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Return to sports following discectomy: does a consensus exist?

Henrik C Bäcker1,2,3, Michael A Johnson4, Jack Hanlon5

  • 1Department of Orthopaedic Surgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville VIC 3050, Melbourne, Australia. Henrik.baecker@sports-med.org.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Spine surgeons often recommend avoiding high-impact sports for up to three months after lumbar discectomy. However, there is no consensus on return-to-activity guidelines following this common spinal procedure.

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AthletesDiscectomyRehabilitationReturnSports

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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.