Return to sports following discectomy: does a consensus exist?

Area of Science:

• Spine Surgery
• Rehabilitation Medicine
• Sports Medicine

Background:

• Lumbar discectomy is a frequent spinal procedure in the USA.
• Determining safe return-to-activity timelines for highly active patients post-discectomy is crucial.
• Sports participation is a significant risk factor for disc herniation.

Purpose of the Study:

• To survey spine surgeons' opinions on patient return-to-activity timelines post-lumbar discectomy.
• To understand the rationale behind surgeons' recommendations for postoperative activity levels.
• To identify specific sports and activities surgeons advise patients to avoid.

Main Methods:

• A questionnaire was developed by five fellowship-trained spine surgeons.
• The survey targeted 168 members of the Spine Society of Australia.
• Questions covered surgeon experience, decision-making, surgical techniques, rehabilitation, and patient expectations.

Main Results:

• 83.9% of surgeons discuss postoperative activity levels with patients.
• 71.0% of surgeons view sports as important for functional outcomes.
• Commonly avoided activities include weightlifting (35.7%), rugby (21.4%), horseback riding (17.9%), and martial arts (14.3%).
• 25.8% of surgeons consider return to high activity a risk for recurrence.
• 48.4% of surgeons recommend return to high activity after 3 months.

Conclusions:

• No established consensus exists for rehabilitation protocols or return-to-activity guidelines after lumbar discectomy.
• Recommendations are influenced by individual surgeon experience and training.
• A common recommendation is to avoid sports for up to three months post-surgery.