This investigation is a Level III study, meaning that it is retrospective. The purpose of this study was to assess the relationship between the type of bone graft used and the presence or absence of a contract in a group of professional athletes who underwent anterior cervical discectomy and fusion (ACDF). 

Current reports are confined to smaller cohorts, and the choice of graft type in ACDF remains disputed. Single-level ACDF for cervical disc herniation, cervical fracture, or transitory paraparetic event: a retrospective study of 54 elite athletes. The senior surgeon studied professional athletes who had ACDF performed; 39 had structural iliac crest autografts, and 15 had allografts. Bony fusion was confirmed in all autograft patients and in 13 out of 15 allograft patients. Only 2 of the 15 players (13.3%) had their clearance to return to play pushed back by a full season. In total, 43 out of 50 players (88%), including 25 out of 27 who were “self-employed” and 18 out of 23 who were “league-contracted,” returned to professional play. 

Using a structural iliac crest autograft in the surgical treatment of cervical disease in professional athletes is associated with excellent union and return to play rates. An extra 13.3% of patients missed a season due to allograft use. Independent athletes, on average, returned to competition a full season before their league-contracted counterparts.