Cervical Spine Injury After Virtual Reality Gaming

A Case Report

D. Baur; C. Pfeifle; C. E. Heyde


J Med Case Reports. 2021;15(312) 

In This Article


Rapid movements during VR gaming can lead to injuries and should not be underrated. In addition to rapid movements, the additional weight of VR headsets (460–610 g) as well as the decoupling of audiovisual stimuli from the actual proprioceptive information should be considered. We considered stress and avulsion fractures as possible fracture types responsible for the injury in our patient.

The weight of the VR headset and the controllers used by both hands are not comparable to the weight of wet clay and the metal and wood shovels used by workers in the past.

Therefore, we think an avulsion is unlikely to be the underlying cause of the injury in the patient in our study. Since the patient had been playing VR games for many hours weekly with lightweight devices in his hands and on his head, we conclude that a stress-type fracture seems to be the more likely reason for the dislocated fracture of the spinous process from the seventh cervical vertebra. This theory is supported by the absence of edema and soft tissue defects in the MRI scan. The repetitive movements and intense gaming habits could have led to a fatigue fracture. This possibility is underlined by the negative HU measurement in the CT scan of the upper spine, as well as by the inconspicuous osteoporosis laboratory results. According to previous studies in the literature, conservative treatment with a semi-rigid collar usually leads to a rapid recovery without permanent limitations to the cervical range of motion or lasting pain in the lower cervical spine.

In 2016–2018, approximately 170 million active users of similar headsets were registered worldwide.[11] In the future, this new type of trauma can have greater relevance due to the increasingly widespread use of this technology among gamers and other users.