The impact of a cervical spine diagnosis on the careers of National Football League athletes.
METHODS
Cohort study.


OBJECTIVE
To determine the effect of cervical spine pathology on athletes entering the National Football League.


BACKGROUND
The association of symptomatic cervical spine pathology with American football athletes has been described; however, it is unknown how preexisting cervical spine pathology affects career performance of a National Football League player.


METHODS
The medical evaluations and imaging reports of American football athletes from 2003 to 2011 during the combine were evaluated. Athletes with a cervical spine diagnosis were matched to controls and career statistics were compiled.


RESULTS
Of a total of 2965 evaluated athletes, 143 players met the inclusion criteria. Athletes who attended the National Football League combine without a cervical spine diagnosis were more likely to be drafted than those with a diagnosis (P = 0.001). Players with a cervical spine diagnosis had a decreased total games played (P = 0.01). There was no difference in the number of games started (P = 0.08) or performance score (P = 0.38). In 10 athletes with a sagittal canal diameter of less than 10 mm, there was no difference in years, games played, games started, or performance score (P > 0.24). No neurological injury occurred during their careers. In 7 players who were drafted with a history of cervical spine surgery (4 anterior cervical discectomy and fusion, 2 foraminotomy, and 1 suboccipital craniectomy with a C1 laminectomy), there was no difference in career longevity or performance when compared with matched controls.


CONCLUSIONS
This study suggests that athletes with preexisting cervical spine pathology were less likely to be drafted than controls. Players with preexisting cervical spine pathology demonstrated a shorter career than those without; however, statistically based performance and numbers of games started were not different. Players with cervical spinal stenosis and those with a history of previous surgery demonstrated no difference in performance-based outcomes and no reports of neurological injury during their careers.
*Department of Orthopaedic Surgery, Northwestern University, Evanston, IL †Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH; and ‡Department of Orthopaedic Surgery, NorthShore University, Evanston, IL.
Gregory D
GD
Schroeder
T Sean
TS
Lynch
Daniel B
DB
Gibbs
Ian
I
Chow
Mark W
MW
LaBelle
Alpesh A
AA
Patel
Jason W
JW
Savage
Gordon W
GW
Nuber
Wellington K
WK
Hsu
D000328:Adult; D056352:Athletes; D054874:Athletic Performance; D002322:Career Mobility; D002574:Cervical Vertebrae / Q000293:injuries / Q000473:pathology* / Q000601:surgery; D002755:Choice Behavior; D004185:Disability Evaluation; D005538:Football; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D018570:Risk Assessment; D013122:Spinal Diseases / Q000453:epidemiology* / Q000601:surgery; D013130:Spinal Stenosis / Q000453:epidemiology / Q000601:surgery; D055009:Spondylosis / Q000453:epidemiology / Q000601:surgery