Anybody watching the World Cup or familiar with soccer has heard of Neymar; the star of the Brazilian National Soccer team and plays his club ball next to Messi at Barcelona. During a game against Columbia in the Quarterfinals of the World Cup, Neymar was involved in an aerial challenge with a Columbian player that involved a knee to the lumbar spine of the Brazilian. Afterwards, Neymar was taken on a stretcher to the hospital where he was diagnosed with a Lumbar 3 vertebrae fracture.
Amid all the reports of potential paralysis, the good news is that neurologic injury is extremely rare from this type of injury. The Columbian player made contact with his knee against the muscles of the low back of Neymar. Some of the forces imparted by the blow could have caused a fracture or in combination with muscular contraction caused a piece of the spine bone (Vertebra) to break (fracture). The most common areas of the spine to break would be the Spinous Processes or the Transverse processes. These bony prominences serve as muscle attachment points and do not have a weight bearing responsibility. In other words, even with a fracture, the Spine is stable and the patient can walk and do activities as long as pain is under control.
Typically, with this group of stable, non-surgical injuries, pain control is the first step which involves bracing or a brief period of immobilization. Similar to rib fractures, time will eventually heal the injury and activity as tolerated is instituted once the patient feels better (typically 2-4 weeks). On average, fracture healing requires 6 weeks and then the patient can begin to resume normal activities. The long term prognosis from these injuries is good and most people are back to full activity within 3-6 months.
The good news for Neymar is that he should expect a full recovery with no limitations over the next 3-4 months. The bad news for Brazil is that there best player won’t be on the field for the World Cup.
Paul Saiz, MD