December 10, 2014
1 min read

Disc herniations in NFL players occur at higher spine levels, may not affect RTP

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ORLANDO, Fla. — National Football League athletes were found to have a higher rate of upper-level disc herniations; however, the injuries may not have an impact on career length or production, according to a presenter here.

During the Cervical Spine Research Society Annual Meeting, Wellington K. Hsu, MD, discussed the results of a study that examined 42 NFL athletes who underwent surgery for cervical disc herniations between 1979 and 2013. Among the athletes included, 16 were treated for upper-level herniations and 26 were treated for lower-level herniations.

“There was a similar return-to-play rate after upper- and lower-cervical surgery, similar performance-based outcomes for either upper- or lower-level problems, and the adjacent segment degeneration rate was 10%,” Hsu said. “This is within a 2-year period of time; one would argue that it is slightly more than we would expect from the general population.”

Hsu added that foraminotomies appeared to lead to a higher return-to-play rate, but also a higher reoperation rate within a 2-year period.

Hsu and colleagues found the C3-C4 disc was found to be at higher risk for a collision athlete than it was for the general population, as demonstrated by the 38% of athletes in the study who had an upper-level herniation.

The researchers also found, however, that there was no statistical difference in return-to-play rates for athletes who had an upper- or lower-level herniation. Return-to-play rates in athletes who had a fusion or foraminotomy were also not statistically significantly different, according to Hsu. However, foraminotomies had a higher reoperation rate, at about 50%.

“The distribution of cervical disc herniation is different from elite athletes compared with the general population. It appears that the upper-level cervical herniation seems to be more common in this patient group,” Hsu said. “They are younger, and there is a higher incidence of trauma, so that may cause this disc level to degenerate.”

It was also found that defensive backs were at a higher risk for developing a cervical problem, Hsu said, and linebackers were at a higher risk for developing upper-level cervical problems. – by Robert Linnehan


Hsu WK. Paper #48. Presented at: Cervical Spine Research Society Annual Meeting. Dec. 4-6, 2014; Orlando, Fla.

Disclosure: Hsu has no relevant financial disclosures.