Best Practice Case Studies-Lumbar Disk Herniations and Radiculopathy in Athletes

Pdf Summary

Lumbar disk herniation (LDH) is a prevalent source of low back pain (LBP) in athletes, influencing morbidity and healthcare costs in the U.S. The physical demands of sports make athletes particularly susceptible to LDH, often accompanied by radiculopathy and degenerative disk disease (DDD). LDH arises when forces disrupt the annulus fibrosus of the intervertebral disk, often exacerbated by sports, as seen in football, golf, and power lifting, where significant forces are exerted on the spine. The natural aging process and genetic predispositions further contribute to disk degeneration, which is notably prevalent in athletes across various sports.<br /><br />Symptoms of LDH can include axial LBP, radicular pain, and sensory/motor deficits, varying with the size, location, and inflammatory nature of the herniation. Diagnosis involves physical exams such as the straight leg raise, and imaging techniques like MRI, which is the gold standard for confirming LDH. Treatment combines both nonoperative and operative strategies. Nonoperative care, focusing on pain management and physical therapy, is often effective, with about 90% of patients achieving favorable outcomes. However, given the urgency for athletes to return to their sports, surgical intervention is considered earlier, particularly if conservative methods fail after approximately 6 weeks.<br /><br />Surgical options, primarily laminotomy with diskectomy, aim to relieve symptoms and facilitate a faster return to play. Despite this, studies suggest there may be no significant long-term differences in outcomes between operative and non-operative treatments. Approximately 80-88% of athletes return to sports post-treatment, albeit with variations across sports. The decision between treatments is influenced by sport-specific and patient-specific factors to optimize recovery and performance. Overall, managing LDH in athletes involves balancing the urgency to return to sport with the effectiveness of treatment modalities.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 55

Topic Spine

Keywords

3rd Edition, CASE 55

3rd Edition

Spine

lumbar disk herniation

low back pain

athletes

radiculopathy

degenerative disk disease

MRI

nonoperative treatment

surgical intervention

laminotomy with diskectomy

return to sports