Performance-Based Outcomes After Nonoperative Treatment, Discectomy, and/or Fusion for a Lumbar Disc Herniation in National Hockey League Athletes

Schroeder, Gregory D.; McCarthy, Kathryn J.; Micev, Alan J.; Terry, Michael A.; Hsu, Wellington K.

doi:10.1177/0363546513499229

Cited by 54 publications

(58 citation statements)

References 23 publications

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“…The proportion of athletes who successfully returned to play after lumbar discectomy ranged from 75% to 100% in the seven articles [2,10,17,19,23,24,29] that reported this outcome measure. Of note, the definition of ''return to play'' varied among the articles.…”

Section: Resultsmentioning

confidence: 99%

“…Of note, the definition of ''return to play'' varied among the articles. Several articles [2,19,24,29] defined this as return to active participation in the previous sport, but some had stricter definitions such as being on the active roster [10,17] or logging 1 minute of play time in a regular season game [23].…”

Section: Resultsmentioning

confidence: 99%

“…In addition, there were four Olympians who participated in water polo, skiing, and swimming, two professional sailors, one professional ballerina, and one professional mixed martial arts fighter ( Table 2). The average age reported in these studies for patients undergoing lumbar discectomy ranged from 19.4 to 31.1 years [2,8,9,17,23,24,28,29]. The average body mass index (BMI) in studies that reported this statistic ranged from 21.9 to 35.5 kg/m 2 [2,8,10,28,29].…”

Section: Study Qualitymentioning

confidence: 97%

“…Postsurgical outcomes were compiled including the percentage of athletes who were able to return to play at their previous level of competition (10 articles reporting) [2, 8-10, 17, 19, 23, 24, 28, 29], the recovery period after lumbar discectomy to return to play (four articles) [8,23,24,29], the number of games played after surgery (three articles) [8,9,17], the number of years played after surgery (two articles) [10,17], and performance outcomes based on statistical performance both before and after lumbar discectomy (three articles) [8,10,17]. Performance scores for two studies [9,17] based on a previously published scoring system [5] using statistics unique to each sport and position were used as an outcome measure. For example, in the study by Hsu [9], performance scores for the quarterback position were based on a formula that included passing yards, rushing yards, touchdowns, and interceptions.…”

Section: Study Qualitymentioning

confidence: 99%

“…There were variations in this formula based on position played. Schroeder et al [17] described a similar formula for hockey players based on goals, assists, and shots on goal and was individualized based on position. In baseball athletes [8], the performance outcome measure was determined for hitters as the batting average and for pitchers the earned run average.…”

Section: Study Qualitymentioning

confidence: 99%

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Outcomes of Lumbar Discectomy in Elite Athletes: The Need for High-level Evidence

Nair

Kahlenberg

Hsu

2015

Clinical Orthopaedics &Amp; Related Research

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Background Although lumbar discectomy for treatment of lumbar disc herniation in the general population generally improves patients' pain, function, and validated outcomes scores, results of treatment in elite athletes may differ because of the unique performance demands required of competitive athletes. Questions/purposes We performed a systematic review to answer the following questions: (1) What proportion of athletes return to play after lumbar discectomy, and what is the effect of sport? (2) What is the expected recovery time after lumbar discectomy in elite athletes? (3) What is the expected career length and performance of elite athletes after lumbar discectomy? Methods We performed a systematic literature review of articles of lumbar discectomy in the elite athlete population through the MEDLINE and EMBASE databases from 1947 to 2013. Elite athletes were defined as professional, Olympic, or National Collegiate Athletic Association Division I collegiate level. A hand search of the references of all key articles was performed to ensure inclusion of all relevant studies. Information regarding study design, types of athletes, level of sport, recovery time, return to sport, length of career after surgery, and career performance after surgery was extracted. Ten articles met the inclusion and exclusion criteria for this review. These articles consisted of levels III and IV data and were graded based on the Methodological Index for Non-Randomized Studies (MINORS) scale. Results Overall, the studies included in this review found that 75% to 100% of athletes were able to return to elite competition after operative treatment. In general, a higher proportion of baseball players returned to elite competition compared with other athletes. The reported recovery period after lumbar discectomy ranged from 2.8 to 8.7 months. The average career length after lumbar discectomy ranged from 2.6 to 4.8 years. Elite athletes reached an average of 64.4% to 103.6% of baseline preoperative statistics after lumbar discectomy with variable performance based on sport. Conclusions A high proportion of elite athletes undergoing lumbar discectomy return to play with variable performance scores on return. Future prospective studies are needed to compare the recovery time, career longevity, and performance for athletes undergoing lumbar discectomy versus nonoperative treatment for lumbar disc herniation.

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