title: Epidural steroid injection for lumbar disc herniation in NFL athletes.
abstract: OBJECTIVE
  To our knowledge, there is no published information on the efficacy of epidural steroid injections for the treatment of lumbar disc herniation in an athletic population. The purpose of this study was to evaluate the efficacy of epidural corticosteroid injection for treatment of lumbar disc herniation in a group of National Football League (NFL) players.
  
  
  METHODS
  We retrospectively reviewed the records of all NFL players who underwent an epidural steroid injection at our institution for incapacitating pain secondary to an acute lumbar disc herniation (confirmed on magnetic resonance imaging) from 2003 to 2010. Our primary outcome was success of the injection, defined as return to play. The secondary outcome of the study was to evaluate risk factors for failure of this treatment approach.
  
  
  RESULTS
  Seventeen players had a total of 37 injections for 27 distinct lumbar disc herniation episodes from 2003 to 2010. The success rate of returning an athlete to play for a given episode of disc herniation was 89% (24 of 27 episodes) with an average loss of 2.8 practices (range = 0-12) and 0.6 games (range = 0-2) after the injection. Four players required a repeat injection for the same episode. Three of these four players ultimately failed conservative management and required surgical intervention. Risk factors for failing injection therapy included sequestration of the disc herniation on magnetic resonance imaging (P = 0.01) and weakness on physical examination (P = 0.002). There were no complications reported.
  
  
  CONCLUSIONS
  In this highly selective group of professional athletes, our results suggest that epidural steroid injections are a safe and effective therapeutic option in the treatment of symptomatic lumbar disc herniation.
authors.affiliation: Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY 10021, USA. krycha@hss.edu
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Krych
authors.forename: Daniel
authors.initials: D
authors.lastname: Richman
authors.forename: Mark
authors.initials: M
authors.lastname: Drakos
authors.forename: Leigh
authors.initials: L
authors.lastname: Weiss
authors.forename: Ronnie
authors.initials: R
authors.lastname: Barnes
authors.forename: Frank
authors.initials: F
authors.lastname: Cammisa
authors.forename: Russell F
authors.initials: RF
authors.lastname: Warren
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D056352:Athletes; D001265:Athletic Injuries / Q000188:drug therapy* / Q000601:surgery; D005538:Football / Q000293:injuries*; D006801:Humans; D007268:Injections, Epidural; D007405:Intervertebral Disc Displacement / Q000188:drug therapy* / Q000601:surgery; D017116:Low Back Pain / Q000188:drug therapy; D008161:Lumbosacral Region / Q000293:injuries / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones