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Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta-analysis.

Publication ,  Journal Article
Reiman, MP; Sylvain, J; Loudon, JK; Goode, A
Published in: Br J Sports Med
February 2016

BACKGROUND: Lumbar disc herniation has a prevalence of up to 58% in the athletic population. Lumbar discectomy is a common surgical procedure to alleviate pain and disability in athletes. We systematically reviewed the current clinical evidence regarding athlete return to sport (RTS) following lumbar discectomy compared to conservative treatment. METHODS: A computer-assisted literature search of MEDLINE, CINAHL, Web of Science, PEDro, OVID and PubMed databases (from inception to August 2015) was utilised using keywords related to lumbar disc herniation and surgery. The design of this systematic review was developed using the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Methodological quality of individual studies was assessed using the Downs and Black scale (0-16 points). RESULTS: The search strategy revealed 14 articles. Downs and Black quality scores were generally low with no articles in this review earning a high-quality rating, only 5 articles earning a moderate quality rating and 9 of the 14 articles earning a low-quality rating. The pooled RTS for surgical intervention of all included studies was 81% (95% CI 76% to 86%) with significant heterogeneity (I(2)=63.4%, p<0.001) although pooled estimates report only 59% RTS at same level. Pooled analysis showed no difference in RTS rate between surgical (84% (95% CI 77% to 90%)) and conservative intervention (76% (95% CI 56% to 92%); p=0.33). CONCLUSIONS: Studies comparing surgical versus conservative treatment found no significant difference between groups regarding RTS. Not all athletes that RTS return at the level of participation they performed at prior to surgery. Owing to the heterogeneity and low methodological quality of included studies, rates of RTS cannot be accurately determined.

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Published In

Br J Sports Med

DOI

EISSN

1473-0480

Publication Date

February 2016

Volume

50

Issue

4

Start / End Page

221 / 230

Location

England

Related Subject Headings

  • Treatment Outcome
  • Sport Sciences
  • Return to Sport
  • Lumbar Vertebrae
  • Low Back Pain
  • Intervertebral Disc Displacement
  • Humans
  • Health Status
  • Diskectomy
  • Athletic Performance
 

Citation

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Reiman, M. P., Sylvain, J., Loudon, J. K., & Goode, A. (2016). Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta-analysis. Br J Sports Med, 50(4), 221–230. https://doi.org/10.1136/bjsports-2015-094691
Reiman, Michael P., Jonathan Sylvain, Janice K. Loudon, and Adam Goode. “Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta-analysis.Br J Sports Med 50, no. 4 (February 2016): 221–30. https://doi.org/10.1136/bjsports-2015-094691.
Reiman, Michael P., et al. “Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta-analysis.Br J Sports Med, vol. 50, no. 4, Feb. 2016, pp. 221–30. Pubmed, doi:10.1136/bjsports-2015-094691.

Published In

Br J Sports Med

DOI

EISSN

1473-0480

Publication Date

February 2016

Volume

50

Issue

4

Start / End Page

221 / 230

Location

England

Related Subject Headings

  • Treatment Outcome
  • Sport Sciences
  • Return to Sport
  • Lumbar Vertebrae
  • Low Back Pain
  • Intervertebral Disc Displacement
  • Humans
  • Health Status
  • Diskectomy
  • Athletic Performance