Ability to Return to Golf Following Spinal Surgery: A Retrospective Review
Lumbar spinal surgery has historically been described as sometimes limiting patients return to many activities, including golf. There are no specific guidelines if and when lumbar fusion patients can return to golf. A comprehensive literature review revealed no studies concerning spinal patient's ability to return to golf at or near pre surgery levels.
To examine a retrospective cohort of spinal surgery patients who self identified themselves as golfers and evaluate their ability to return to golf at pre-surgical levels.
Retrospective Case Control Cohort
Hypothesis: Most spinal surgery patients can return to play golf after surgery and do so at a similar level.
Patients who self identified themselves as regular golfers and underwent spinal surgery were given a questionnaire asking about their pre surgical golf activity. This included number of times golfed per month, pain level, pain medication use, and self reported handicap. These data points were collected for 1 and 2 years preoperatively and compared those results post operatively. Patients were classified as decompression only, small fusion (1-2 levels), or large fusion (3+ levels). Time from surgery to return to golfing was also recorded. If patients were unable to return following surgery, they were still included in the analysis. IRB approval was obtained. VAS scores were analyzed using the sign test. Age, gender, pain med usage, and type of surgery were analyzed as independent predictors of return to golf (logistic regression) and time to return to golf (regression).
35 patients completed the questionnaire, average age was 59.6 years. 6 were decompression only, 14 were small fusion patients and 15 were large fusions. Average number of days golfing at 2 years preoperatively was 59.6/year and was 48.1 at one year preoperatively. Average handicap preoperatively was 20.3. Average patient VAS was 6.5 when golfing, with a general VAS of 5.6. 26/35 (74%) of patients returned to play golf post surgically. The average time to return to golf post surgically was 8.1 months. Average handicap postoperatively was 23.2. Average VAS while golfing improved to 2 (p<0.001, sign test). Average number of days per year golfing was 49, with 56% of responders playing more than 40 days/year. If this was less than preoperatively, 9 stated pain was at least part of the reason, with lack of interest, time and money also contributing. 6/14 short fusions did not return to golf, 2/15 long fusions did not return, and 1/9 decompressions did not return. Univariate logistic regression indicated that type of surgery was not significant in determining the eventual return to golf (p=0.127), nor was age (p=0.637), or gender (p=0.627). Univariate regression indicated that type of surgery (p=0.268), age (p=0.340), and gender (p=0.228) were also not predictors for time to return.
In this patient cohort, a large majority of golfing patients were able to return to golf near pre-surgical levels in all three surgical groups. Pain level while golfing postoperatively was significantly decreased. Note: This data is pilot data for a larger, prospective study examining spinal fusion patients and their golf game pre and post surgery, including biomechanical evaluation.