Return to sports after lumbar disc herniation surgery: a survey of German surgeons and postoperative patient experiences.

Abstract

Purpose Lumbar disc herniation often requires temporary restriction of sports activity before and after surgery. Evidence-based guidance for postoperative return to sports is limited. This study aimed to assess surgeons' recommendations and compare them with patient-reported return-to-sport behavior using two survey-based datasets. Methods We analyzed two independent survey datasets: an online survey of German Spine Society (DWG) members assessing postoperative sports recommendations, and a single-center patient survey evaluating sports activity before and after lumbar disc surgery. Results A total of 183 DWG members participated in this online survey in 2019. Factors such as the height of the affected intervertebral disc (88%) or suspected segmental instability (61%) did not affect the recommended sports break. However, the type of sport in case of segmental instability played an important role for the surgeons (63%). Most surgeons recommended starting rehabilitation within 2-4 weeks, while a slight majority considered regular sporting activity appropriate from around 8 weeks after surgery. These findings were contrasted with a patient survey of 106 patients at a single spine center, assessing the actual pre- and postoperative return to sports. Resumption of sports after surgery was reported in 12.1 ± 11.7 weeks. The preoperative performance level was restored after 15.2 weeks. Conclusion Surgeons' recommendations for postoperative sports resumption after lumbar disc surgery show considerable variability and reflect limited evidence. Patient-reported return to sports in a single-center cohort appears to occur later than recommended, although the datasets are not directly comparable due to differences in design and setting. Prospective studies are needed to establish evidence-based guidelines.