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

Abstract

Sports are relevant to younger populations in society. Adolescent idiopathic scoliosis (AIS) patients who undergo surgical correction of the spine are often intensively involved in sports. For that, returning to the sport is often an important concern for the patients and their families. To the best of our knowledge, there is still a lack of scientific data indicating established recommendations about the time of returning to sport activities after surgical spinal correction. The aim of this study was to investigate (1) when AIS patients return to athletic activities after a posterior fusion, and (2) if they change their activities postoperatively. Furthermore, another question was (3) if the length of the performed posterior fusion or (4) fusion to the lower lumbar spine could have an influence on the rates or time of returning to sport activities postoperatively. Data collection was performed using questionnaires assessing patients’ contentment and athletic activity. Athletic activities were categorized into three categories: (1) contact, (2) contact/non-contact and (3) non-contact sports. The intensity of exercised sports, the time of returning to the sport and changes in sport habits were documented. Radiographs were evaluated pre- and postoperatively to determine the Cobb angle and the length of the posterior fusion via the identification of the upper (UIV) and lower instrumented vertebra (LIV). Stratification analysis due to the fusion length was performed to answer a hypothetical question. This retrospective survery of 113 AIS patients treated with a posterior fusion revealed that, on average, returning to sport activities required 8 months of postoperative rest. The preoperative to postoperative rate of patients participating in sport activities increased from 88 (78%) to 94 (89%). Furthermore, postoperatively, a relevant shift of exercised activities from contact to non-contact sports was noted. Further subanalysis revealed that only 33 subjects were able to return to exactly the same athletic activities as before surgery (10 months postoperatively). The assessment of radiographs revealed that in this study group, the length of the performed posterior fusion and fusions to the lower lumbar spine had no influence on the time of return to athletic activities. The results of this study might shed some light on postoperative recommendations for sport activities after AIS treatment with a posterior fusion and may be beneficial for surgeons treating patients.

Adolescent Idiopathic Scoliosis Surgery: Postoperative Functional Outcomes at 32 Years Mean Follow-Up

“…However, in some patients, especially after extremely long spine fusion, the loss of mobility could make it difficult for patients to play at the same level as preoperatively. According to Pepke et al [14], 29.2% of a series of 33 patients operated of spinal fusion for AIS could return to the same level of preoperative sport activity. Many patients in this study who resumed sports postoperatively shifted from contact sports toward lower level and intensity sports activities.…”

Factors influencing participation in sports, exercise, and physical activity in adolescents with idiopathic scoliosis: a protocol for a qualitative secondary data analysis

“…There is a small body of evidence surrounding safety of when it is appropriate for an individual to return to sports, exercise, or physical activity following corrective surgery in AIS (23,24,88). However, there remains very little information regarding rates of participation and uptake of sports, exercise, and physical activity (21,27).…”

“…There is some evidence to suggest no difference in restrictions towards sporting activity following spinal fusion compared to nonoperative treatment (21). Whilst the majority of routine practice encourages exercise following spinal surgery for AIS, individuals are usually advised to avoid contact sports post-operatively (22)(23)(24). Individuals with AIS who regularly participate in physical activity have improved HRQOL, physical and mental wellbeing, and self-esteem (6,17,25,26).…”

The Long-term Effects of Improving the Motor Neural Transmission Verified with Clinical Neurophysiology Methods in Patients with Surgically Treated Idiopathic Scoliosis

“…Kinesiotherapeutic treatment [8,9] and bracing [10][11][12][13] for improving the proper body posture, in the majority of IS patients provide only partial benefits for slowing down the progression of the pathological curvature. Negrini et al [14,15] concluded on the necessity for surgical intervention in IS patients with a primary Cobb angle of 40-45 degrees when a fast worsening of the pathology is expected.…”