Long-term results and surgical strategy development for degenerative disease treatment in athletes: a retrospective single-center study
Byvaltsev V.A. Kalinin A.A. Aliyev M.A. Pestryakov Y.Y. Riew K.D.
September 2024Springer Science and Business Media Deutschland GmbH
European Spine Journal
2024#33Issue 93359 - 3368 pp.
Purpose: To analyze of the results of spine surgical treatment of athletes with lumbar degenerative disease and development of a surgical strategy based on the preoperative symptoms and radiological changes in the lumbar spine. Methods: For 114 athletes with lumbar degenerative disease were included in the present study. Four independent groups were studied: (1) microsurgical/endoscopic discectomy (n = 35); (2) PRP therapy in facet joints (n = 41); (3) total disc replacement (n = 11); (4) lumbar interbody fusion (n = 27). We evaluated postoperative clinical outcomes and preoperative radiological results. The average postoperative follow-up was 5 (3;6), 3.5 (3;5), 3 (2;4) and 4 (3;5) years, respectively. The analysis included an assessment of clinical outcomes (initial clinical symptoms, chronic pain syndrome level according to the VAS, quality of life according to the SF-36 questionnaire, degree of tolerance to physical activity according to the subjective Borg Rating of Perceived Exertion Scale) and radiological data (Dynamic Slip, Dynamic Segmental Angle, degenerative changes in the facet joint according to the Fujiwara classification and disc according to the Pfirrmann classification; changes in the diffusion coefficient using diffusion-weighted MRI). Results: The median and 25–75% quartiles timing of return to sports were 12.6 (10.2;14.1), 2.8 (2.4;3.7), 9 (6;12), and 14 (9;17) weeks, respectively. We examined the type of surgical treatment utilized, as well as the preoperative clinical symptoms, severity of degenerative changes in the intervertebral disc and facet joint, the timing of return to sports, the level of pain syndrome, the quality of life according to SF-36, and the degree of tolerance to physical activity. We then developed a surgical strategy based on individual preoperative neurological function and lumbar morphological changes. Conclusions: In this retrospective study, we report clinical results of four treatment options of lumbar spine degenerative disease in athletes. The use of developed patient selection criteria for the analyzed surgical techniques is aimed at minimizing return-to-play times.
Degenerative disease , Endoscopic discectomy , Lumbar interbody fusion , Lumbar spine , Microdiscectomy , Preoperative planning , PRP therapy , Rehabilitation , Return to sport , Sports , Surgical strategy , Total disc replacement
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Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russian Federation
Department of Neurosurgery, Railway Clinical Hospital, Irkutsk, Russian Federation
Department of Traumatology, Orthopedic and Neurosurgery, Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russian Federation
Department of Neurosurgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Department of Orthopedic Surgery, Columbia University, NY, United States
Department of Neurological Surgery, Weill Cornell Medical School, NY, United States
Department of Neurosurgery
Department of Neurosurgery
Department of Traumatology
Department of Neurosurgery
Department of Orthopedic Surgery
Department of Neurological Surgery
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