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Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta-analysis.

dc.contributor.author Goode, A
dc.contributor.author Loudon, JK
dc.contributor.author Reiman, Michael P
dc.contributor.author Sylvain, J
dc.coverage.spatial England
dc.date.accessioned 2016-02-01T14:24:49Z
dc.date.issued 2016-02
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/26491033
dc.identifier bjsports-2015-094691
dc.identifier.uri https://hdl.handle.net/10161/11566
dc.description.abstract BACKGROUND: Lumbar disc herniation has a prevalence of up to 58% in the athletic population. Lumbar discectomy is a common surgical procedure to alleviate pain and disability in athletes. We systematically reviewed the current clinical evidence regarding athlete return to sport (RTS) following lumbar discectomy compared to conservative treatment. METHODS: A computer-assisted literature search of MEDLINE, CINAHL, Web of Science, PEDro, OVID and PubMed databases (from inception to August 2015) was utilised using keywords related to lumbar disc herniation and surgery. The design of this systematic review was developed using the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Methodological quality of individual studies was assessed using the Downs and Black scale (0-16 points). RESULTS: The search strategy revealed 14 articles. Downs and Black quality scores were generally low with no articles in this review earning a high-quality rating, only 5 articles earning a moderate quality rating and 9 of the 14 articles earning a low-quality rating. The pooled RTS for surgical intervention of all included studies was 81% (95% CI 76% to 86%) with significant heterogeneity (I(2)=63.4%, p<0.001) although pooled estimates report only 59% RTS at same level. Pooled analysis showed no difference in RTS rate between surgical (84% (95% CI 77% to 90%)) and conservative intervention (76% (95% CI 56% to 92%); p=0.33). CONCLUSIONS: Studies comparing surgical versus conservative treatment found no significant difference between groups regarding RTS. Not all athletes that RTS return at the level of participation they performed at prior to surgery. Owing to the heterogeneity and low methodological quality of included studies, rates of RTS cannot be accurately determined.
dc.language eng
dc.relation.ispartof Br J Sports Med
dc.relation.isversionof 10.1136/bjsports-2015-094691
dc.subject Lumbar spine
dc.subject Surgery
dc.subject Athletic Injuries
dc.subject Athletic Performance
dc.subject Diskectomy
dc.subject Health Status
dc.subject Humans
dc.subject Intervertebral Disc Displacement
dc.subject Low Back Pain
dc.subject Lumbar Vertebrae
dc.subject Return to Sport
dc.subject Treatment Outcome
dc.title Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta-analysis.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/26491033
pubs.begin-page 221
pubs.end-page 230
pubs.issue 4
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Orthopaedics
pubs.organisational-group Orthopaedics, Physical Therapy
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 50
dc.identifier.eissn 1473-0480


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