Fabricant Peter D, Admoni Sha-har, Green Daniel W, Ipp Lisa S, Widmann Roger F
Hospital for Special Surgery, New York, NY 10021, USA.
J Pediatr Orthop. 2012 Apr-May;32(3):259-65. doi: 10.1097/BPO.0b013e31824b285f.
The cause of adolescent idiopathic scoliosis (AIS) is unknown and is currently believed to be multifactorial. AIS is a largely asymptomatic condition and many adolescents with AIS are involved with organized athletics and physical activity. To date, no data exist indicating predictors of return to physical activity after posterior spinal fusion for AIS. In this cohort study, adolescents who underwent posterior spinal fusion for AIS were evaluated to determine what clinical, surgical, and demographic variables predicted rate of return play in organized athletics.
Forty-two athletically active adolescents who underwent posterior spinal fusion for AIS at a single tertiary care academic orthopaedic institution by a single surgeon were analyzed for clinical, surgical, and demographic predictors of return to presurgical activity levels. Data were collected by chart review, patient interview, and completion of postoperative SRS-22 outcomes score.
At an average of 5.5 years follow-up, 25 patients (59.5%) had returned to sports at an equal or higher level of physical activity. Three variables were independently associated with return to athletic activity postoperatively. The relationship between distal level of fusion and rate of return to play demonstrated a statistically significant stepwise decline from T11 to L4. Lenke classification and final SRS-22 score were also predictive of return to activity. No complications related to return to play were reported.
In this retrospective cohort study, distal level of fusion, Lenke classification, and postoperative SRS-22 score were each independent predictors of rate of return to preoperative level of athletic activity after posterior spinal fusion for AIS.
Prognostic Level II: retrospective Study.
青少年特发性脊柱侧凸（AIS）的病因尚不清楚，目前认为是多因素的。AIS在很大程度上是无症状的，许多患有AIS的青少年参与有组织的体育运动和身体活动。迄今为止，尚无数据表明AIS后路脊柱融合术后恢复体育活动的预测因素。在这项队列研究中，对接受AIS后路脊柱融合术的青少年进行评估，以确定哪些临床、手术和人口统计学变量可预测其恢复有组织体育运动的比率。
对42名在一家三级医疗学术骨科机构由同一位外科医生进行AIS后路脊柱融合术的活跃青少年运动员进行分析，以确定恢复术前活动水平的临床、手术和人口统计学预测因素。通过病历审查、患者访谈以及完成术后SRS-22结局评分来收集数据。
平均随访5.5年时，25名患者（59.5%）恢复到同等或更高水平的体育活动。有三个变量与术后恢复体育活动独立相关。融合远端水平与恢复运动比率之间的关系显示，从T11到L4有统计学意义的逐步下降。Lenke分类和最终SRS-22评分也可预测恢复活动情况。未报告与恢复运动相关的并发症。
在这项回顾性队列研究中，融合远端水平、Lenke分类和术后SRS-22评分均是AIS后路脊柱融合术后恢复术前运动活动水平比率的独立预测因素。
预后II级：回顾性研究。
