Return to sports after surgery to correct adolescent idiopathic scoliosis: A survey of the Spinal Deformity Study Group

Spinal Deformity Study Group

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background context: There are no guidelines for when surgeons should allow patients to return to sports and athletic activities after spinal fusion for adolescent idiopathic scoliosis (AIS). Current recommendations are based on anecdotal reports and a survey performed more than a decade ago in the era of first/second-generation posterior implants. Purpose: To identify current recommendations for return to sports and athletic activities after surgery for AIS. Study design/setting: Questionnaire-based survey. Patient sample: Adolescent idiopathic scoliosis after corrective surgery. Outcome measures: Type and time to return to sports. Methods: A survey was administered to members of the Spinal Deformity Study Group. The survey consisted of surgeon demographic information, six clinical case scenarios, three different construct types (hooks, pedicle screws, hybrid), and questions regarding the influence of lowest instrumented vertebra (LIV) and postoperative physical therapy. Results: Twenty-three surgeons completed the survey, and respondents were all experienced expert deformity surgeons. Pedicle screw instrumentation allows earlier return to noncontact and contact sports, with most patients allowed to return to running by 3 months, both noncontact and contact sports by 6 months, and collision sports by 12 months postoperatively. For all construct types, approximately 20% never allow return to collision sports, whereas all surgeons allow eventual return to contact and noncontact sports regardless of construct type. In addition to construct type, we found progressively distal LIV resulted in more surgeons never allowing return to collision sports, with 12% for selective thoracic fusion to T12/L1 versus 33% for posterior spinal fusion to L4. Most respondents also did not recommend formal postoperative physical therapy (78%). Of all surgeons surveyed, there was only one reported instrumentation failure/pullout without neurologic deficit after a patient went snowboarding 2 weeks postoperatively. Conclusions: Modern posterior instrumentation allows surgeons to recommend earlier return to sports after fusion for AIS, with the majority allowing running by 3 months, noncontact and contact sports by 6 months, and collision sports by 12 months.

Original languageEnglish (US)
Pages (from-to)951-958
Number of pages8
JournalSpine Journal
Volume15
Issue number5
DOIs
StatePublished - May 1 2015

Fingerprint

Scoliosis
Sports
Spinal Fusion
Running
Spine
Skiing
Surveys and Questionnaires
Surgeons
Return to Sport
Neurologic Manifestations
Thorax
Demography
Outcome Assessment (Health Care)
Guidelines
Therapeutics

Keywords

  • Adolescent idiopathic scoliosis
  • Return to sports
  • Spinal deformity surgery
  • Sports participation

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Return to sports after surgery to correct adolescent idiopathic scoliosis : A survey of the Spinal Deformity Study Group. / Spinal Deformity Study Group.

In: Spine Journal, Vol. 15, No. 5, 01.05.2015, p. 951-958.

Research output: Contribution to journalArticle

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abstract = "Background context: There are no guidelines for when surgeons should allow patients to return to sports and athletic activities after spinal fusion for adolescent idiopathic scoliosis (AIS). Current recommendations are based on anecdotal reports and a survey performed more than a decade ago in the era of first/second-generation posterior implants. Purpose: To identify current recommendations for return to sports and athletic activities after surgery for AIS. Study design/setting: Questionnaire-based survey. Patient sample: Adolescent idiopathic scoliosis after corrective surgery. Outcome measures: Type and time to return to sports. Methods: A survey was administered to members of the Spinal Deformity Study Group. The survey consisted of surgeon demographic information, six clinical case scenarios, three different construct types (hooks, pedicle screws, hybrid), and questions regarding the influence of lowest instrumented vertebra (LIV) and postoperative physical therapy. Results: Twenty-three surgeons completed the survey, and respondents were all experienced expert deformity surgeons. Pedicle screw instrumentation allows earlier return to noncontact and contact sports, with most patients allowed to return to running by 3 months, both noncontact and contact sports by 6 months, and collision sports by 12 months postoperatively. For all construct types, approximately 20{\%} never allow return to collision sports, whereas all surgeons allow eventual return to contact and noncontact sports regardless of construct type. In addition to construct type, we found progressively distal LIV resulted in more surgeons never allowing return to collision sports, with 12{\%} for selective thoracic fusion to T12/L1 versus 33{\%} for posterior spinal fusion to L4. Most respondents also did not recommend formal postoperative physical therapy (78{\%}). Of all surgeons surveyed, there was only one reported instrumentation failure/pullout without neurologic deficit after a patient went snowboarding 2 weeks postoperatively. Conclusions: Modern posterior instrumentation allows surgeons to recommend earlier return to sports after fusion for AIS, with the majority allowing running by 3 months, noncontact and contact sports by 6 months, and collision sports by 12 months.",
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