Return To Play After Symptomatic Lumbar Disc Herniation in Elite Athletes: A Systematic Review and Meta-Analysis of Operative Versus Non-Operative Treatment

OrthoMedia ◽  
2022 ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 999-1001
Author(s):  
Joseph R. Dettori

Citation: Sedrak P, Shahbaz M, Gohal C, Madden K, Aleem I, Khan M. Return to Play After Symptomatic Lumbar Disc Herniation in Elite Athletes: A Systematic Review and Meta-analysis of Operative Versus Nonoperative Treatment. Sports Health. Feb 10 2021:1 941 738 121 991 782.


2021 ◽  
pp. 194173812199178
Author(s):  
Phelopater Sedrak ◽  
Mustafa Shahbaz ◽  
Chetan Gohal ◽  
Kim Madden ◽  
Ilyas Aleem ◽  
...  

Context: The prevalence of symptomatic lumbar disc herniation (LDH) in athletes can be as high as 75%. For elite athletes diagnosed with LDH, return to play (RTP) is a major concern, and thus comparing surgical with nonoperative care is essential to guide practitioners and athletes, not just in terms of recovery rates but also speed of recovery. Objective: The purpose of this systematic review is to provide an update on RTP outcomes for elite athletes after lumbar discectomy versus nonoperative treatment of LDHs. Data Sources: A search of the literature was conducted using 3 online databases (MEDLINE, EMBASE, and PubMed) to identify pertinent studies. Study Selection: Yielded studies were screened according to the inclusion criteria. Study Design: Systematic review with meta-analysis. Level of Evidence: Level 4. Data Extraction: Relevant data were extracted. A meta-analysis was performed comparing RTP rate for all comparative studies. Results: Twenty studies met the inclusion criteria and were included in this review. Overall, 663 out of 799 patients (83.0%) returned to play in the surgical group and 251 out of 308 patients (81.5%) returned to play in the nonoperative group. No statistically significant difference for RTP rate was found (odds ratio, 1.39; 95% CI, 0.58-3.34; P = 0.46; I2, 71%). The mean time to RTP for patients undergoing lumbar discectomy was 5.19 months (range 1.00-8.70 months), and 4.11 months (range 3.60-5.70 months) for those treated conservatively. Conclusion: There was no significant difference in RTP rate between athletes treated with operative or nonoperative management of LDHs, nor did operative management have a faster time to RTP. Athletes should consider the lack of difference in RTP rate in addition to the potential risks associated with spinal surgery when choosing a treatment option. Future randomized controlled trials are needed on this topic to allow for high-powered conclusions.


2020 ◽  
Vol 20 (10) ◽  
pp. 1573-1585
Author(s):  
Sjoerd Stevens ◽  
Anouk Agten ◽  
Annick Timmermans ◽  
Frank Vandenabeele

Author(s):  
Steven J. Kamper ◽  
Raymond W. J. G. Ostelo ◽  
Sidney M. Rubinstein ◽  
Jorm M. Nellensteijn ◽  
Wilco C. Peul ◽  
...  

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Musa Sani Danazumi ◽  
Abdulsalam Mohammed Yakasai ◽  
Shehu Usman Ibrahim ◽  
Auwal Bello Hassan ◽  
Usman Usman Zakari ◽  
...  

2017 ◽  
Vol 1 (21;1) ◽  
pp. E45-E52 ◽  
Author(s):  
Hong Jiang

Background: Lumbar disc herniation (LDH), a common disease, is often treated conservatively, frequently resulting in spontaneous resorption of the herniated disc. The incidence of this phenomenon, however, remains unknown. Objective: To analyze the incidence of spontaneous resorption after conservative treatment of LDH using computed tomography and magnetic resonance imaging. Study Design: Meta-analysis and systematic review of cohort studies. Setting: The work was performed at The Suzhou Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine. Methods: We initiated a search for the period from January 1990 to December 2015 using PubMed, Embase, and the Cochrane Library. Two independent reviewers examined the relevant reports. The references from these reports were also searched for additional trials using the criteria established in the PRISMA statement. Results: Our results represent the pooled results from 11 cohort studies. The overall incidence of spontaneous resorption after LDH was 66.66% (95% CI 51% – 69%). The incidence in the United Kingdom was 82.94% (95% CI 63.77% – 102.11%). The incidence in Japan was 62.58% (95% CI 55.71% – 69.46%). Limitations: Our study was limited because there were few sources from which to extract data, either in abstracts or published studies. There were no randomized, controlled trials that met our criteria. Conclusions: The phenomenon of LDH reabsorption is well recognized. Because its overall incidence is now 66.66% according to our results, conservative treatment may become the first choice of treatment for LDH. More large-scale, double-blinded, randomized, controlled trials are necessary to study the phenomenon of spontaneous resorption of LDH. Key words: Lumbar, disc herniation, spontaneous resorption, conservative treatment, incidence, country, meta-analysis, systematic review, observational studies, study designs


Author(s):  
Kresten Wendell Rickers ◽  
Peter Heide Pedersen ◽  
Torben Tvedebrink ◽  
Søren Peter Eiskjær

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