Surgical treatment of lumbar disc herniation no more effective than conservative treatment in competitive athletes.

About 75 percent of all competitive athletes are affected by a lumbar disc herniation during their career. Since a quick return-to-sports (RTS) is of great importance for this group of patients, surgery is often opted for.

The researchers investigated whether a conservative approach can achieve equally good results as surgery.

In their systematic study with meta-analysis, the results of the surgical and non-surgical treatment options in question and the individual surgical methods were compared with each other. The study included 1107 patients with lumbar disc herniation, average age: of 28.3 years; 98.2 percent men. It concerned the vertebral segments: L3/L4, L4/L5, L5/S1. 308 of them were treated conservatively, and 799 patients were treated surgically. The surgical procedures used were microscopic lumbar discectomy (MLD), percutaneous endoscopic discectomy (PED), and micro-endoscopic discectomy (MED). On average, 83% of the operated athletes returned to the sport after a good 5 months. Of the conservatively treated athletes, 81.5% returned after just over 4 months!

In addition, the researchers found that competitive athletes affected by a lumbar disc herniation were about 2.5 times more likely to be treated surgically than non-operatively. The researchers could not find a sufficient explanation for this(Sedrak et al. 2021).