Lower-back related injuries in an athletic population are common and may have severe implications for the athletes sporting career. The focus of this work was to review epidemiology, intervention strategies, and recommendations for return to practice and competition for athletes with lumbar disc degeneration and herniated disc. Conservative treatments for discogenic degeneration and lumbar spine herniation are generally sufficient for athletic populations to restore functional movement. Athletes that fail to respond to conservative measures may consider lumbar discectomy, with high levels of return to pre-competition levels observed following effective surgery. Surgical procedures such as spinal fusion and disc replacement require careful consideration, and should only be recommended if the athlete fails to respond to vigorous conservative treatments. Spinal disc implants have durability and mechanical loading concerns, whereas spinal fusion may ultimately prevent participation in contact sports. Specific guidelines for return to practice and competition remain poorly defined, thus future investigations should address this gap in knowledge. Return to sports should be carefully recommended after the athlete demonstrates sufficient improvements in neuro-physiological, biomechanical, and psychological domains. The correct rehabilitative exercise programme is vital to the rehabilitation of athletes following injury, and should consider frequent monitoring of pain, range of motion and muscle function.
Spinal fusion on adolescent idiopathic scoliosis patients with the level of L4 or lower can increase lumbar disc degeneration with sagittal imbalance 35 years after surgery
