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The authors' findings overall show a relatively encouraging RTP rate with some sports-specific differences being apparent. There is some early evidence to suggest a decrement in performance in certain sports such as baseball and professional. As stated earlier, we lack a lot of important data, such as the baseline neurologic status of patients prior to and following surgery, persistent radiographic spinal stenosis or cord signal changes, as well as alignment and degeneration-related structural factors.

Longer-term outcomes data such as secondary neurologic decline or rates of further spine surgery is not yet available, but hopefully greater urgency toward transparency of data especially for athletes performing in professional and high-end collegiate leagues will prevail, similar to the greater awareness of head injuries in sports.

This article will hopefully prompt a dialogue among leaders in the field of sports medicine, such as being represented by the senior author of this study, to start an overdue, more-formal discussion on the question of when is it safe to return to play after a neck injury and a similar question for patients who have received some form of neck surgery. Following the lead of the head injury task forces, a good baseline might be reached by answering the following five questions explicitly or implicitly raised by Molinari et al in their illustrative case report.

What is an acceptable clinical neurologic status radiculopathy, myelopathy for RTP and how do we objectively test for such? What is the role of MRI findings in RTP, such as space available for the cord, cord signal changes, and cord compression?

Along these lines, developing a national sports-related spinal cord injury registry in countries with organized sports, such as Canada has done with the International Collaboration on Repair Discoveries project activities, would seem to be a desirable next step. National Center for Biotechnology Information , U. Journal List Global Spine J v. Global Spine J. Published online Jan 5. Robert W. Molinari , 1 Krystle Pagarigan , 2 Joseph R.

Dettori , 2 Robert Molinari, Jr. Dehaven 1. Krystle Pagarigan 2 Spectrum Research, Inc. Joseph R. Dettori 2 Spectrum Research, Inc. Robert Molinari, Jr. Kenneth E. Author information Article notes Copyright and License information Disclaimer. Address for correspondence Robert W. Received Nov 3; Accepted Dec 1.

This article has been cited by other articles in PMC. Associated Data Supplementary Materials Supplementary material. Keywords: return to play, cervical spine surgery, athletes, guidelines. Study Rationale and Context The diagnosis and surgical treatment of spinal disorders in athletic patients are relatively straightforward and well defined.

Clinical Questions Among athletes who undergo surgery of the cervical spine: What proportion RTP after their presurgery sport? Among those who return to their sport, how long do they continue to play? Materials and Methods Study design: Systematic review. Search: PubMed and bibliographies of key articles. Dates searched: Database inception to August 19, Analysis: Descriptive statistics. Details about our methods can be found in the online supplementary material.

Results Study Characteristics We identified nine observational, retrospective series consisting of patients who met the inclusion criteria and form the basis for this report Table 1 ; Fig.

Table 1 Study characteristics, return to play, performance, and duration. Open in a separate window. Proportion Returned to Play Table 2 Table 2 Frequency of return to play for professional athletes by sport. National Football League Hsu compared a performance score among non—defensive linemen with at least 2-year follow-up after surgery using a standardized, previously published scoring system.

Major League Baseball One report of seven pitchers who returned to Major League Baseball compared pre- versus postoperative performance. Illustrative Case Report A year-old professional hockey player sustained a violent collision with another player during a hockey game.

Discussion The majority of the existing literature on this topic reports successful return to athletic competition, including contact sport participation, after single-level ACDF surgery for cervical herniated disk. Limitations There is a paucity of existing quality literature assessing the proportion of athletes returning to the sport following cervical surgery.

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Create Listings. Tired of ads on Kongregate? You can now be Ad-Free! To play games on Kongregate, you must have Javascript enabled! However, as time progressed his condition worsened. In July , tests showed Manning had dangerous degeneration in his spine and underwent a third, similar surgery, but Manning was unsatisfied with his improvement.

In September , Manning sought a more complete solution, and underwent a single-level anterior cervical fusion. This approach allows a more complete decompression of the nerve, and less likelihood of re-herniation. And interestingly, a 1 level fusion often results in no noticeable difference in range of motion, even in a professional athlete.