs at the time of presentation, so the first step is to alert athletes and the community to prevent them.

Keywords: life-threatening; skimboarding; spinal cord; traumatic cervical spine injury; water sport injuries.

Figure 1. Cervical CT scan

Left to right: Sagittal soft tissues (red arrow shows spinal cord compression between the C2-C3 segment), sagittal bone, coronal, and axial (yellow arrows show dislocated facets, reverse “hamburger bun” sign)

Figure 2. 3D cervical CT scan

Left to right: Translation (arrow) and bilateral fracture and dislocated facets (red circles).

Figure 3. Postoperative cervical CT scan (bone)

Sagittal and coronal (A-C), axial (C1-C4), and 3D (D-E).

Figure 4. Postoperative cervical MRI scan (sagittal)

The scan shows effective spinal cord decompression but important spinal cord contusion at C2-C3 (red arrowhead) due to important adjacent swelling until medulla (yellow arrows). MRI, magnetic resonance imaging

Figure 5. Spinal movement

(A) Cartesian coordinate system with the IAR as the center. Translation and rotation can occur in both of their respective directions about each axis. (B) A sketch of an idealized cervical vertebral column illustrating the mean location and a two standard deviation range of distribution of the IAR of the typical cervical motion segments. IAR, instantaneous axis rotation Adapted from Loughenbury et al., with permission from the original publisher [9].