Former Professional Rugby Players Have Greater Cervical Spine Degeneration Than the General Population

Newswise — CHARLOTTESVILLE, VA (JULY 21, 2015). French researchers used clinical examinations and magnetic resonance imaging (MRI) studies to determine whether retired professional rugby players experience more serious symptoms of cervical spine degeneration than people in the general population. To the best of the authors’ knowledge, this is the largest study of its kind covering any professional contact sport, and it confirms greater cervical spine degeneration in former rugby players. The research findings are reported and discussed in the article, “Clinical and radiological cervical spine evaluation in retired professional rugby players,” by David Brauge, MD, and colleagues, published today online, ahead of print, in the Journal of Neurosurgery: Spine (http://thejns.org/doi/full/10.3171/2015.1.SPINE14594). The researchers compared cervical spine symptoms and evidence of injury in two groups of men: 101 men who had retired from professional rugby (mean age 40.3 years, range 35 to 47 years) and 85 volunteers who had never participated in competitive rugby or any other sport on the professional level (control group; mean age 41.6 years, range 35 to 49 years). Participants in the two groups were matched according to age, sex, type of employment, smoking habits, and current sports training. The researchers evaluated spine symptoms in all of the participants and spine MRI findings in a sample of 50 men, 25 from the retired rugby player group and 25 from the control group. Complaints of chronic neck pain and reduced neck mobility were reported significantly more often in the former rugby player group (50.5%) than in the control group (31.8%). When these symptoms were evaluated using a neck pain visual analog scale and the Neck Disability Index, however, there was no statistically significant difference in the level of pain reported by the former rugby players and the level of pain reported by the volunteers. MRI studies focused on anatomical signs of degeneration in the cervical spine as well as on the status of paraspinal muscles. The researchers report that compared to volunteers in the control group, retired rugby players had significantly narrower vertebral canals (which house the spinal cord) and greater foraminal stenosis (narrowing of the foramen through which spinal nerve roots exit the vertebral canal). When the researchers examined study participants’ musculature in the vicinity of the spine, they found that retired rugby players had significantly greater muscle mass (and less fat) than the volunteers. The researchers hypothesize that the stronger paraspinal muscles found in former rugby players may aid in controlling the level of spinal pain in this group.

Retired rugby players had undergone significantly more surgeries for degenerative spine conditions (10 cases [9.9%]) than volunteers (no cases). In all 10 surgical cases, the operation was performed for disc herniation and radiculopathy, and in nine cases, surgery was performed during the rugby players’ professional careers. The researchers note that most of the former players returned to play after surgery, “indicating that spine surgery does not completely prohibit contact sports in professional athletes.”

In summary, when asked about the findings of the study, Dr. Brauge said, “A few years after the end of their careers, professional rugby players seem to have more degenerative symptoms and lesions on the cervical spine. These symptoms are exceptionally disabling (3 of 101 cases in this study). Our definitive conclusion should be reasonably prudent; we still can’t assert that the lesions worsen with time or that the disease stabilizes with the end of the rugby activity.”

Brauge D, Delpierre C, Adam P, Sol JC, Bernard P, Roux FE. Clinical and radiological cervical spine evaluation in retired professional rugby players. Journal of Neurosurgery: Spine, published online, ahead of print, July 21, 2015; DOI: 10.3171/2015.1.SPINE14594.

Disclosure: This study was supported by funding from the Fédération Française de Rugby, Ligue Nationale de Rugby, Institut de Recherche sur la Moelle Epinière et l’Encéphale (IRME), Société Française de Chirurgie du Rachis (SFCR), and Centre Hospitalier Universitaire de Toulouse.

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The Journal of Neurosurgery: Spine is a monthly peer-reviewed journal focused on neurosurgical approaches to treatment of diseases and disorders of the spine. It contains a variety of articles, including descriptions of preclinical and clinical research as well as case reports and technical notes. The Journal of Neurosurgery: Spine is one of four monthly journals published by the JNS Publishing Group, the scholarly journal division of the American Association of Neurological Surgeons. Other peer-reviewed journals published by the JNS Publishing Group each month include the Journal of Neurosurgery, Neurosurgical Focus, and the Journal of Neurosurgery: Pediatrics. All four journals can be accessed at www.thejns.org.

Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 8,300 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the brain, spinal column, spinal cord, and peripheral nerves. For more information, visit www.AANS.org.