When do patients return to physical activities and athletics after scoliosis surgery? A validated patient questionnaire based study

Study Design. A retrospective chart review with a survey. Objectives. This study seeks to determine time of return to normal, physical and athletic activities, and delaying factors after all pedicle screw fixation. Summary of Background Data. Return to athletic activity after posterior spine fusion (PSF) in adolescent idiopathic scoliosis (AIS) is largely dependent on a surgeon's philosophy. Some allow contact and collision sports by 6 and 12 months, while others avoid contact sports for 1 year and never allow collision sports. We have utilized a patient driven self-directed approach. Methods. The sports activity questionnaire (SAQ) was developed and activities were categorized into normal (school, gym, and backpack), physical (running, bending, and bicycling) and athletics (AAP criteria: noncontact, contact and collision sports). SAQ was validated through the "test-retest" method on 25 patients and retesting after 3 weeks to minimize recall bias. Questions with kappa >0.7 were included. Patient demographics, x-ray measurements, and perioperative details were recorded. Results. Ninety five patients completed the SAQ. By 3 months; 77% (72/93) returned to school, 60% (54/90) to bending, 52% (48/93) to carrying backpacks, 43% (37/87) to running, and 37% (30/81) to gym. By 6 months, 54% (27/50) returned to noncontact sports, and 63% (21/33) to contact sports. 79% and 53% returned to preoperative level of contact and noncontact sports, respectively. Higher body mass index (BMI) was a risk for delayed return (>3 mo) to school and gym (P<0.05), while fusion below L2 and younger age for running, bending, and carrying backpacks (P<0.05). In contrast, there was no patient/ curve characteristics associated with a delay to sports. Lowest instrumented vertebra (LIV), Lenke types were not risk factors. There was no correction loss, implant failure, or complications. Conclusion. Patients return to athletics much earlier than expected; a quarter returned by 3 months, and over half by 6 months. Age and LIV are determinants for return to physical activity.