Modern Instrumentation Can Lead to Quicker Return to Sports After Fusion for AIS
Posted on July 14, 2015
Advances in modern instrumentation may allow a surgeon to recommend an earlier return to sports for a patient after fusion for adolescent idiopathic scoliosis, according to results of a recently published study.
Researchers gathered the opinions of 23 surgeons, considered experts in the treatment of spinal deformity, from the Spinal Deformity Surgery Group. The researchers sent a survey to the surgeons asking for demographic information, as well as their opinions on six different clinical cases, three types of constructs and other postoperative information.
Surgeons who responded to the survey said pedicle screw instrumentation allowed patients participating in non-contact and contact sports to return to play at an average of 6 months and at an average of 1 year for collisions sports. Patients were allowed to return to running at an average of 3 months.
Return to play using pedicle screw instrumentation was quicker overall compared with hybrid and hook constructs, according to the researchers. Although 20% of surgeons did not allow for the return to collision sports after surgery using any construct, all surgeons reported permitting the eventual return to contact and noncontact sports regardless of construct type.
Survey responses showed progressively distal lowest-instrumented vertebra caused more surgeons to never permit patients to return to collision sports (12% for selective thoracic fusion to T12/L1 vs. 33% for posterior spinal fusion to L4).
The researchers also found individual factors, such as a patient’s desire to return to collision sports, influenced surgeon recommendations. – by Robert Linnehan
Disclosure: Lehman Jr. reports receiving grants from DARPA and DMRDP paid directly to his institution. He is also a deputy editor for The Spine Journal and an associated editor for Journal of Bone and Joint Surgery.