Focal degenerative disc disease in the lumbar spine is broadly categorized into three clinical types: (1) asymptomatic disc degeneration, (2) degenerative disc disease resulting in low back pain (LBP) and (3) focal disc prolapse resulting in compression of the spinal nerve root producing the clinical picture of radiculopathy or sciatica. Whenever possible, non-surgical management is the favoured option, but when persistent nerve root compression does not respond to conservative measures, surgical decompression of the nerve root is required. A variety of operative procedures and approaches exists to deal with focal disc prolapse. Such procedures include open discectomy, microdiscectomy and endoscopic percutaneous discectomy. In some situations, in addition to discectomy, a vertebral fusion procedure is also required.

Although the fine details of surgical technique are beyond the scope of this paper, two cases have been selected for discussion because they represent common clinical scenarios encountered by the spinal surgeon, but there is limited published information specific to the athlete with such an injury. We have therefore addressed the issues specific to return to sport rather than focus on the myriad surgical procedures that can be performed on the lumbar spine.