ATHLETIC ACTIVITY AFTER SPINE SURGERY IN CHILDREN AND ADOLESCENTS: RESULTS OF A SURVEY OF THE SRS

Paul T. Rubery*
and David S. Bradford#
*Rochester, NY
and #San Francisco, CA

PURPOSE:
Athletic activity is increasingly important in society. Patients are very concerned about returning to sports and exercise after spinal surgery. There are few guidelines for surgeons regarding either appropriate sports, or the appropriate time to resume sports after spinal surgery.

METHODS:
A questionnaire was designed to poll the members of The Scoliosis Research Society regarding their opinions and experience with athletic activity after spine surgery. The form was mailed to the 721 individuals on the SRS mailing list.

RESULTS:
There were 316 forms returned. Of these, 278 indicated that the respondent performed fusion on children and adolescents. Two hundred sixty one (261) completed forms, representing approximately 45% of the society's estimated active clinicians, were reviewed. There was an even distribution of reported years of practice, and surgical case mix. Ninety–seven percent of respondents usually utilize segmental fixation in scoliosis surgery. Sixty–three percent of respondents do not routinely utilize instrumentation in fusions of grade I and II spondylolisthesis, but do in fusions of grades III and IV. Fifty–one percent do not brace post–operative scoliosis patients. Nearly eighty percent use external post–operative immobilization in spondylolisthesis. Formal physical therapy is unlikely to be recommended by members of our society regardless of procedure, although post–operative home exercise is utilized by many after spondylolisthesis fusion. The majority of patients are returned to gym class between 6 months and one year (range immediate to never) after surgery. Most respondents return patients to non–contact sports between 6 months and one year post–op. Contact sports are generally withheld until one–year post–operative. Close to 20% of respondents require, and 35% suggest, that patients never return to collision sports. Twenty percent of respondents for scoliosis and 5% for spondylolisthesis reported having notable adverse outcomes attributed to athletic activity. Selected details will be presented. Additional data that attempts to reveal the surgeon's thought process regarding both when to resume sports, as well as future effects of sports on the spine will be presented. Sixty two percent of respondents indicated that they provide surgical care for cervical spine disorders in this age group. Forty seven percent of these allow patients to resume all but collision sports, 21% prohibit contact sports as well. Three percent reported notable negative outcomes attributed to sports after cervical spine surgery. Selected details will be presented. These survey results show the varying approaches SRS members have to post–operative athletic activity, and provide a starting point for investigations regarding alternative approaches.