Return-to-play outcomes after full-endoscopic spine surgery under local anesthesia in professional baseball players: Comparison by timing of surgery

Shutaro Fujimoto; Takashi Inokuchi; Shunsuke Tamaki; Kosuke Sugiura; Makoto Takeuchi; Masatoshi Morimoto; Fumitake Tezuka; Kazuta Yamashita; Junzo Fujitani; Koichi Sairyo

doi:10.1016/j.jos.2024.01.006

Return-to-play outcomes after full-endoscopic spine surgery under local anesthesia in professional baseball players: Comparison by timing of surgery

J Orthop Sci. 2024 Jan 31:S0949-2658(24)00007-1. doi: 10.1016/j.jos.2024.01.006. Online ahead of print.

Affiliations

¹ Department of Orthopedics, Tokushima University, 3-18-15 Kuramoto, Tokushima 770-8503, Japan; Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo 060-8543, Hokkaido, Japan.
² Department of Orthopedics, Chikamori Hospital, 1-1-16, Okawasuji, Kochi 780-8522, Kochi, Japan.
³ Department of Orthopedics, Tokushima University, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
⁴ Department of Orthopedics, Tokushima University, 3-18-15 Kuramoto, Tokushima 770-8503, Japan. Electronic address: sairyokun@gmail.com.

PMID: 38302309
DOI: 10.1016/j.jos.2024.01.006

Abstract

Background: Full-endoscopic spine surgery via a transforaminal approach (TF-FESS) is minimally invasive and could help athletes quickly return to play. When treating professional athletes, we have to consider their season schedule. In this study, we investigated the characteristics of Japanese professional baseball players who underwent TF-FESS and examine how the timing of surgery influenced their postoperative course.

Methods: Ten players who underwent TF-FESS (discectomy, foraminoplasty, or thermal annuloplasty according to their diagnosis) under local anesthesia were analyzed. Multilevel surgeries were performed at the same time in patients with lesions at multiple levels. The patients were divided into three groups according to timing of surgery (pre/during/post-season). Time to complete return to play and duration of official game loss were compared between the three groups.

Results: All players (100 %) could return to their original level of professional play after FESS surgery. Seven of the 10 patients underwent two-level surgery. The mean time until complete return to play was 4.6 months (range, 2-8 months) and the mean duration of game loss was 1.5 months (range, 0-4 months). The mean duration of game loss was shorter in the post-season group than in the other groups (0.9 vs 2,4 months), and 4 of 6 patients in the post-season group did not miss any games.

Conclusions: TF-FESS is a good technique for achieving a quick return to play in professional baseball players. In particular, surgery performed during the post-season could allow players to return to play after adequate rehabilitation with no game loss.

Keywords: Baseball player; Full-endoscopic spine surgery; Local anesthesia; Return to play.