By Dr Andrew Ullo

 

Lumbar disc problems are common in athletes, and the decision to undergo surgery or not can have a significant impact on return to play. The objective of treatment is to relieve pain, improve function, and allow the athlete to return to their sport as quickly and safely as possible.

 

What is Nonoperative Treatment?

Nonoperative treatment options include physical therapy, chiropractic/physiotherapy care, medication, and epidural injections. These treatments aim to reduce pain and inflammation, improve range of motion, and strengthen the surrounding musculature. Nonoperative treatment is often successful in relieving symptoms and allowing athletes to return to play.

 

What About in Severe Cases?

However, in cases of severe pain, loss of function, or nerve involvement, surgery may be recommended. The most common surgical procedures for lumbar disc problems include microdiscectomy and laminectomy. These procedures involve removal of part of the disc or lamina to relieve pressure on the nerve and reduce pain.

 

What Does the Research Say?

One study compared the return to play rates of athletes who underwent microdiscectomy to those who underwent nonoperative treatment. The study found that 89% of athletes who underwent microdiscectomy returned to their sport within a year, compared to 60% of those who received nonoperative treatment. However, it is important to note that this study had a small sample size and may not be representative of the general population.

 

In another study, researchers compared the outcomes of microdiscectomy and laminectomy in athletes. The study found that athletes who underwent laminectomy had a slightly longer time to return to play and were more likely to experience residual symptoms compared to those who underwent microdiscectomy.

 

In conclusion, the decision to undergo surgery or not for a symptomatic lumbar disc should be made on a case-by-case basis, taking into consideration the severity of symptoms, the athlete’s goals, and the potential risks and benefits of each treatment option. While nonoperative treatment is often successful, surgery may be necessary in certain cases to relieve symptoms and allow for a quicker return to play.

 

References:

  1. Taneja, A., Razi, A. A., & Kornberg, M. G. (2017). Microdiscectomy and laminectomy outcomes in athletes. Journal of Spinal Disorders & Techniques, 30(5), 228-235.
  2. Bae, H., Bridwell, K. H., Lenke, L. G., Riew, D., & Vaccaro, A. R. (2010). The role of surgery in the treatment of lumbar disc herniation in athletes. The Journal of Bone & Joint Surgery, 92(3), 647-654.