Outcomes Following Surgical Intervention for Sports-Related Stinger Injuries

Introduction: Among athletes in contact sports, including football and rugby, at least half of all players report having suffered at least one stinger injury in their career. Stinger injuries are also known as cervical cord or brachial plexus neuropraxia. Treatment ranges from conservative management to surgical intervention. To better understand and manage stinger injuries in the arena of sports, this study analyzes the patient characteristics, comorbidities, and outcomes of surgical management of sports-related stinger injuries in pediatric and adult patients.

Methods: The National (Nationwide) Inpatient Sample was queried from 2015-2019 for all patients admitted to hospitals with ICD-10 diagnosis codes for sports-related stinger injuries and ICD-10 procedure codes for various nerve decompression surgeries. Demographic information, baseline comorbidities, complications, and discharge dispositions were compared between patients who underwent surgical treatment and those who were managed medically. A multivariate logistic regression was performed to determine independent predictors of outcomes, while controlling for age, gender, and Elixhauser Comorbidity Index. All statistical analyses were performed using Statistical Product and Service Solutions (SPSS, V. 29).

Results: Of 170 patients with sports-related stinger injuries, 15 of these patients received operative management. Patients with sports-related stinger injuries who received surgical intervention were more likely to be of white race (p < 0.001), be in the lower 50th percentile median income (p < 0.001), and be on medicare insurance (p=0.049). They were more likely to have hypertension (p=0.043), smoker status (p=0.027), and have chronic anticoagulant/antiplatelet use (p=0.001). There were no statistically significant differences between groups for length of stay, routine discharge, and discharge disposition - parameters that are representative of patient outcome status.

Conclusion : Our study found that there are no differences in outcomes between patients who receive surgical intervention for sports-related stinger injuries and those who receive medical management. This finding provides neurosurgeons with insight regarding the importance of prioritizing a conservative approach for recovery with athletes experiencing stinger injuries who seek guidance on return to play.