Does the Level of Cervical Disc Herniation Surgery Affect Performance-based Outcomes in National Football League Athletes?

Harry, T.; Burgmeier, Robert J.; Mitchell, Sean M.; Hecht, Andrew C.; Maroon, Joseph C.; Nuber, Gordon W.; Hsu, Wellington K.

doi:10.1097/brs.0000000000001868

Cited by 19 publications

(24 citation statements)

References 14 publications

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“…From the initial 2,215 records identified, 495 duplicates were subsequently removed, and this left 1720 unique studies. After full text review, 13 articles 3,6,8,12,17,18,20,21,23,29,31,33,36 were determined to meet all inclusion criteria and subsequently used for data analysis, with a Cohen’s κ coefficient >0.8 between reviewers (Figure 1). See Table 1 for comprehensive demographics and major results from included studies.…”

Section: Resultsmentioning

confidence: 99%

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Return-to-Play Outcomes in Elite Athletes After Cervical Spine Surgery: A Systematic Review

Leider

Piche

Khan

et al. 2021

Sports Health: A Multidisciplinary Approach

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Context: Return-to-play (RTP) outcomes in elite athletes after cervical spine surgery are currently unknown. Objective: To systematically review RTP outcomes in elite athletes after anterior cervical discectomy and fusion (ACDF), cervical disc replacement (CDR), or posterior foraminotomy (PF) surgery. Data Sources: EMBASE, PubMed, Cochrane, and Medline databases from inception until April 2020. Keywords included elite athletes, return to play, ACDF, foraminotomy, and cervical disc replacement. Study Selection: Eligible studies included those that reported RTP outcomes in elite athletes after cervical spine surgery. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Data were extracted by 2 independent reviewers. Results: The primary outcomes of interest were rates and timing of RTP. Secondary outcomes included performance on RTP. A total of 1720 studies were initially screened. After inclusion criteria were applied, 13 studies with a total of 349 patients were included. A total of 262 (75%) played football, 37 (11%) played baseball, 19 (5%) played rugby, 10 (3%) played basketball, 10 (3%) played hockey, 9 (3%) were wresters, and 2 (1%) played soccer. ACDF was reported in 13 studies, PF in 3 studies, and CDR in 2 studies. The majority of studies suggest that RTP after surgical management is safe in elite athletes who are asymptomatic after their procedure and may lead to higher rates and earlier times of RTP. There is limited evidence regarding RTP or outcomes after CDR or multilevel surgery. Conclusion: The management and RTP in elite athletes after cervical spine injury is a highly complex and multifactorial topic. The overall evidence in this review suggests that RTP in asymptomatic athletes after both ACDF and PF is safe, and there is little evidence for decreased performance postoperatively. Surgical management results in a higher RTP rate compared with athletes managed conservatively.

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Section: Resultsmentioning

confidence: 99%

“…Mai et al 17 reported on single-level ACDF and PF outcomes in 40 NFL players for CDH. A total of 34 players underwent ACDF, and 23 (67.6%) returned to play for an average of 2.6 years postoperatively.…”

Section: Resultsmentioning

confidence: 99%

Return-to-Play Outcomes in Elite Athletes After Cervical Spine Surgery: A Systematic Review

Leider

Piche

Khan

et al. 2021

Sports Health: A Multidisciplinary Approach

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“…80,93 Adjacent segment degeneration occurred in 10% of players undergoing ACDF, while those treated with foraminotomy had an RTP rate of 92% and returned earlier than those with ACDF but had a 50% reoperation rate. 80…”

Section: Resultsmentioning

confidence: 99%

“…50,122 Players with cervical disc herniation may safely RTP, but RTP decreased to approximately 70% in those requiring anterior cervical discectomy and fusion (ACDF). 80,93 Adjacent segment degeneration occurred in 10% of players undergoing ACDF, while those treated with foraminotomy had an RTP rate of 92% and returned earlier than those with ACDF but had a 50% reoperation rate. 80…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of the Orthopaedic Literature Involving National Football League Players

Kluczynski

Kelly

Lashomb

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: Orthopaedic injuries of National Football League (NFL) players can have a deleterious effect on their health, with minimal to no high-level evidence on the management of these injuries. Purpose: To summarize all data published between January 1980 and March 2018 on orthopaedic injuries experienced by NFL candidates and professional players in the NFL. Study Design: Systematic review; Level of evidence, 4. Methods: A literature search of studies examining orthopaedic injuries in the NFL was performed through the PubMed, Embase, and CINAHL databases. The review included studies of orthopaedic injuries in college football recruits attending the NFL Combine as well as professional NFL players. Excluded were studies of nonorthopaedic injuries, such as concussions, traumatic brain injury, facial injuries, and vascular injuries, as well as case reports. Results: A total of 147 articles met the inclusion criteria and were divided into 11 topics based on anatomic site: general (16%), spine (13%), shoulder (13%), elbow (3%), hand and wrist (3%), trunk (0.7%), hip and pelvis (7%), thigh (3%), knee (24%), ankle (5%), and foot (12%). Of these studies, 74% were of level 4 evidence. Most studies obtained data from the NFL Combine database (26%), by searching the internet (24%), and via the NFL Injury Surveillance System (22%). Studies using internet search methods to identify injuries consistently found fewer participants than studies using the NFL Injury Surveillance System. Conclusion: This systematic review provides National Collegiate Athletic Association and NFL team physicians with a single source of the most current literature regarding orthopaedic injuries in NFL players. Most research was published on knee, spine, shoulder, and foot injuries and consisted of level 4 evidence. A substantial portion of the published literature was based on data obtained from internet searches and may not accurately represent the NFL population.

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Cervical Disc Herniation in Athletes

Patel

Rosenthal

Hsu

2019

Spinal Conditions in the Athlete

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Does the Level of Cervical Disc Herniation Surgery Affect Performance-based Outcomes in National Football League Athletes?

Abstract: 4.

Cited by 19 publications

References 14 publications

Return-to-Play Outcomes in Elite Athletes After Cervical Spine Surgery: A Systematic Review

Return-to-Play Outcomes in Elite Athletes After Cervical Spine Surgery: A Systematic Review

A Systematic Review of the Orthopaedic Literature Involving National Football League Players

Cervical Disc Herniation in Athletes

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