Spondylolysis and Spondylolisthesis in Athletes.

This article is an update on spondylolysis and spondylolisthesis in athletes, from diagnosis to treatment, based on our service experience and a literature review.

Spinal Injuries in the Overhead Athlete.

Purpose Of Review: Treatment of overhead athletes requires a systematic approach that will make an accurate diagnosis, deliver effective treatment, and make timely and safe return to sport.

Recent Findings: New data has shown success rates and return to play effectiveness after different types of cervical and lumbar surgery. Cervical foraminotomy has been shown to have the highest rate and fastest return to play, but with the highest incidence of need for revision surgery.

Cervical Disc Herniations, Radiculopathy, and Myelopathy.

The key to successful treatment of elite athletes is optimizing the medical care at every step: injury prevention and sport-specific training; comprehensive history and physical examination; high-quality and complete diagnostic studies; accurate diagnosis; control and completion of rehabilitation program; minimally invasive, safe, and effective surgeries; risk assessment for return to sport; guided and gradual return to sport; and continued rehabilitation and exercise program after return to sport.

Asymptomatic Spinal Cord Compression: Is Surgery Necessary to Return to Play.

Advising athletes with asymptomatic cervical canal stenosis on their return to active play is a topic of considerable debate, with no definitive guidelines in place. Once cervical canal stenosis is identified, often through imaging following other injuries, it is difficult to predict the risk of future injury upon return to play in both contact and collision sports. Consequently, the decision can be a complicated one for the athlete, family, and physician alike.

Updated Return-to-Play Recommendations for Collision Athletes After Cervical Spine Injury: A Modified Delphi Consensus Study With the Cervical Spine Research Society.

Background: Previous studies have attempted to establish return-to-play (RTP) guidelines in collision sport athletes after cervical spine injury; however, recommendations have been limited by scant high-quality evidence and basic consensus survey methodologies.

Objective: To create relevant clinical statements regarding management in collision sport athletes after cervical spine injury, and establish consensus RTP recommendations.

Methods: Following the modified Delphi methodology, a 3 round survey study was conducted with spine surgeons from the Cervical Spine Research Society and National Football League team physicians in order to establish consensus guidelines and develop recommendations for cervical spine injury management in collision sport athletes.

Return to Play After Anterior Cervical Discectomy and Fusion in Professional Athletes.

Background: Data are limited on return to play after anterior cervical discectomy fusion (ACDF) in professional athletes.

Purpose: To determine the rate and time of return to play among professional athletes after ACDF.

Study Design: Case series; Level of evidence, 4.

Non-union rate with stand-alone lateral lumbar interbody fusion.

Retrospective radiographic analysis.To determine the fusion rate of stand-alone lateral lumbar interbody fusion (LLIF). Biomechanical studies have indicated that LLIF may be more stable than anterior or transforaminal lumbar interbody fusion.

Sagittal alignment after lumbar interbody fusion: comparing anterior, lateral, and transforaminal approaches.

Study Design: Retrospective radiographic analysis.

Objective: To determine which lumbar interbody technique is most effective for restoring lordosis, increasing disk height, and reducing spondylolisthesis.

Summary Of Background Data: Lumbar interbody fusions are performed in hopes of increasing fusion potential, correcting deformity, and indirectly decompressing nerve roots.

Return-to-play outcomes after microscopic lumbar diskectomy in professional athletes.

Background: It has been shown a microscopic lumbar diskectomy (MLD) is effective in getting professional athletes back to their sport after a herniated nucleus pulposus (HNP). There is a need for more information on the time it takes professional athletes to return after surgery.

Purpose: To determine average time for return to play and success in returning to play for professional athletes undergoing MLD.

Cost-effectiveness of image-guided spine surgery.

Objective: To determine if image-guided spine surgery is cost effective.

Methods: A prospective case series of the first 100 patients undergoing thoracolumbar pedicle screw instrumentation under image-guidance was compared to a retrospective control group of the last 100 patients who underwent screw placement prior to the use of image-guidance. The image-guidance system was NaviVision (Vector Vision-BrainLAB) and Arcadis Orbic (Siemens).