Do we underestimate the ability of patients to return to physical and athletic activities after scoliosis surgery? Avalidated patient questionnaire based study

BACKGROUND CONTEXT: The recommendation to return to physical activity after scoliosis surgery is debatable. While surgeons err on the side of delaying activities, no studies exist that evaluate when patients are actually returning to their physical and athletic activities. PURPOSE: This study seeks to evaluate when adolescent idiopathic scoliosis (AIS) patients tend to return to sports and related activities after undergoing pedicle screw posterior spinal fusion. STUDY DESIGN/SETTING: A validated questionnaire based study. PATIENT SAMPLE: 82 patients who completed the survey. OUTCOME MEASURES: Return to school, sports, gym. METHODS: A 24-question survey was validated on 30 AIS patients who underwent posterior spinal fusion. After validation, the survey was administered randomly using Survey Monkey. Patient demographic, X-ray image measurements, estimated blood loss (EBL) length of stay, levels fused, and operative time were recorded on those who responded. Wilcoxon signed rank tests and Fisher's exact tests were utilized. RESULTS: 82 patients completed the survey with a median age of 16 years, 51° preop Cobb, 15.8° postop Cobb, 12 levels fused and EBL of 525ml. By 3 months postsurgery, 75% (59/79) of patients returned to school, 32% (20/63) to gym, 51% (39/77) to carrying backpacks and 56% (44/78) to bending. 75% (55/73) returned to running by 6 months and 41% (30/73) by 3 months. By 6 months, 51% (22/43) returned to non-contact sports and 58% (15/26) returned to contact sports. 23% (12/ 53) were back to either type of sport within 3 months. 77% (20/26) returned to contact sports and 53% (22/43) returned to non-contact sports at their preoperative level. Age at surgery (16.6 vs 14.3 years) correlated significantly with earlier return to running and ability to bend (p5 .023, p = .005). Patients with fusion at or below L3 took significantly longer to return to running, bending and carrying backpacks (p = 0.017, p = 0.001, p = 0.005). At most recent follow-ups, there was no loss of correction, implant failure or complications. CONCLUSIONS: Patients return to activities much earlier than recommended. Age and LIV are important determinants for return to physical activity at an earlier time. A quarter of patients returned to contact/noncontact sports within 3 months, and over half returned by 6 months. The majority of patients (93% non-contact and 96% contact sports) returned to their preoperative level within 1 year. FDA DEVICE/DRUG STATUS: This abstract does not discuss or include any applicable devices or drugs.