Surgical Treatment for Lumbar Disc Herniations in Athletes.

Injuries to the lumbar region such as lumbar disc herniation (LDH) are relatively common occurrences in athletic activities.Fortunately many patients suffering from LDH, whose symptoms consist of low back and radicular pain, improve with careful conservative treatment. However those cases which exhibit severe clinical signs and symptoms in spite of conservative management ultimately undergo surgery.Over a 10 year period, 50 patients have been treated operatively. The surgical procedure consists of fenestration and discectomy. We examined the prognosis of 27 patients who were younger than 32 years and have often participated in athletic activities.Thirteen were athletes and the other 14 performed less stressful activities. After surgery, all 13 athletes were treated with a trunk muscle strengthening program, while 7 (53.8%) were able to return to their former level of play and 4 (30.8%) remain asymptomatic in less stressful activities.It appears that careful fenestration and discectomy followed by therapeutic exercise are successful for treatment of severe disc herniations in athletes occuring at the L4-5 space or lower, at least for a fixed period of time.