TY - JOUR
T1 - Does the level of cervical disc herniation surgery affect performance-based outcomes in national football league athletes?
AU - Mai, Harry T.
AU - Burgmeier, Robert J.
AU - Mitchell, Sean M.
AU - Hecht, Andrew C.
AU - Maroon, Joseph C.
AU - Nuber, Gordon W.
AU - Hsu, Wellington K.
N1 - Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2016
Y1 - 2016
N2 - Study Design. Retrospective cohort study. Objective. The aim of this study was to determine whether the level of a cervical disc herniation (CDH) procedure will uniquely impact performance-based outcomes in elite athletes of the National Football League (NFL). Summary of Background Data. Comparative assessments of postsurgical outcomes in NFL athletes with CDH at different levels are unknown. Further, the surgical decision-making for these types of injuries in professional football athletes remains controversial. Methods. NFL players with a CDH injury at a definitive cervical level were identified through a review of publicly available archives. Injuries were divided into upper-(C2-C4) and lower-level (C4-T1) CDH. The impact on player outcomes was determined by comparing return to play statistics and calculating a "Performance Score" for each player on the basis of pertinent statistical data, both before and after surgery. Results. A total of 40 NFL athletes met inclusion criteria. In the upper-level group, 10 of 15 (66.6%) players successfully returned to play an average of 44.6 games over 2.6 years. The lower-level cohort had 18 of 25 (72%) players return to play with an average of 44.1 games over 3.1 years. There was no significant difference in the rate of return to play (P 0.71). Postsurgical performance scores of the upper and lower-level groups were 1.47 vs. 0.69 respectively, with no significant difference between these groups (P 0.06). Adjacent segment disease requiring reoperation occurred in 10% of anterior cervical discectomy and fusion patients. In 50% of foraminotomy patients, a subsequent fusion was required. Conclusion. A uniquely high percentage of upper-level disc herniations develop in NFL athletes, and although CDH injuries present career threatening implications, an upper-level CDH does not preclude a player from successfully returning to play at a competitive level. In fact, these athletes showed comparable postsurgical performance to those athletes who underwent CDH procedures at lower cervical levels.
AB - Study Design. Retrospective cohort study. Objective. The aim of this study was to determine whether the level of a cervical disc herniation (CDH) procedure will uniquely impact performance-based outcomes in elite athletes of the National Football League (NFL). Summary of Background Data. Comparative assessments of postsurgical outcomes in NFL athletes with CDH at different levels are unknown. Further, the surgical decision-making for these types of injuries in professional football athletes remains controversial. Methods. NFL players with a CDH injury at a definitive cervical level were identified through a review of publicly available archives. Injuries were divided into upper-(C2-C4) and lower-level (C4-T1) CDH. The impact on player outcomes was determined by comparing return to play statistics and calculating a "Performance Score" for each player on the basis of pertinent statistical data, both before and after surgery. Results. A total of 40 NFL athletes met inclusion criteria. In the upper-level group, 10 of 15 (66.6%) players successfully returned to play an average of 44.6 games over 2.6 years. The lower-level cohort had 18 of 25 (72%) players return to play with an average of 44.1 games over 3.1 years. There was no significant difference in the rate of return to play (P 0.71). Postsurgical performance scores of the upper and lower-level groups were 1.47 vs. 0.69 respectively, with no significant difference between these groups (P 0.06). Adjacent segment disease requiring reoperation occurred in 10% of anterior cervical discectomy and fusion patients. In 50% of foraminotomy patients, a subsequent fusion was required. Conclusion. A uniquely high percentage of upper-level disc herniations develop in NFL athletes, and although CDH injuries present career threatening implications, an upper-level CDH does not preclude a player from successfully returning to play at a competitive level. In fact, these athletes showed comparable postsurgical performance to those athletes who underwent CDH procedures at lower cervical levels.
KW - Anterior cervical discectomy and fusion
KW - Cervical disc herniation
KW - National football league
KW - Posterior cervical foraminotomy
KW - Professional athletes
UR - http://www.scopus.com/inward/record.url?scp=84991457534&partnerID=8YFLogxK
U2 - 10.1097/BRS.0000000000001868
DO - 10.1097/BRS.0000000000001868
M3 - Article
C2 - 27749509
AN - SCOPUS:84991457534
SN - 0362-2436
VL - 41
SP - 1785
EP - 1789
JO - Spine
JF - Spine
IS - 23
ER -