Endoscopic Lumbar Discectomy in Professional Athletes: A Case Series and Structured Rehabilitation Protocol Enabling Rapid Return to Play.

Authors

Marc Szadkowski, Xavier Castel, Jean Baptiste Odent, Elie Saghbini, Anuj Gupta, Sebastien Pinon, Thais Dutra Vieira, Henri d'Astorg

Published in

Orthopaedic journal of sports medicine. Volume 14. Issue 7. Pages 23259671261459223. Epub Jul 17, 2026.

Abstract

Full-endoscopic lumbar discectomy (FELD) has become a validated, minimally invasive treatment for lumbar disc herniation (LDH). However, evidence remains scarce regarding outcomes and rehabilitation strategies for professional athletes undergoing this procedure.
The purpose of this study is to evaluate return to play (RTP) outcomes, functional recovery, and postoperative complications in professional athletes undergoing FELD, and to describe the structured postoperative rehabilitation protocol implemented. It was hypothesized that FELD, combined with standardized rehabilitation, would result in a high RTP rate within 3 months and restoration of preinjury performance levels.
Case series; Level of evidence 4.
Twenty professional athletes with LDH who underwent FELD between 2021 and 2024 were included. All included patients were elite athletes, defined as professional or international-level competitors. This included athletes participating in top-tier professional basketball and rugby leagues, as well as winter sports athletes competing at the international level (World Cup and Olympic competitions). Outcome measures included pain (visual analog scale [VAS]), disability (Oswestry Disability Index [ODI]), quality of life (Short Form-12 [SF-12]), time to RTP, and postoperative level of athletic performance, which were objectively evaluated by return to official competition (defined as participation in official matches or competitive events at the preinjury level). All patients followed a standardized, phased rehabilitation protocol incorporating progressive strength and flexibility testing. Descriptive statistics were used to summarize the data. Paired comparisons were performed using the Student t test or the Wilcoxon signed-rank test, depending on data distribution, with statistical significance set at P < .05.
The mean age of patients was 25.5 ± 3.7 years, and 75% were men. The mean RTP time was 3.4 months. At 1-year follow-up, 80% of athletes had resumed their preinjury performance level. VAS and ODI scores improved significantly (P < .005), with 90% reporting excellent satisfaction. No major complications occurred, although 4 patients experienced recurrent herniation, and 3 underwent reoperation. One athlete did not RTP.
Our study demonstrated that FELD combined with a structured rehabilitation pathway appears to be a safe and effective surgical option for professional athletes with LDH, which may facilitate early RTP and high functional recovery.

PMID:
42471997
Bibliographic data and abstract were imported from PubMed on 19 Jul 2026.

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