In the News
Mr. Vellore's interview in THE AGE newspaper
Walsh looking at lengthy wait, says spine expert
By Marnie Vinall December 27, 2022
The type of surgery Carlton star Sam Walsh recently underwent can leave elite athletes on the sidelines for between four and six months, according to a leading Melbourne surgeon.
Last Friday, the club revealed the former No. 1 draft pick will miss at least the first month of the 2023 season after requiring a microdiscectomy procedure on his back, which involves the removal of a bulging disc portion to relieve pressure on a nerve.
Dr Yagnesh Vellore, neurosurgeon and spine surgeon, and founder and director of Advanced Neurosurgery at Epworth Richmond Hospital, says general advice for a patient’s recovery following a microdiscectomy would be not to lift more than five kilograms for at least six weeks following surgery.
Vellore stressed that, as he has no contact with the Carlton player, his advice is general and Walsh’s individual condition and recovery would be determined by his surgeon.
"My advice to normal patients would be that at around sort of three months post-op, they could return to most of the general activities that they were able to perform prior to having this problem," said Vellore, adding that patients could commence walking as exercise day one after surgery.
Vellore said that most studies and literature on microdiscectomies and elite athlete recovery time – which comes mostly out of the United States – showed that while there is a general consensus returning to elite sport performance would not be immediate, it definitely was possible.
"Generally speaking, most of these papers quote figures anywhere between sort of three to eight months as when people return to sports."
Vellore added there are a lot of factors to be considered, including the exact type of disc herniation, post-operation recovery, whether there are any complications, and the treating surgeon’s specific protocol and expertise.
However, he added: “The earliest that one could potentially, you know, indulge in elite sports would be no less than three months because they have instances in the States where elite athletes have tried to return to sport earlier than three months and have ended up with the recurrence of the disc prolapse, etc.
"So I will say potentially there’s a scope for an athlete after having a microdiscectomy to return to sports anywhere sort of four to six months. Again, this depends on each individual."
Walsh is only 22, but while Vellore said needing a microdiscectomy isn’t very common for someone in their 20s, it does happen, and being an athlete may be a risk factor.
"We do see them in people of all ages including in the 20s," said Vellore "... [and] if you look at the literature, there’s a prevalence of around sort of up to 60 per cent of athletes having a lumbar disc herniation, whether or not all of them end up becoming symptomatic or requiring surgery, that's a different issue."
Vellore added that herniated discs could recur. He said there was a 5 to 10 per cent chance of this happening within the first year.
"The thing about athletes, however, they’re not the same as the general population,” he said, because they have added “sheer and compressive forces on their spine when they practise and compete."
"That’s going to be a bit different for someone who’s a bit more sedentary. So perhaps the risk of recurrence could be a little bit higher, [but] there’s not a whole amount of data when it comes to athletes and discectomies."
Carlton have already ruled out Walsh for the start of the season and will assess the time of his potential return after the first month, in what is a weighty blow for the club’s finals aspirations.
Walsh didn’t play the final home-and-away game of 2022 due to back issues, forced to watch on as the Blues lost to Collingwood by one point and fell out of the top eight.
The club had hoped Walsh would recover with rest, but after consulting specialists, decided surgery was necessary.
Carlton’s football manager Brad Lloyd said Walsh was recovering and that his rehab would begin in the new year but stressed the long-term nature of the process.
"Throughout the last few months, our number one priority has been for Sam’s wellbeing in managing this issue, which is why we explored every possible conservative treatment option," Lloyd said.
Following this extensive process, it was clear that given all alternative treatments had not progressed his recovery, surgery was the required option to correct the issue.
Due to the long-term nature of this rehabilitation, it isn’t possible to confirm a set date for his return right now.
"Once the opening month of the season has been completed though, we expect to be able to provide more clarity on his expected return to play."
Read full article online.