Perhaps the most dreaded procedure in all of professional golf is back surgery. Tiger Woods, once the sport’s phenomenon who formerly knew no bounds, has now discovered. Back surgery’s effectiveness has increased over the years, but for professional athletes who return to the situations that irritate and injure the spin, multiple surgeries may be the unfortunate result.
During the 2013 season, Woods forced himself through the grueling ordeal of playing with a lumbar disc herniation. This type of back injury comes from damage to the lower spine. It’s an injury common to in people who make repetitive or jarring, twisting motions, where torque is applied to the spine during rotation. Although Woods knew he was at risk for aggravating the earlier injury, he played on. The result was, as anyone could have predicted, an aggravated back injury and spine surgery.
Woods had a microdiscectomy, which is most often used to relieve leg pain due to radiculopathy. Radiculopathyoccurs when the nerve roots (where nerves exit the spinal column) are pinched.
During a microdiscectomy, the surgical opening in the back is small, about 1 to 1.5 inches. A surgeon accesses the damaged area through a small incision in the lower back along the midline. The surgeon moves the back muscles off the lamina of the spine. The nerve root is then temporarily displaced to the side while the surgeon removes debris from disc material and any protruding disc material responsible for irritating or compressing the nerve. After the encasing membrane of the spine is opened, the surgeon removes part of the interior facet joint, which allows the nerve a measure of relief. The spine surgeon then removes fragments of the damaged disc.
Foremost on the surgeon’s mind is the need to preserve as much healthy tissue and ligament as possible. It is important that not a single ligament, muscle or joint is severed or otherwise weakened since this could create even worse problems for the patient.
A microdiscectomy can be performed during an outpatient visit. Some patients may need a single overnight stay. Early recovery is relatively rapid and a patient can usually go back to light activities almost right away.Twisting, bending, and lifting are best postponed for some time, however. For some people if may take up to six weeks after surgery before normal activities may resume. This is almost certainly true for professional athletes.
Fortunately for Tiger, microdiscectomyis an excellent option for leg pain and some instances of back pain when there is damage to the disc structure of the lumbar spine. The success rate of microdiscectomy is high, about 90 to 95%. This means that most people enjoy pain relief after the procedure.
Of course, complete healing requires patient cooperation. Hard driving competitors like Tiger Woods often leap back into the very same kinds of activities that caused the injury in the first place. After an initial microdiscectomy, up to 20% of patients will require a second procedure. The risk of needing a second microdiscectomyis significantly increased by factors such as male gender, smoking, a strenuous physical occupation, and sexual activity.1
While we wish Tiger Woods the best of luck in his spine surgery and his recovery, we wonder if it is just a matter of time before Tiger will be, once again, visiting his orthopaedic surgeon.
- Shimia M, Babaei-Ghazani A, Sadat BE, Habibi B, Habibzadeh A. Risk factors of recurrent lumbar disk herniation. Asian J Neurosurg. Apr 2013;8(2):93-96. doi:10.4103/1793-5482.116384