Epidemiology of Spine-Related Neurologic Injuries in Professional Baseball Players

Abstract

Study design: A retrospective case series study.

Objective: To analyze the epidemiology of diagnoses of degenerative cervical and lumbar spinal conditions among Major League Baseball (MLB) and Minor League Baseball (MiLB) players.

Summary of background data: Repetitive high-energy forces in professional baseball players may predispose them to degenerative cervical and lumbar spinal conditions. There is a lack of data concerning the epidemiology of these injuries in professional baseball.

Methods: Deidentified data on spine injuries were collected from all MLB and MiLB teams from 2011 to 2016 from the MLB-commissioned Health and Injury Tracking System database. Rates of diagnoses of common degenerative spinal conditions as well as their impact on days missed due to injury, necessitation of surgery, and player participation and career-ending status were assessed. Injury rates were reported as injuries per 1000 athlete-exposures in concordance with prior studies.

Results: Over 2011 to 2016, 4246 days of play were missed due to 172 spine-related injuries. 73.3% were related to the lumbar spine and 26.7% to the cervical spine. There were similar rates of surgery required for these injuries (18.3% of lumbar injuries vs. 13.0% of cervical injuries, P = 0.2164). Mean age of players with cervical injuries was higher compared with the lumbar group (27.5 vs. 25.4, P = 0.0119). Average number of days missed due to lumbar injuries was significantly higher than those due to cervical injuries (34.1 vs. 21.6 d, P = 0.0468). Spine injury rates for pitchers were significantly higher than those of other position players (0.086 per 1000 athlete-exposures vs. 0.037, P < 0.0001).

Conclusion: Neurologic diagnoses relating to the cervical and lumbar spine lead to substantial disability among MLB and MiLB players as well as days missed from play. Pitchers have over double the rates of injury compared with other position players. Lumbar conditions were associated with significantly higher numbers of days missed from play.Level of Evidence: 4.