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Prognosis for neck and back disc hernations for baseball pitchers

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Q: I'm watching the reports on several major league baseball pitchers who are in treatment for neck and back disc herniations. What's the prognosis for these guys?

A: The results of a recent study showed that major league baseball pitchers can recover from a neck or back disc herniation. It may take a while but they can even return-to-play after surgical treatment.

How did they come to this conclusion? Public records were searched for information from 1984 to 2009. They found 40 major league baseball pitchers with a history of disc herniation and then followed the results of treatment.

Everyone included in the study had surgery for the problem. They either had a spinal fusion or a disc replacement. Although return-to-play status was the defining measure of success, there were other factors assessed. How long it took to go from the last game player before injury back to the playing field was one of those measures.

According to the statistical analysis of the 40 pitchers in the study, it takes an average of about one year for players with neck herniations to fully recover fully. And players with a low back disc herniation experience an average of seven months between injury and return-to-play. That's a full season at least for both groups. But if the injury occurs mid-season, then a seven to 12-month period of time can extend into two seasons.

What about performance for these players? By performance we are talking about pitching statistics such as earned run average, innings pitched, and walks plus hits per innings. By comparing the pitcher's pre-injury stats to his post-injury performance, it is possible to see if his pitching performance is better-same-or-worse from preinjury to post-treatment.

A closer look at all the data showed that the biggest before and after surgery difference was in the number of innings pitched per season. In both groups (pitchers with cervical or lumbar disc herniations), players pitched fewer innings after surgery.

When those statistics were compared to players with similar injuries treated conservatively (nonoperative care), the players in the nonoperative group had better post-treatment stats. The major difference was in the number of players who were able to return-to-play in the conservative care group (far less than in the surgical group).

Major league baseball pitchers with disc herniations can indeed recover and return to sports action as good as ever. The disc injury does not necessarily mean the end of a career or even reduced performance. But expect a season or even two to go by before finding your favorite number in the dugout.

Reference: David W. Roberts MD, et al. Outcomes of Cervical and Lumbar Disk Herniations in Major League Baseball Pitchers. In Orthopedics. August 2011. Vol. 34. No. 8. Pp. 602-609.

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