Anterior Cervical Discectomy and Fusion in Professional Athletes

Allograft Versus Autograft

Abstract

Study Design: 

Level III—retrospective study.

Objective: 

The aim was to evaluate the effect method of bone grafting and contract status have on outcomes in a cohort of professional athletes treated with anterior cervical discectomy and fusion (ACDF).

Summary of Background Data: 

The choice of graft-type in ACDF is controversial, with current reports limited to smaller cohorts.

Materials and Methods: 

Retrospective analysis of 54 professional athletes treated with single level ACDF for cervical disc herniation, cervical fracture, or transient paraparetic event.

Results: 

A case series of professional athletes with ACDF by the senior surgeon were evaluated, 39 with structural iliac crest autograft and 15 with allograft. All autograft patients had confirmed bony fusion, whereas 13/15 allograft patients had a confirmed bony fusion. Each of these players (2/15, 13.3%) was delayed for clearance for return to play by 1 season. In total, 43/50 players (88%) returned to professional play; 25/27 (92.6%) of them “self-employed” and 18/23 (78.2%) “league-contracted.”

Conclusions: 

Surgical treatment of cervical pathology in the professional athlete with structural iliac crest autograft results in high union and return to play rates. Use of allograft resulted in a 13.3% increased rate of missing an additional season. Self-employed athletes returned to play 1 season earlier than league-contracted athletes on average.