Pro athletes may safely return to competition after lumbar microdiscectomy

CHICAGO — The pooled rate of return to play following lumbar microdiscectomy for herniated disc nucleus was 83.5%, according to results presented at the North American Spine Society Annual Meeting, and the overall return to play rate for elite athletes with a herniated disc after this procedure was 84.5%.

The findings were from the first study to pool results from level 3 and 4 published articles, which, according to Samuel C. Overley, MD, of New York, was done to help guide decision-making and manage expectations after athletes sustain disc herniations (DH).

Based on results of the meta-analysis of outcomes for microdiscectomy, “it is a safe, viable and effective option for helping athletes return to play,” Overley said in his presentation.

The investigators used return to play as the sole outcome they looked at in two-reviewer studies of adult Major League or Olympic athletes with symptomatic DHs. The athletes included were usually treated operatively, but four studies had a nonoperative treatment arm.

Nine articles met the inclusion criteria with 558 elite athletes treated with lumbar microdiscectomy and 190 athletes who underwent nonoperative management.

The return to play rate for just the athletes who underwent lumbar microdiscectomy “was statistically strongly in favor of elite athletes returning to competition,” Overley said.

“When we looked at the four studies that had a nonoperative arm, the odds ratio of return to play [was] slightly in favor of the lumbar microdiscectomy cohort, rather than the nonop [group]. However, there was no statistical difference between these two groups.”

The results showed a 1.13 odds ratio of return to play with a symptomatic lumbar DH. – by Susan M. Rapp

Reference:

McAnany SJ, et al. Paper #34. Presented at: North American Spine Society Annual Meeting; Oct. 14-17, 2015; Chicago.

Disclosure: Overley reports no relevant financial disclosures.