Background context:

Sports-related spinal injuries can be catastrophic in nature. Athletes competing in collision sports (e.g., football) may be particularly prone to injury given the high-impact nature of these activities. Due to the profound impacts on health and quality-of-life, sports-related spinal injuries are also associated with a 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 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.


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

Study design/setting:

A 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.


The legal research database, Westlaw Edge (Thomson Reuters), was queried for cases in the United States involving sports-related spinal injuries from 1950-2021. 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 (e.g., collision vs. non-collision sport) and level of play were obtained. Legal claims, spinal injuries sustained, and clinical symptoms were 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.


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 injury (n=37, 49%), which included paraplegia (n=6, 8%) and quadriplegia (n=31, 41%), followed by chronic/refractory pain (n=32, 43%). Non-collision sport cases had a higher percentage of premises liability (41% vs. 11%, p=0.006) claims and chronic/refractory pain cases (53% vs. 28%, p=0.04). Conversely, collision sport cases had a higher proportion of workers’ compensation/no fault litigation (23% vs. 4%, p=0.03) and cases involving disc herniation (29% vs. 9%, respectively; p=0.04).


Sports-related spinal injuries are associated with 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 preventative guidelines for safe-sports practice in Academic 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.


Chronic Pain; Litigation; Paraplegia; Quadriplegia; Spine Surgery; Sports-related Spinal Injury; Tort reform.

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Litigation involving sport-related spinal injuries: a comprehensive review of reported legal claims in the United States

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