Medical Student Vanderbilt University School of Medicine
Introduction: Cervical/lumbar total disc replacements (TDRs) are often performed for degenerative conditions but rarely in elite athletes. Guidelines regarding return-to-play (RTP) in athletes after TDRs are lacking. We conducted a systematic review on athletes undergoing cervical/lumbar TDRs.
Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, PubMed/Embase/Cochrane/Scopus/Web of Science databases were queried for all primary literature related to cervical/lumbar TDRs in athletes. A descriptive analysis was performed.
Results: 486 studies were screened and 8 met inclusion criteria.
CERVICAL: Five studies discussed RTP after cervical TDR in 51 athletes, of which 7 were professional, 20 semi-professional, and 24 recreational. Of the 7 professional athletes, one played contact sports (kickboxing), the other 6 were baseball players (3), lugers (2), and a marathoner (1). Of the semi-professional athletes, contact sport participation was unknown. All 7 professional and 20 semi-professional athletes successfully returned-to-play to their previous level of competition and 20/24 recreational athletes returned-to-play between 12-68 weeks without any future injury. Four recreational athletes did not RTP, for reasons otherwise not specified.
LUMBAR: Three studies discussed RTP after lumbar TDR in 50 athletes, of which 17 were professional, 6 semi-professional, and 27 recreational. Of the 17 professional athletes, 8 played contact sports (2 boxing, 2 alpine skiing, judo, football, rugby, soccer). All 17 professional athletes and 6 semi-professional athletes successfully returned-to-play to their previous level of competition between 10-96 weeks without any future injury.
Conclusion : We identified 8 studies discussing RTP after cervical/lumbar TDRs in athletes. A paucity of data exists regarding return to contact sports after TDR. Though successful return was described, these were rarely to contact sports, specifically 17% of cervical TDRs and slightly more common at 44% in lumbar TDRs. Further investigation into RTP and long-term sport participation is needed.
