Development of differentiated surgical tactics in the treatment of degenerative disease of the lumbar spine in patients involved in professional athletes

The lack of an objectively based treatment strategy to guide spinal surgeons when treating professional athletes prompted us to study the experience of treating such patients. Purpose. To analyze the results of neurosurgical treatment of professional athletes and those with degenerative disease of the lumbar spine, to develop a clinical and instrumental algorithm for differentiated surgical tactics. Material and methods. An analysis was made of the results of neurosurgical treatment of 114 professional athletes and those with degenerative disease of the lumbar spine, who underwent: (1) microsurgical/endoscopic discectomy (n=35); (2) PRP therapy of the facet joints (FJ) (n=41); total arthroplasty of intervertebral discs (IVD) (n=11); rigid decompressive and stabilizing interventions (n=27). Postoperative clinical outcomes and preoperative instrumental results were assessed. Results. A correlation was established between the method of surgical treatment and preoperative clinical symptoms, the severity of degenerative changes in the IVD and DS, the timing of return to sports, the long-term level of pain, quality of life according to SF-36 and the degree of tolerance to physical activity. To optimize the results of surgical treatment of the analyzed patients, an algorithm for planning neurosurgical treatment tactics was developed, based on individual preoperative neurological manifestations and morphological changes in the lumbar segments. Conclusion. The use of a personalized method of neurosurgical treatment in a group of patients who are professionally involved in sports can ensure: rapid restoration of preoperative sports activity, reduce the risk of perioperative complications, and reduce financial costs for non-core treatment