CCSP – Misc Exam Study Guide
Solutions Updated 2024
Three Phases of Ligament Healing - ANSWER✔✔-• Inflammation. occurs within 3
days after injury. Inflammatory mediators give way to fibroblasts that produce type III
collagen and proteoglycans.
• Repair and regeneration. The second phase occurs about 6 weeks after injury as type 3
collagen decreases and type I collagen increases. Histologically, collagen fibers are
oriented along the longitudinal axis of the ligament and fibroblasts are mature at 6
weeks postinjury.
• Remodeling. Ligament remodeling, the third phase, lasts a year or more after the
injury. Although mechanical testing of conservatively treated grade 2 MCL tears tested
at 1 year exhibited normal parameters for ultimate load and stiffness, the MCL regains
only 50% to 70% of its elasticity and strength by 1 year. As collagen content increases,
the healing ligament has a larger cross section than a normal ligament.
Cervical Spine Conditions & Contact Sports:
No Contraindication to Participation* - ANSWER✔✔-• Resolved burner
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,• Spina bifida occulta
• Type 2 Klippel-Feil congenital one-level fusion
• Developmental stenosis of spinal canal (canal/vertebral body ratio <0.8)
• Mild ligamentous sprain with no laxity
• Healed, stable compression fracture of vertebral body
• Healed, stable end-plate fracture
• Healed "clay shoveler's" fracture
• Healed intervertebral disk bulge
• Stable, one-level anterior or posterior surgical fusion
*Provided individual is asymptomatic and neurologically normal and has full range of
pain-free cervical motion.
Cervical Spine Conditions & Contact Sports:
Relative Contraindications to Participation* - ANSWER✔✔-• Recurrent acute and
chronic burners
• Developmental canal stenosis with:
- episode of cervical cord neurapraxia
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, - intervertebral disk disease
- MRI evidence of cord compression
• Ligamentous sprain with mild laxity (<3.5 mm anteroposterior displacement and 11°
rotation)
• Healed, nondisplaced Jefferson fracture
• Healed, stable, mildly displaced vertebral body fracture without a sagittal component
or neural ring involvement
• Healed, stable neural ring fractures
• Healed intervertebral disk herniation
• Stable, two-level anterior or posterior surgical fusion
*Provided individual is asymptomatic and neurologically normal and has full range of
pain-free cervical motion.
Cervical Spine Conditions & Contact Sports:
Absolute Contraindications to Participation - ANSWER✔✔-• Odontoid agenesis,
hypoplasia, or os odontoidium
• Atlanto-occipital fusion
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Solutions Updated 2024
Three Phases of Ligament Healing - ANSWER✔✔-• Inflammation. occurs within 3
days after injury. Inflammatory mediators give way to fibroblasts that produce type III
collagen and proteoglycans.
• Repair and regeneration. The second phase occurs about 6 weeks after injury as type 3
collagen decreases and type I collagen increases. Histologically, collagen fibers are
oriented along the longitudinal axis of the ligament and fibroblasts are mature at 6
weeks postinjury.
• Remodeling. Ligament remodeling, the third phase, lasts a year or more after the
injury. Although mechanical testing of conservatively treated grade 2 MCL tears tested
at 1 year exhibited normal parameters for ultimate load and stiffness, the MCL regains
only 50% to 70% of its elasticity and strength by 1 year. As collagen content increases,
the healing ligament has a larger cross section than a normal ligament.
Cervical Spine Conditions & Contact Sports:
No Contraindication to Participation* - ANSWER✔✔-• Resolved burner
Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 1/22
,• Spina bifida occulta
• Type 2 Klippel-Feil congenital one-level fusion
• Developmental stenosis of spinal canal (canal/vertebral body ratio <0.8)
• Mild ligamentous sprain with no laxity
• Healed, stable compression fracture of vertebral body
• Healed, stable end-plate fracture
• Healed "clay shoveler's" fracture
• Healed intervertebral disk bulge
• Stable, one-level anterior or posterior surgical fusion
*Provided individual is asymptomatic and neurologically normal and has full range of
pain-free cervical motion.
Cervical Spine Conditions & Contact Sports:
Relative Contraindications to Participation* - ANSWER✔✔-• Recurrent acute and
chronic burners
• Developmental canal stenosis with:
- episode of cervical cord neurapraxia
Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 2/22
, - intervertebral disk disease
- MRI evidence of cord compression
• Ligamentous sprain with mild laxity (<3.5 mm anteroposterior displacement and 11°
rotation)
• Healed, nondisplaced Jefferson fracture
• Healed, stable, mildly displaced vertebral body fracture without a sagittal component
or neural ring involvement
• Healed, stable neural ring fractures
• Healed intervertebral disk herniation
• Stable, two-level anterior or posterior surgical fusion
*Provided individual is asymptomatic and neurologically normal and has full range of
pain-free cervical motion.
Cervical Spine Conditions & Contact Sports:
Absolute Contraindications to Participation - ANSWER✔✔-• Odontoid agenesis,
hypoplasia, or os odontoidium
• Atlanto-occipital fusion
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