Endoscopic Diskectomy in Athletes: A Systematic Review and Meta-Analysis

Athletes are at increased risk of lumbar disk herniation due to degenerative and traumatic factors. Prior studies have evaluated the efficacy of traditional open diskectomy in athletes; however, there is limited evidence regarding the utility of endoscopic diskectomy for athletes recovering from lumbar disk herniations. Our objective is to evaluate the efficacy of endoscopic diskectomy in athletes with lumbar disk herniation, focusing on return to play and pain outcomes. Studies on athletes with lumbar disk herniation who underwent endoscopic diskectomy were included. Case reports and case series with fewer than 10 patients were excluded. PubMed-Medline and Ovid-Medline databases were searched, with the last search conducted in May 2024. Quality assessment/risk of bias was assessed using the Methodological Index for Non-Randomized Studies (MINORS) tool for non-comparative studies. Data were synthesized using a random effects model. Meta-analyses were conducted using R software (R Core Team, 2024). Four studies with a total of 119 athletes were included. The combined return to play rate was 96% (95% CI: 90-100%), with a mean return to play time of 8.25 weeks (95% CI: 6.51-10.46 weeks). The mean differences in leg and back VAS were -68.83 (95% CI: -102.05 to -35.61) and -68.42 (95% CI: -101.45 to -35.40), respectively. Endoscopic diskectomy in athletes is associated with high return to play rates and significant pain reduction. Future studies that stratify outcomes based on the level of competition and specific endoscopic diskectomy technique are needed to fully assess the utility of endoscopic diskectomy in athletes.