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Association of Burners with Cervical Canal and Foraminal Stenosis

John D. Kelly, IV, MD^,, David Aliquo, MEd, ATC, Michael R. Sitler, EdD, ATC, Charles Odgers, MD and Ray A. Moyer, MD

Department of Orthopaedics and Sports Medicine, Temple University Hospital, Philadelphia, Pennsylvania
Department of Kinesiology, Temple University, Philadelphia, Pennsylvania

Presented at the interim meeting of the AOSSM, Atlanta, Georgia, February 1996.

Address correspondence and reprint requests to John D. Kelly, IV, MD, Department of Orthopaedics and Sports Medicine, Temple University Hospital, 3401 North Broad Street, Philadelphia, PA 19140

The purpose of this study was to determine whether the burner phenomenon is associated with cervical canal and foraminal stenosis in a scholastic population. Lateral cervical radiographs were reviewed for 64 athletes, 15 to 18 years of age, who had sustained at least one burner. Controls consisted of age-matched athletes who had sustained head or neck trauma without evidence of the burner phenomenon (N = 32). Pavlov ratios were calculated for levels C-3 through C-6; both mean minimum and mean average ratios were determined. Available oblique radiographs from both the study (N = 31) and control (N = 15) groups were then used to calculate the foramen/vertebral body ratio—a measure of relative foraminal height. Significant differences were found between the burner and control groups for the mean minimum and mean average Pavlov ratios and foramen/vertebral body ratios. Scholastic athletes sustaining the burner phenomenon have an increased risk of cervical canal and foraminal stenosis as measured by the Pavlov and foramen/vertebral body ratios, respectively. The foramen/vertebral body ratio is an easily reproducible and reliable means of assessing foraminal dimensions from oblique radiographs and controls for x-ray magnification and rotation. Foraminal stenosis assessment may prove useful in predicting burner risk, especially in athletes with extension-compression injuries.

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