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Return to sports following discectomy: does a consensus exist?

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Abstract

Introduction

In the USA, lumbar discectomy is one of the most commonly performed spinal procedures. As certain sports are considered to be major risk factors for disc herniation, the question remains as to when highly active patients should return to their previous level of activity. This study aimed to analyze spine surgeons’ opinions on when patients may return to activities following discectomy as well as their underlying rationale for their decision.

Methods

A questionnaire was designed by five different fellowship-trained spine surgeons for the 168 members of the Spine Society of Australia. Questions on the surgeons experience, decision making, preferred surgical technique, the postoperative rehabilitation and the response to patient expectations were included.

Results

In total, 83.9% of surgeons discuss the postoperative level of activity with their patients. Sport is considered as an important contributor for good functional outcome by 71.0% of surgeons. Surgeons recommend avoiding, often permanently, weightlifting (35.7%) of the time, rugby (21.4%), horseback riding (17.9%) as well as martial arts (14.3%) postoperatively even with previous training. The return to high levels of activity is considered as a major risk factor for disc herniation recurrence by 25.8% of surgeons. Return to high level of activity is typically recommended after 3 months by 48.4% of surgeons.

Conclusion

So far no consensus on the rehabilitation protocol and return to level of activity exists. Recommendations depend on personal experience as well as the individuals’ training, and typically, a period of avoidance of sport for up to 3 months is recommended.

Level of evidence: Level III, therapeutic and prognostic study.

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Acknowledgements

We thank the Spine Society of Australia for their help and forwarding the survey.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville VIC 3050, Melbourne, Australia

    Henrik C. Bäcker, Peter Turner & John Cunningham

  2. Neurosciences Clinical Institute, Epworth Richmond, Richmond, Melbourne, Australia

    Henrik C. Bäcker, Michael A. Johnson, Patrick Chan, Peter Turner & John Cunningham

  3. Department of Orthopaedic Surgery, Auckland City Hospital, Grafton, New Zealand

    Henrik C. Bäcker & Jack Hanlon

  4. Department of Neurosurgery, Alfred Health, 315, Victoria, 3181, Prahran, Australia

    Patrick Chan

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Contributions

HCB, JC, MAJ, PC and PE designed the study and the questionnaire. HCB, JH, PT, JC and MAJ performed the research. PT, MAJ, JC, PC and HC provided help and advice on the creation of the questionnaire. HCB, JH analyzed the data. HCB, JC, PC, PT and MAJ were involved in writing the manuscript. All authors read and approved the final manuscript.

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Correspondence to Henrik C. Bäcker.

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Bäcker, H.C., Johnson, M.A., Hanlon, J. et al. Return to sports following discectomy: does a consensus exist?. Eur Spine J 33, 111–117 (2024). https://doi.org/10.1007/s00586-023-07776-4

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  • DOI: https://doi.org/10.1007/s00586-023-07776-4

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