Resumption of sport after spinal fusion for adolescent idiopathic scoliosis: a review of the current literature

Abstract

Background Adolescent idiopathic scoliosis (AIS) is a frequent disorder. Since patients with AIS are typically as active as age-matched controls and post-operative reduction in physical activity has detrimental effects on their well-being, return to sport (RTS) is an important perioperative concern. Aim of the present study is to review the literature concerning return to sport after spinal fusion for AIS. Methods This work was carried out in accordance with Preferential Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search was carried out in December 2020. Only peer-reviewed randomized controlled trials (RCTs), retrospective studies (RS), retrospective case series (RCS) and perspective cohort studies (PCS) were considered for inclusion. Results Six studies were included; only one of them was prospective. All the authors reported a time to RTS ranging between 6 and 18 months. Between 28 and 36.6% of all patients changed sport, choosing lower impact activities, mostly due to loss of flexibility of the spine. No complications due to return to play were noted. Conclusion According to current evidence, patients who received spinal arthrodesis for AIS can safely return to any sport, even those that require extreme levels of spinal and pelvic movements such as gymnastics and golf. As there is little evidence, however, of the spinal loading that occurs during such movements, there is a lack of scientific evidence-based recommendations or guidelines surgeons and other health care providers can follow. Prospective comparative studies are needed to investigate these biomechanical and clinical issues. Level of evidence Level III.

Return to sport after posterior spinal fusion for adolescent idiopathic scoliosis: what variables actually have an influence? A retrospective study

“…There is substantial agreement that, after spinal fusion, they can perform maximal-effort sport movements without injury [7][8][9] and can produce comparable trunk and lower extremity kinematics as their healthy peers while participating in high intensity activities, such as running and jumping [8,9]. Nevertheless, there is a paucity of studies that evaluate variables that influence the return to sport (RTS) after surgery [4,[10][11][12]. 6.1 ± 1.9 6.2 ± 1.9 0.89 SRS-22 (total)…”

“…Nevertheless, current guidelines for postoperative physical activities resumption are mostly derived from expert opinion and a few evidence-based recommendations exist regarding timing of RTS after spinal fusion for AIS [ 4 ]. As ability to return to specific sports has not been studied, it is difficult to guide both surgeon and patient with appropriate expectations regarding postoperative RTS.…”

Operative Korrektur der idiopathischen Adoleszentenskoliose – Pro Bewegungserhalt

“…Ein aktueller Review-Artikel untersuchte unabhängig von solchen Empfehlungen die tatsächliche Sportfähigkeit und die Wiederaufnahme von Sport nach versteifenden Skolioseoperationen und fand, dass trotz prinzipieller Erlaubnis alle Sportarten auszuführen, bis zu einem Drittel der Patienten aus eigener Entscheidung zu weniger belastenden Sportarten wechselte [13].…”

Return to Sport after Adolescent Idiopathic Scoliosis (AIS) Correction Surgery: A Retrospective Data Analysis

“…On the other hand, within the past few years, the first study groups have published studies about the resumption of sport activities after a spinal fusion in AIS patients. In their review of five retrospective studies and one prospective study, Barile et al reported about the safety of returning to any sport activities, even those with extreme spinal loads that occur while exercising (e.g., gymnastics or golf) [ 16 ]. In their retrospective survey of 95 AIS patients after a posterior fusion, another group reported that surgically treated AIS patients returned to athletics much earlier than expected [ 17 ].…”