Percutaneous nucleotomy in elite athletes

Percutaneous nucleotomy in elite athletes is considered a minimally invasiv e treatment of lumbar disc herniation. However, long-term effectiveness has not been established by careful follow-up studies. This article evaluates the outcome of percutaneous nucleotomy in elite athletes who have undergone the procedure. Thirty elite athletes with lumbar disc herniation who under went percutaneous nucleotomy and had been followed for at least 2 years wer e compared with a matched group of 42 nonathletes. The outcome in athletes was worse than in nonathletes. Early return to vigorous sports activity in less than 3 months correlated with increased symptoms. Similarly, more exte nsive resection of disc material was associated with an unexpected rapid wo rsening of the outcome and the lower rate of return to preoperative spores. Patient selection and postoperative management of athletes and nonathletes undergoing percutaneous nucleotomy should be the same, and the procedure i n athletes is probably not worthwhile if they do not obey postoperative man agement such as the timing of return to sports activity.