You don’t have to be a Pittsburgh fan for your heart to have been in your throat watching this week’s Steelers-Bengals game. The game had just started on Monday night when Steelers’ linebacker Ryan Shazier was suddenly on the ground after a headfirst tackle, and showing no movement from the waist down. Other players dropped to their knees to pray, and the sports world held its collective breath as he was taken off of the field on a spine board and rushed to a nearby hospital.
The immediate fear upon seeing Shazier trying to flip over and pointing to his back without moving his legs was that the injury was to the spinal cord itself. Had it been ripped, the end result would have been paralysis below the point of injury. But after undergoing both a CT and an MRI, doctors indicated that his injury was significant, but far better than what was originally feared: he was diagnosed with a spinal contusion.
What is a spinal contusion? It’s an injury that’s common in football. Essentially it’s a bruise like any other that occurs when capillaries break, blood leaks out and swelling of an area occurs. It’s just that because of its position in close proximity to the spine, the immediate impact is far more worrisome, ad can be dangerous. When the nerves that are close to the spinal cord are impinged upon by swelling, it can have an effect on “the spinal cord’s ability to send and receive messages from the brain to the body’s systems that control sensory, motor and autonomic function below the level of the injury” according to the American Association for Neurological Surgeons (AANS).
Spinal contusions are different from spinal concussions, a lesser-known injury whose official term is cervical cord neurapraxia, or CCN. CCN can also happen after the type of high-speed head collision that Shazier was involved in, and can cause the same type of brief paralysis that a contusion can. The difference between the two is that a spinal cord concussion’s symptoms usually last less than a day, and sometimes are only present for a few minutes, while recovery from a spinal cord contusion takes longer, and it is less clear as to when he will be able to return to play.
The specifics of Shazier’s injury and its aftermath will become much more apparent over the next few days as the swelling subsides. What is already known is that he will not need surgery, which is an indication that there is no unstable spine fracture and nothing pressing on the spinal cord, and that he is continuing to improve, with movement returning in his lower extremities. Experts expect that after a period of immobilization and treatment with anti-inflammatory steroid medications, he will undergo further tests to determine how much room the spinal cord has and what the condition is of various spinal canal bones, discs and ligaments. No matter what the outcome, it seems clear that the worst case scenario was avoided and he will be able to walk again.