Is return to professional rugby union likely after anterior cervical spinal surgery?

Abstract

We have examined the outcome in 19 professional rugby union players who underwent anterior cervical discectomy and fusion between 1998 and 2003. Through a retrospective review of the medical records and telephone interviews of all 19 players, we have attempted to determine the likelihood of improvement, return to professional sport and the long-term consequences. We have also attempted to relate the probability of symptoms in the neck and radicular pain in the arm to the position of play. Neck and radicular pain were improved in 17 patients, with 13 returning to rugby, the majority by six months after operation. Of these, 13 returned to their pre-operative standard of play, one to a lower level and five have not played rugby again. Two of those who returned to the game have subsequently suffered further symptoms in the neck, one of whom was obliged to retire. The majority of the players with problems in the neck were front row forwards. A return to playing rugby union after surgery and fusion of the anterior cervical spine is both likely and safe and need not end a career in the game.

Outcomes After Anterior Cervical Discectomy and Fusion in Professional Athletes

“…Several authors have reported through experiential guidelines and management algorithms that there is no contraindication to RTP after a single-level anterior cervical fusion if an individual has a solid arthrodesis, absence of neurological deficits, and normal cervical range of motion. [3][4][5][6][7][8][9][10]24,29 Overall, these recommendations are primarily based on expert opinion resulting from clinical experience and indirect literature on the topic. In 1997, Torg and Ramsey-Emrhein 8 set forth one of the earliest recommendations regarding RTP in the setting of cervical fusion.…”

“…10 This study retrospectively reviewed 19 professional rugby players who underwent ACDFs over a 5-year period. The aim of the study was to assess the safety and efficiency of ACDF in a high-energy contact sport setting and to document whether athletes were able to RTP.…”

“…[4][5][6][7][8][9] These recommendations are based mostly on expert opinion resulting from clinical practice experience, with only 3 retrospective series on the topic. [10][11][12] Here, we report a series of 15 professional athletes who underwent anterior cervical discectomy and fusion (ACDF) by a single surgeon, representing a spectrum of preoperative cervical spine pathologies. The purpose of this paper is to characterize our diagnostic and surgical criteria, type of surgical intervention, and postoperative neurological imaging results and rehabilitation and also report our subsequent RTP decisions and outcomes.…”

Return to Play in Elite Contact Athletes after Anterior Cervical Discectomy and Fusion: A Meta-Analysis

“…After 2-reviewer assessment, 6 articles were identified that met all of the inclusion criteria. [10][11][12][13][14][15] One study was excluded as the methodology of the article relied on an analysis of team injury reports and newspaper archives, and not on the direct treatment of players. 12 The 5 studies that were selected for inclusion were all retrospective case series.…”

“…[10][11][12][13][14][15] While these studies have provided some guidance on the ability to return to play after ACDF, most of the data is from small retrospective case series.…”