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Performance-Based Outcomes Following Lumbar Discectomy in Professional Athletes in the National Football League

Hsu, Wellington K. MD*†

doi: 10.1097/BRS.0b013e3181bf8bb5
Occupational Health/Ergonomics

Study Design. Retrospective cohort study.

Objective. To determine the performance-based outcomes in National Football League (NFL) athletes after discectomy for a lumbar disc herniation (LDH).

Summary of Background Data. Long-term outcomes following surgical treatment in elite athletes in the NFL are unknown. Postoperative outcomes may be significantly different from the general population due to the exceptional physical demands imposed by the sport.

Methods. National Football League players diagnosed with a lumbar disc herniation were identified using information from press releases, team injury reports, and newspaper archives. Demographic, treatment, and performance data based on vital statistics to each position were recorded for each player over the length of his career. Using a modification of a previously published scoring system (Carey et al, Am J Sports Med 2006;34:1911–7) based on game statistics, a “Performance Score” was calculated for each player both before and after diagnosis of LDH.

Results. A total of 137 National Football League players were identified as having an LDH necessitating treatment. Ninety-six players underwent surgical treatment with a lumbar discectomy, and 34 athletes were treated nonoperatively. Seventy-eight percent of athletes treated surgically for an LDH returned to play in at least 1 NFL game. Players treated surgically played in statistically more games post-treatment (36) than those treated nonoperatively (20) (P < 0.002). There was no significant difference between the Performance Score preoperatively and postoperatively over the length of the players' careers. Age at diagnosis, body mass index, Pro Bowl appearances, and position played did not significantly affect outcome.

Conclusion. The data in this study suggests that even though a lumbar discectomy has career-threatening implications, a large percentage of NFL athletes return to play at competitive levels. Despite the general opinion of many NFL general managers, players who are able to complete the rigorous rehabilitation required to return to play after lumbar discectomy can expect excellent performance-based outcomes after surgery.

Although lumbar disc herniations are common injuries in the elite athlete, long-term outcomes following treatment are unknown. In this study, we identified 137 National Football League players from 1979 to 2008 who were treated for a lumbar disc herniation. Clinical outcomes based on statistical performance and return-to-play rates were far better than expected.

From the Departments of *Orthopaedic Surgery and †Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.

Acknowledgment date: May 6, 2009. Revision date: August 4, 2009. Acceptance date: August 4, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. One or more of the author(s) has/have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this manuscript: e.g., honoraria, gifts, consultancies, royalties, stocks, stock options, decision making position.

Address correspondence and reprint requests to Departments of Orthopaedic Surgery and Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 North St. Clair St, Suite 1350, Chicago, IL 60611; E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.