Case ReportCatastrophic Return to Play in Rugby After Double Cervical ArthrodesisBrauge, David MD*,†; Sol, Jean C. MD, PhD*,‡; Djidjeli, Imène MD*,‡; Roux, Franck E. MD, PhD*,‡Author Information *Pôle Neuroscience—Neurochirurgie, Hôpital de Purpan et Faculté de Médecine, Toulouse, France; †Institut de Biomécanique Humaine George Charpak, Arts et Métier ParisTech, Paris, France; and ‡Université Paul Sabatier, UPS, Toulouse, France. Corresponding Author: David Brauge, MD, Pôle Neuroscience—Neurochirurgie, Hôpital Purpan, 31059 Toulouse, France (email@example.com). The authors report no conflicts of interest. Received November 13, 2017 Accepted March 17, 2018 Clinical Journal of Sport Medicine: January 2020 - Volume 30 - Issue 1 - p e8-e10 doi: 10.1097/JSM.0000000000000637 Buy Metrics Abstract Abstract: For high-level athletes, most experts consider that 1-level arthrodesis in cervical spine surgery does not prevent return to play. Nevertheless, return remains controversial in cases of 2-level fusions. We report the case of a 27-year-old professional rugby player. He had had a double cervical fusion C5C6 and C6C7 for cervical hernia and was allowed to continue rugby activities afterward. Four years after this surgery, his neck was forced in hyperflexion during a match and complete tetraplegia occurred. A computed tomography scan showed a C3C4 unilateral facet dislocation. The patient was rapidly operated on. At follow-up, 2 years after the accident, the patient remained tetraplegic with no neurologic improvement. If no definitive conclusion can be established on this first observation, many precautions must be taken before a return-to-play decision, especially in contact sports. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.