Outcome of Lumbar Spine Surgery in Elite Athletes vs. Untrained : Matched Cohort Study from SWESPINE

Sammanfattning: Background: Low back pain may be treated surgically if a mechanical cause can be identified. In elite athletes,certain spinal adaptations have been described, from the diver’s kyphosis to the gymnast’s spondylolysis. Some of these chronic spinal changes have previously been identified to influence the long-term result of spinal surgery of untrained patients. Purpose:The aim of this study is to determine whether elite athletes have a betteror worse outcome of spinal surgery compared tophysicallyinactivepatients.Methods:Data from patients registered in Swedish National Spine Register SWESPINE between 1996-2014 were analyzed. The patient reported outcome measures (PROM: s)preoperatively, after one year, and two yearswere evaluated with the following instruments: Visual Analogue Scale (VAS) for leg-and back pain, Oswestry Disability Index (ODI) and EuroQol five-dimension scale(EQ5D)for health-related quality of life. Results:Surgical treatmentwas associated withimprovements in VAS for leg pain in both groups (-48 for elite athletes vs. -53 for physically inactive patients) with nostatistically significant difference between the two groups (p = 0.203). VAS forback pain improved in both groups (-37 vs. -44) without a statistically significant difference between the two groups (p=0.073). ODI improved in both groups (-32 vs. -37)withouta statistically significant difference between the two groups (p = 0.142). EQ5D improved the first year for both groups (0.15 vs.0.11)with a decline the second year (-0.15 vs. -0.13) for both groups without a statistically significant difference between both groups (p = 0.140). There was no statistically significant difference forAUC VAS leg (p = 0.178) and AUC VAS back (p= 0.99). However, there was a statistically significant difference for ODI (p = 0.017) and EQ5D (p = 0.002). Conclusion:Disability, back-and leg pain decreasedafter spinal surgery. Quality of life increased the first year but decreased the second year. There was only astatistical difference of outcome between elite-active patients and non-active patients of the AUC for ODI and EQ5D.