Iwamoto Jun, Sato Yoshihiro, Takeda Tsuyoshi, Matsumoto Hideo
Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan.
Open Access J Sports Med. 2011 Mar 18;2:25-31. doi: 10.2147/OAJSM.S17523. eCollection 2011.
The purpose of the study was to confirm the short-term outcome of conservative treatment in terms of the ability to return to play and factors influencing return to play in athletes with symptomatic lumbar disc herniation. A total of 100 consecutive athletes (72 male and 28 female) who consulted our sports medicine clinic during the 16-year period between September 1993 and October 2009 because of severe low back pain and/or leg pain/numbness due to lumbar disc herniation were studied. The mean age of the subjects was 23 years. All of them were conservatively treated by being advised to discontinue their sporting activities with/without short-term medication. After the subjective symptoms had reduced by more than 80%, individual training was started in order to allow the athletes to return to play. Seventy-nine athletes (79.0%) returned to play at an average of 4.8 months (range 1-12 months) after the start of treatment and were able to sustain the activities for at least 6 months, the minimum duration of follow-up in the study. The outcome of the conservative treatment was not influenced by the intensity of the sporting activity. Multiple logistic regression analyses showed that the severity of the symptoms prior to the start of treatment was the factor influencing the ability of the athletes to return to play. The present study confirmed the satisfactory short-term outcome of conservative treatment in athletes with symptomatic lumbar disc herniation regarding return to play and revealed that subjective symptoms prior to the start of treatment appeared to be a key factor in return to play after conservative treatment.
本研究的目的是就有症状的腰椎间盘突出症运动员恢复运动的能力以及影响其恢复运动的因素，确认保守治疗的短期效果。在1993年9月至2009年10月的16年期间，共有100名因腰椎间盘突出症导致严重腰痛和/或腿痛/麻木而到我们运动医学诊所就诊的连续运动员（72名男性和28名女性）参与了研究。受试者的平均年龄为23岁。他们均接受了保守治疗，根据情况被建议停止体育活动，同时可选择短期用药。在主观症状减轻超过80%后，开始进行个体化训练，以使运动员能够恢复运动。79名运动员（79.0%）在治疗开始后平均4.8个月（范围为1 - 12个月）恢复运动，并且能够持续进行至少6个月的活动，这是本研究的最短随访时长。保守治疗的效果不受体育活动强度的影响。多元逻辑回归分析表明，治疗开始前症状的严重程度是影响运动员恢复运动能力的因素。本研究证实了有症状的腰椎间盘突出症运动员在恢复运动方面保守治疗的短期效果令人满意，并揭示出治疗开始前的主观症状似乎是保守治疗后恢复运动的关键因素。
