BACKGROUND CONTEXT

Sports-related spinal injuries can be catastrophic in nature. Athletes competing in collision sports (eg, football) may be particularly prone to injury given the high-impact nature of these activities. Due to the oftentimes profound impact of sports-related spinal injuries on health and quality-of-life, they are also associated with a substantial risk of litigation. However, no study to date has assessed litigation risks associated with sports-related spinal injuries. A better understanding of the risk factors surrounding these legal claims may provide insights into injury prevention and other strategies to minimize litigation risks. In addition, it may allow the spine surgeon to better recognize the health, socioeconomic, and legal challenges faced by this patient population.

PURPOSE

To provide a comprehensive assessment of reported legal claims involving sports-related spinal injuries, including a comparative analysis of legal outcomes between collision and non-collision sports. To discuss strategies to prevent sports-related spinal injuries and minimize litigation risks.

STUDY DESIGN/SETTING

Retrospective review.

PATIENT SAMPLE

Athletes experiencing spinal injuries during sports.

OUTCOME MEASURES

Outcomes included verdict outcome (defendant vs. plaintiff), legal claims, injuries sustained, clinical symptoms, and award payouts.

METHODS

The legal research database Westlaw Edge (Thomson Reuters) was queried for legal claims brought in the United States from 1950 to 2021 involving sports-related spinal injuries. Verdict or settlement outcomes were collected as well as award payouts, time to case closure, case year, and case location. Demographic data, including type of sport (ie collision vs. non-collision sport) and level of play were obtained. Legal claims, spinal injuries sustained, and clinical symptoms were also extracted. Furthermore, the nature of injury, injured spinal region, and treatment pursued were collected. Descriptive statistics were reported for all cases and independent-samples t-tests and chi-square tests were used to compare differences between collision and non-collision sports.

RESULTS

Of the 840 cases identified on initial search, 78 met our criteria for in-depth analysis. This yielded 62% (n=48) defendant verdicts, 32% (n=25) plaintiff verdicts, and 6% (n=5) settlements, with a median inflation-adjusted award of $780,000 (range: $5,480–$21,585,000) for all cases. The most common legal claim was negligent supervision (n=38, 46%), followed by premises liability (n=23, 28%), and workers’ compensation/no fault litigation (n=10, 12%). The most common injuries sustained were vertebral fractures (n=34, 44%) followed by disc herniation (n=14, 18%). Most cases resulted in catastrophic neurological injury (n=37, 49%), either paraplegia (n=6, 8%) or quadriplegia (n=31, 41%), followed by chronic/refractory pain (n=32, 43%). Non-collision sport cases had a higher percentage of premises liability claims (41% vs. 11%, p=.006) and alleged chronic/refractory pain (53% vs. 28%, p=.04). Conversely, collision sport cases had a higher proportion of workers’ compensation/no fault litigation (23% vs. 4%, p=.03) and cases involving disc herniation (29% vs. 9%, respectively; p=.04).

CONCLUSION

Sports-related spinal injuries are associated with multiple and complex health, socioeconomic, and legal consequences, with median inflation-adjusted award payouts nearing $800,000 per case. In our cohort, the most commonly cited legal claims were negligent supervision and premises liability, emphasizing the need for prevention guidelines for safe sports practice, especially in non-professional settings. Cases involving athletes participating in non-collision sports were significantly associated with claims citing chronic/refractory pain, highlighting the importance of long-term care in severely injured athletes.

中文翻译：

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涉及运动相关脊柱损伤的诉讼：对过去 70 年美国报道的法律索赔的全面回顾

背景语境

与运动相关的脊柱损伤本质上可能是灾难性的。鉴于这些活动的高冲击性，参加碰撞运动（例如，足球）的运动员可能特别容易受伤。由于与运动相关的脊柱损伤通常会对健康和生活质量产生深远影响，因此它们还与诉讼的重大风险相关联。然而，迄今为止，还没有研究评估与运动相关的脊柱损伤相关的诉讼风险。更好地了解围绕这些法律索赔的风险因素可能会提供对伤害预防和其他策略的见解，以最大限度地减少诉讼风险。此外，它可以让脊柱外科医生更好地认识到这一患者群体面临的健康、社会经济和法律挑战。

目的

对报告的涉及与运动相关的脊柱损伤的法律索赔进行全面评估，包括对碰撞和非碰撞运动之间的法律结果进行比较分析。讨论预防与运动相关的脊柱损伤和最小化诉讼风险的策略。

研究设计/设置

回顾性审查。

患者样本

运动员在运动中遭受脊椎损伤。

结果测量

结果包括判决结果（被告与原告）、法律索赔、持续受伤、临床症状和赔偿金额。

方法

法律研究数据库 Westlaw Edge（汤森路透）查询了 1950 年至 2021 年在美国提出的涉及与运动相关的脊柱损伤的法律索赔。收集判决或和解结果以及奖励支出、结案时间、案件年份和案件地点。获得了人口统计数据，包括运动类型（即碰撞与非碰撞运动）和比赛水平。还提取了法律索赔、脊髓损伤和临床症状。此外，还收集了受伤的性质、受伤的脊柱区域和所追求的治疗。报告了所有案例的描述性统计数据，并使用独立样本t检验和卡方检验来比较碰撞和非碰撞运动之间的差异。

结果

在初步搜索确定的 840 个案例中，有 78 个符合我们的深入分析标准。这产生了 62% (n=48) 的被告判决、32% (n=25) 的原告判决和 6% (n=5) 的和解，通货膨胀调整后的赔偿中位数为 780,000 美元（范围：5,480 美元至 21,585,000 美元）个案。最常见的法律索赔是监管疏忽 (n=38, 46%)，其次是经营场所责任 (n=23, 28%)，以及工伤赔偿/无过错诉讼 (n=10, 12%)。最常见的受伤是椎骨骨折(n=34, 44%)，其次是椎间盘突出 (n=14, 18%)。大多数病例导致灾难性神经损伤 (n=37, 49%)，要么是截瘫(n=6, 8%) 或四肢瘫痪 (n=31, 41%)，其次是慢性/难治性疼痛 (n=32, 43%)。非碰撞运动案例中场所责任索赔的比例更高（41% 对 11%，p=.006）和所谓的慢性/难治性疼痛（53% 对 28%，p=.04）。相反，碰撞运动案件中工人赔偿/无过错诉讼的比例更高（23% 对 4%，p=.03）和涉及椎间盘突出的案件（分别为 29% 对 9%；p=.04） .

结论

与运动相关的脊柱损伤与多种复杂的健康、社会经济和法律后果有关，经通货膨胀调整后的奖励支出中位数接近每例 800,000 美元。在我们的队列中，最常被引用的法律索赔是疏忽监督和场所责任，强调需要安全运动实践的预防指南，尤其是在非专业环境中。涉及运动员参加非碰撞运动的案例与以慢性/顽固性疼痛为由的索赔显着相关，突出了对严重受伤的运动员进行长期护理的重要性。