title: Performance-based outcomes after nonoperative treatment, discectomy, and/or fusion for a lumbar disc herniation in National Hockey League athletes.
abstract: BACKGROUND
  Ice hockey players have a high incidence of lumbar spine disorders; however, there is no evidence in the literature to guide the treatment of an ice hockey player with a herniated lumbar disc.
  
  
  OBJECTIVE
  To determine the performance-based outcomes in professional National Hockey League (NHL) athletes with a lumbar disc herniation after either nonsurgical or surgical treatment.
  
  
  METHODS
  Descriptive epidemiological study.
  
  
  METHODS
  Athletes in the NHL with a lumbar disc herniation were identified through team injury reports and archives on public record. The return-to-play rate, games played per season, points per game, and performance score for each player were determined before and after the diagnosis of a lumbar disc herniation. Statistical analysis was used to compare preinjury and postinjury performance measures for players treated with either nonsurgical or surgical treatment.
  
  
  RESULTS
  A total of 87 NHL players met the inclusion criteria; 31 underwent nonoperative care, 48 underwent a discectomy, and 8 underwent a single-level fusion. The return-to-play rate for all players was 85%. There was a significant decrease in performance in all players after a lumbar disc herniation in games played per season, points scored per game, and performance score. A comparison of the posttreatment results for the nonsurgical and surgical patient groups revealed no significant difference in performance measures. Notably, the lumbar fusion group did not show a decrease in games played per season or performance score after surgery, likely secondary to a small sample size.
  
  
  CONCLUSIONS
  National Hockey League players with a lumbar disc herniation have a high return-to-play rate regardless of the type of treatment; however, performance-based outcomes may decrease compared with preinjury levels. The study data suggest that a lumbar fusion is compatible with a return to play in the NHL, which is in contrast to other professional sports.
authors: Gregory D. Schroeder, Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 676 North St Clair, Suite 1350, Chicago, IL 60611. g-schroeder@md.northwestern.edu.
authors: Gregory D
authors: GD
authors: Schroeder
authors: Kathryn J
authors: KJ
authors: McCarthy
authors: Alan J
authors: AJ
authors: Micev
authors: Michael A
authors: MA
authors: Terry
authors: Wellington K
authors: WK
authors: Hsu
mesh_terms: D006688:Hockey / Q000502:physiology*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013123:Spinal Fusion; D016896:Treatment Outcome
keywords: discectomy; fusion; ice hockey; lumbar disc herniation; lumbar spine