Artikel
Sports after lumbar discectomy
Sportfähigkeit nach lumbaler Bandscheibenoperation
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Veröffentlicht: | 11. April 2007 |
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Objective: Due to the importance that sport gained in our society, more and more patients of all age groups are interested in practicing sport after lumbar discectomy. Thus the treating surgeons are often asked which is the best time to return to sporting activity. So far only very few publications, mostly concerning professional athletes have discussed this topic. There are no guidelines, recommendations are based on personal experience and vary widely.
Methods: In the prospective randomized study we investigated 84 patients who underwent standard lumbar discectomy. Mean age was 42 (24-58) years, 51 men and 33 woman, 51.9% with a predominant desk work, 28.4% with physical work and recreational sporting activities of 4h per week. In 43 patients the operated level was L5/S1, in 36 L4/5 and in 5 L3/4. Preoperative onset of symptoms was 4 weeks in median with a VAS of 4.28 and a NASS score of 3.8. We divided the collective into two groups. All performed rehabilitation sport immediately after operation but group 1 returned to full sporting activities without restrictions after 3 and group 2 after 6 month. Evaluation of the patients was performed preoperatively, 3, 6 and 9 months after intervention.
Results: The clinical outcome 3 months after discectomy corresponded with a mean VAS of 2.23 and a NASS score of 2.14 to the values reported in the literature. 6 and 9 months after intervention and after the different return to full sport activities we could not detect a significantly different clinical outcome between the two groups (NASS Outcome score/VAS 1.87/1.80 versus 2.00/1.85; p>0.05; NASS Outcome score/VAS 1.86/1.93 versus 1.88/1.88; p>0.05). 9 months after intervention the profile of the sport activities changed. 94.7% practiced sport postoperatively versus 76,2% preoperatively but with a reduced extent of training. Patients did not describe a negative influence of the return on full sport activities (93.7%). Most favorite sports were biking, running, Nordic walking, skiing, soccer, fitness.
Conclusions: A return to sporting activities without restriction 3 months postoperatively does not seem to have a negative influence on the clinical outcome after lumbar discectomy compared to a return after 6 month. Under both postoperative concepts the patients showed a continuous improvement on the VAS and the NASS outcome score.