Thank you. Our next speaker is Dr. Ian Kalfus. He'll be speaking about spondylolisis, spondylolisthesis in professional baseball players. Thanks, Zoe. This is work performed primarily by Heath Gould, one of our medical students at our Cleveland Clinic Spine Outcomes Database Lab. Heath is on his way to another meeting in Singapore, so he asked me to present this for him. I have no disclosures pertinent to this study. We all deal with young athletes who present with back pain, who have some element of spondylolisis or spondylolisthesis, so it's a well-known cause of back pain in these patients. These two disorders occur more frequently in sports with repetitive hyperextension or truncal rotation, but there's limited information on the impact on high-level, elite-level baseball players. There's one study from Italy that looked at symptomatic spondylolisis in 21 Olympic baseball players and found a prevalence of a little under 5%. So the purpose of this study was to at least investigate the incidents, the treatment, and the return-to-play outcomes in major and minor league ball players who present with spondylolisis or spondylolisthesis. We were given access to the Major League Baseball's Injury Surveillance Database and queried it for the period 2011-2016 for all players who presented with back pain who also had some imaging studies with their presentation. We identified 272 players, and out of those 75 players, almost 28% had some evidence of spondylolisis or spondylolisthesis. We categorized the demographic and injury-related data, and then we stratified it according to primary diagnosis, baseball position, level of competition, and the treatment modalities used and then used the appropriate statistical analysis. So a little bit of a busy study, busy slide, but demonstrates the 75 players we saw, 47 had spondylolisis, 28 had spondylolisthesis, age primarily was older in the spondylolisthesis group, years of professional service, greater in the spondylolisthesis group, no significant difference with level of competition and the baseball position played. We then stratified it according to minor league versus major league, and again, there were more minor league players who had one or two, one of these two disorders. The significant measurements were the age, obviously, greater with major league, and the years of pro greater with major league. And the return to play was actually lower for major league players compared to minor league players. We stratified it for position players versus pitchers, and again, the primary significant object or analysis here was that position players returned to play sooner than pitchers. And the treatment modalities were stratified according to conservative versus invasive, either injections or surgery, and again, nothing significant there other than return to play was obviously sooner with conservative treatment as opposed to injection and surgery. And then when we broke it down according to treatment and return to play based on the primary diagnosis, we identified that the players with spondylolisthesis actually returned to play sooner than players with spondylolisthesis. Now, there were four patients out of these 75 that end up undergoing surgery, all of them returned to play. They were not included in this particular return to play analysis because their outcome was, or their return to play was averaged nine months. But outside of that, the average return to play was 19 days for patients with spondylolisthesis. So in conclusion, the majority of the affected players were managed successfully with conservative measures. Players with spondylolisthesis returned to play sooner than those with, or spondylolisthesis returned play sooner than those with spondylolisis, that's a typo. Major leaguers returned to play sooner than minor leaguers. Position players sooner than pitchers. And we're now further investigating to assess the effect of these two disorders on primary, on player performance after return to play. I'd like to thank my co-authors with this study. Thank you.

spondylolysis

spondylolisthesis

professional baseball players

return to play

conservative measures