Four serious neck injuries suffered by Queensland teenagers during schoolboy rugby have prompted a review by the sport's governing body.
Nudgee College year 9 student Alexander Clark remains in intensive care at a Brisbane children's hospital after he injured his neck in a Great Public Schools (GPS) rugby match on Saturday.
Alexander is the fourth GPS student to suffer a neck injury since the start of July.
Rugby Australia chief executive Raelene Castle is confident the sport has done all it can to mitigate the risk of injury but her body will examine the four incidents separately.
Ms Castle has also arranged a summit with the nine GPS principals and RA officials on Wednesday to discuss the issue.
"It's 10 years since we've had a very significant incident in schoolboy rugby and the fact we've had a cluster in GPS is something we're concerned about and that's what we will be reviewing," Ms Castle told reporters on Monday.
"If anything pops up and we identify anything specific then we ought to change our policies and procedures off the back of that."
A spinal research advocate who became a teenage quadriplegic after a rugby tackle has suggest 15-a-side matches should be banned at high school level.
Perry Cross, who established the Perry Cross Spinal Research Foundation after his injury at Ballymore in 1994 when he was just 19, said traditional rugby should be replaced with seven-a-side matches.
Ms Castle said she was confident 15s was a safe game and cited a review by Rugby Australia's national safety committee which analysed 5000 school rugby scrums and found no major issues.
As the issue of safety took centre stage, Alexander's school provided an update on the 15-year-old's condition.
Nudgee principal Peter Fullagar released a statement to parents, students and staff saying Alexander was "communicating, alert and in remarkable spirits".
Mr Fullagar said while Alexander's recovery was underway, "we are realistic this may be a long journey".
He also said the school would support the safety review.
"The College has been liaising with Rugby Australia, Queensland Rugby Union, and the GPS Association and we will be fully supportive of any initiatives that review the safety of all rugby players," he said.
Gregory Terrace Year 11 student Conor Tweedy is also in hospital after undergoing spinal surgery and a tracheostomy after a scrum collapsed during a Second XV match on July 21.
Tweedy has muscle paralysis and weakness after his injury that damaged the C4 and C5 vertebrae near the base of his neck.
Last month, two Year 12 Toowoomba Grammar School students needed surgery after dislocating vertebrae in their necks in separate incidents on July 13 and 14.
One of the incidents happened during training and not in a match.
One of the students remains in Brisbane's Princess Alexandra Hospital, but is recovering well, while the other has returned to Toowoomba.