Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters

Abstract

BACKGROUND CONTEXT Major League Baseball (MLB) players are at significant risk for back injury, and back injury accounts for a significant proportion of time spent on the disabled list. MLB players that sustain back injuries are either managed conservatively or undergo operation with the goal of returning to their full level of pre-injury performance. Performance data of MLB players is a readily available method of objectively comparing performance outcomes following recovery from back inury. PURPOSE To better understand differences in performance outcomes and ability to return to play following back injury in MLB players. STUDY DESIGN/SETTING This is a retrospective cohort study comparing performance outcomes in MLB players with back injury who underwent conservative versus surgical managment. PATIENT SAMPLE Major League Baseball players that sustained a documented back injury between 2010 and 2016 as recorded in individual MLB team disabled lists. Inclusion criteria also required that players have statistical performance data available one year prior to the injury and following return to play. OUTCOME MEASURES Various outcome measures of in-game performance were measured using hitting and pitching metrics. Hitting performance was assessed using at bats, hits, batting average, home runs, RBIs, and OPS. Pitching performance was analyzed using win/loss ratio, ERA, saves, innings pitches, strike outs and WHIP. Fast ball velocity and pitch selection was also analyzed. Time on the disabled list and whether players returned to play were determined. METHODS Players who sustained back injury were identified using publically available disabled listings from MLB teams from 2011 to 2016. Conservative versus surgical treatment method was determined by using news media and team-affiliated reporting on injured players. Online statistical data on MLB players performance metrics and pitch selection was gathered for the players meeting inclusion criteria. Performance data was compared from one year prior to the injury to one year following return to play to assess change in performance. RESULTS A total of 187 players were identified who sustained back injury between 2010 and 2016. Of these, data was analyzed from 126 players who met inclusion criteria. A total of 100 and 26 players were treated with conservative and surgical management, respectively. The average age was 33. Surgeries included thoracic and lumbar fusion, and discectomy or microdiscectomy of the lumbar and cervical spine. Players undergoing surgery averaged significantly longer time on the disabled list (126days and 41days, respectively). Pitcher earned run average was increased more in the conservative treatment group than the surgical treatment group (increases of 1.15 and 0.4, respectively). Pitcher fastball velocity decreased and frequency of curveball and change-up pitch selection increased. Players undergoing operative management were less likely to return to play. CONCLUSIONS Major league baseball player performance declines following back injury regardless of the form of treatment. Players undergoing surgery miss more playing time and are less likely to return to play than those undergoing conservative therapy. However, when indicated, surgery may be beneficial in maintaining pitching performance as opposed to conservative management.