Skip To Main Content University of Washington Department of Rehabilitation Medicine
  Department of Rehabilitation Medicine 
  maximizing potential across the lifespan


Overview of spinal interventions


Colonno DV, Harrast MA, Herring SA



Publication Info:

Clin Sports Med, 31(3):409-422


Athletes represent a specific subgroup of highly motivated patients with a unique set of social and psychological incentives. Demands placed on the lumbosacral system are high, and athletes may be particularly prone to the pathology discussed above. For this reason, it is crucial to consider the athlete as a functional whole operating in concert with intrinsic and extrinsic factors and to consider the lumbosacral system within the context of the complete kinetic chain. Spinal interventions should never be considered in isolation but rather as part of a comprehensive rehabilitation program targeting psychosocial as well as biomechanical opportunities. When interventional procedures are warranted, they should be performed according to existing guidelines regarding indication, patient selection, and technique where possible and with systems in place to maximize patient safety and to consistently monitor for response. Each of the interventions discussed above should be performed with fluoroscopic guidance, given the lack of accuracy without fluoroscopy, and generally be reserved for athletes not responding to conservative care. When returning an athlete to play after ESI, we recommend careful serial evaluation as well as involvement of appropriate family members, athletic trainers, and coaches in the decision-making process. Athletes should not return to play with any significant objective neurologic deficits. In appropriate athletes, return to play should occur with graduated and comprehensive rehabilitation as discussed above. Because evidence concerning the interventions discussed in this article is often lacking, clinical judgment is paramount regarding their allocation. The interventions explored above likely do provide viable treatment adjuncts in the carefully selected athlete but are not without risk. Athlete safety and global well being should guide any decision to pursue interventional treatment options.

Link to Article:

Featured Research Articles

Chronic Pain

View the latest research articles on Chronic Pain written by faculty from the Department of Rehabilitation Medicine.

Volunteer to Participate in our Research Studies

The Department of Rehabilitation Medicine is looking for volunteers to participate in research studies on Multiple Sclerosis & Pain Management, and Traumatic Brain Injury.

Level A conformance icon, 
          W3C-WAI Web Content Accessibility Guidelines 1.0
Copyright © 2000-2018 University of Washington