Outcomes After Lumbar Disc Herniation in the National Basketball Association

BACKGROUND: Professional basketball players are at risk for lumbar disc herniation (LDH), yet the evidence guiding treatment after operative or nonoperative management of this condition in the National Basketball Association (NBA) is limited. HYPOTHESIS: NBA players with LDH will have different performance outcomes based on treatment type. STUDY DESIGN: Case-control study. LEVEL OF EVIDENCE: Level 4. METHODS: Athletes in the NBA with an LDH were identified through team injury reports, transaction records, and public sports archives. A 1:2 case-control study was performed in which LDH players and players without LDH were matched for player variables. Statistical analysis was employed to compare pre- and postindex season performance (games played and player efficiency rating [PER]) and career longevity between test subjects and controls in the operatively treated (OT) and nonoperatively treated (NOT) cohorts. RESULTS: A total of 61 NBA players with LDH were included, of whom 34 underwent discectomy and 27 were managed nonoperatively. Return-to-play (RTP) rates did not differ between NOT and OT players (77.8% vs 79.4%). When compared with controls, OT players played significantly fewer games and had a lower PER than controls during the first postoperative season, but no difference was seen 2 and 3 years after surgery, with no difference in postoperative career length. In contrast, no difference in games played or PER was seen between NOT players and controls, although NOT players played significantly fewer postindex seasons. CONCLUSION: NBA players have a high RTP rate regardless of type of treatment for LDH; however, postindex performance differs between surgically and nonoperatively managed patients when compared with players without an LDH. However, further studies with a larger sample size are required for more definitive recommendations. CLINICAL RELEVANCE: There is a high RTP rate after LDH in the NBA, although postindex performance may differ based on operative versus nonoperative treatment.