Department of Orthopaedic Surgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville VIC 3050, Melbourne, Australia.
Neurosciences Clinical Institute, Epworth Richmond, Richmond, Melbourne, Australia.
Eur Spine J. 2024 Jan;33(1):111-117. doi: 10.1007/s00586-023-07776-4. Epub 2023 Jun 6.
In the USA, lumbar discectomy is one of the most commonly performed spinal procedures. As certain sports are considered to be major risk factors for disc herniation, the question remains as to when highly active patients should return to their previous level of activity. This study aimed to analyze spine surgeons' opinions on when patients may return to activities following discectomy as well as their underlying rationale for their decision.
A questionnaire was designed by five different fellowship-trained spine surgeons for the 168 members of the Spine Society of Australia. Questions on the surgeons experience, decision making, preferred surgical technique, the postoperative rehabilitation and the response to patient expectations were included.
In total, 83.9% of surgeons discuss the postoperative level of activity with their patients. Sport is considered as an important contributor for good functional outcome by 71.0% of surgeons. Surgeons recommend avoiding, often permanently, weightlifting (35.7%) of the time, rugby (21.4%), horseback riding (17.9%) as well as martial arts (14.3%) postoperatively even with previous training. The return to high levels of activity is considered as a major risk factor for disc herniation recurrence by 25.8% of surgeons. Return to high level of activity is typically recommended after 3 months by 48.4% of surgeons.
So far no consensus on the rehabilitation protocol and return to level of activity exists. Recommendations depend on personal experience as well as the individuals' training, and typically, a period of avoidance of sport for up to 3 months is recommended.
Level III, therapeutic and prognostic study.
在美国，腰椎间盘切除术是最常进行的脊柱手术之一。由于某些运动被认为是椎间盘突出的主要危险因素，因此仍然存在一个问题，即高度活跃的患者何时可以恢复到之前的活动水平。本研究旨在分析脊柱外科医生对椎间盘切除术后患者何时可以恢复活动的看法，以及他们决策的基本原理。
五位不同专业培训的脊柱外科医生为澳大利亚脊柱学会的 168 名成员设计了一份问卷。问题包括外科医生的经验、决策、首选手术技术、术后康复以及对患者期望的反应。
总共，83.9%的外科医生会与他们的患者讨论术后活动水平。71.0%的外科医生认为运动是良好功能结果的重要贡献因素。外科医生建议患者术后避免举重（35.7%）、橄榄球（21.4%）、骑马（17.9%）和武术（14.3%），即使有之前的训练。25.8%的外科医生认为恢复高水平的活动是椎间盘突出复发的一个主要危险因素。48.4%的外科医生建议在术后 3 个月后恢复高水平的活动。
目前，关于康复方案和恢复活动水平的建议还没有达成共识。建议取决于个人经验以及个人的训练，通常建议避免运动长达 3 个月。
III 级，治疗和预后研究。
