Neck Injuries in Musical Performers: Risk Factors and Treatment Options
Diagnosis and Assessment
- Previous neck surgery or injury increases risk of recurrent problems, according to the American Academy of Otolaryngology-Head and Neck Surgery 1
- Assessment should include examination during instrument playing to accurately identify problematic postures and movements, and evaluate for signs of dysphonia, which may indicate laryngeal injury related to neck problems, as recommended by the American Academy of Otolaryngology-Head and Neck Surgery 1, 2
- Check for neurological symptoms that may indicate more serious conditions requiring immediate referral, as suggested by the American Academy of Otolaryngology-Head and Neck Surgery 2
Imaging
- CT angiography is first-line for evaluating neck injuries when immediate surgical intervention isn't required, with 90-100% sensitivity and 98.6-100% specificity, according to Praxis Medical Insights 3
- MRI is valuable for evaluating spinal cord injury, traumatic disk injury, and ligamentous injury in stable patients, as stated by Praxis Medical Insights 3
Treatment Approach
Acute Management
- For unstable patients with active hemorrhage, expanding hematoma, or hemodynamic instability, immediate surgical exploration is indicated, as recommended by Praxis Medical Insights 3
- For stable patients with soft signs, imaging-guided management is appropriate, according to Praxis Medical Insights 3
- Maintain spinal motion restriction by manually stabilizing the head to minimize motion of head, neck, and spine if acute trauma is suspected, as suggested by the American Heart Association, published in Circulation 4
Rehabilitation
- Neck muscle strengthening exercises reduce head impact magnitude and are a key component of physical therapy, as stated by Praxis Medical Insights 3
- Implementation of specific neck muscle training programs as part of comprehensive neuromuscular training helps prevent recurrent injuries, according to Praxis Medical Insights 3