A great deal of focus, and rightly so, has been placed on the occurrence and consequences of head injuries and concussions in football players. It is, right or wrong, expected and accepted that football players frequently sustain knee, shoulder, and ankle injuries. Acute spine injuries receive much attention, especially if paralysis or nerve injury occurs. What has not been assessed is the long-term effect of football on the integrity of the spine. Certainly football players injure their back and neck when playing but as soon as they feel better, the general belief is that they have recovered. However, an injury to the spine, whether the neck or back, has consequences that can manifest themselves in significant ways years later. It is well-known that eighty percent of individuals suffer a neck or back problem at some time in their life for which they seek treatment from health-care professional. For most individuals the problems resolve or can be managed readily with non-surgical treatment such as chiropractic, physical therapy and anti-inflammatory medication. Less then ten percent of those who receive medical attention ever require surgery.
We surveyed men who had played college football twenty years ago and asked about the state of their spine. Our preliminary survey found that twenty three percent had undergone spine surgery. This is more than twice the rate of the general population. As a neurosurgeon operating on the spine I am not surprised by these results. Spine-centered problems can be profoundly debilitating; studies have shown that individuals who suffer from chronic back problems have the lowest quality-of- life index of any medical group. We need to expand our survey to obtain more solid information but it is clear that those who play football need to be aware that they risk suffering from back and neck problems years after they have stopped playing the game. We also need to begin looking more carefully, not only at ways to protect the cervical spine from dangerous fractures but also at how to protect the spine overall. Most individuals play football for only a relatively few years of their life and should not have to suffer as a consequence many years hence.
