Return to sport after posterior spinal fusion for adolescent idiopathic scoliosis: what variables actually have an influence? A retrospective study

PURPOSE: To retrospectively evaluate a cohort of athletically active patients who underwent surgery for adolescent idiopathic scoliosis (AIS), and to determine which clinical, surgical and anthropometric variables influenced their return to sport after surgery. METHODS: 112 adolescents who underwent high-density posterior fusion for AIS by a single surgeon were analyzed for clinical, surgical and demographic predictors of return to presurgical physical activity levels. Data were retrospectively collected by charts and X-rays analysis and patients interviews. RESULTS: Preoperative main curve Cobb was 64.4 ± 14.12° and obtained correction was 70.0 ± 12.5%. Included patients played many different sports (Table 4), most of all ballet (44/112, 39.2%), swimming (40/112, 35.7%) and gymnastics (32/112, 28.6%). At an average of 50.3 months follow-up, 76 (67.8%) patients returned to sports (RTS) at an equal or higher level than preoperatively. Younger age, lower Lenke curve type and lower main curve Cobb were significantly associated with RTS. As for RTS timing, patients who returned within the first 6 months were younger, with a higher Lenke and a less severe main curve, a more distal UIV and a more proximal LIV. No complications related to RTS were registered. CONCLUSION: In conclusion, patients with adolescent idiopathic scoliosis safely returned to physical activity after surgery. Younger age, higher Lenke type and lower main curve severity predicted a quicker return to sport. However, prospective studies are needed to confirm these findings.