Michiel Frederik Vande Kerckhove
St. Trudo Hospital, Belgium
Title: Lumbar disc herniation in the athlete: Considerations for management and surgical treatment
Biography
Biography: Michiel Frederik Vande Kerckhove
Abstract
A lumbar disc herniation in an athlete can cause significant morbidity and loss of playing time. It can also lead to financial loss, loss of status, psychological problems or even the end of a sports career. Lumbar disc herniation is a mechanical failure of the intervertebral disc to contain the disc material in the intervertebral disc space. This can possibly lead to a mechanical conflict and/or chemical irritation of the neurological structures in the lumbar spinal column. As such it can lead to irradiating pain in one or two legs, back pain, sensory and/or motor disturbances. The practice recommendations endorse an algorithmic approach to management that begins with observation, physical therapy and possibly epidural injections as the initial steps for treatment. Surgery is reserved for those who do not respond well to conservative care. In the general population, surgical treatment for lumbar disc herniation in the form of microdiscectomy has been shown to have excellent outcomes across several randomized controlled trials, with high success rates, return to work, and cost-effectiveness. This paradigm is also true in the athlete population. Studies suggest that a high level of return to sport is possible following lumbar disc surgery. This presentation depicts why it is important to give extra consideration regarding the management, the timing of surgery and the surgical options in lumbar disc herniation in the athlete.