Department of Pediatric Orthopaedics, Cohen Children's Medical Center, Northwell Health System, New Hyde Park, NY.
Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, NY.
Spine (Phila Pa 1976). 2018 Feb 1;43(3):167-171. doi: 10.1097/BRS.0000000000002284.
A retrospective chart review with a survey.
This study seeks to determine time of return to normal, physical and athletic activities, and delaying factors after all pedicle screw fixation.
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.
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.
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.
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."
回顾性图表分析与调查。
本研究旨在确定所有椎弓根螺钉固定后的恢复正常、体育和活动时间以及延迟因素。
青少年特发性脊柱侧凸（AIS）后路脊柱融合术后恢复体育活动在很大程度上取决于外科医生的理念。有些医生允许在术后 6 个月和 12 个月进行接触性和碰撞性运动，而其他医生则避免术后 1 年接触性运动，并且从不允许进行碰撞性运动。我们采用了患者驱动的自我指导方法。
开发了运动活动问卷（SAQ），并将活动分为正常（学校、健身房和背包）、体育（跑步、弯曲和骑自行车）和运动（AAP 标准：非接触、接触和碰撞运动）。通过对 25 名患者进行“测试-重测”方法验证了 SAQ，并在 3 周后进行重测以最小化回忆偏倚。kappa 值大于 0.7 的问题被纳入。记录患者的人口统计学数据、X 射线测量值和围手术期细节。
95 名患者完成了 SAQ。3 个月时，77%（72/93）返回学校，60%（54/90）返回弯曲，52%（48/93）返回背包，43%（37/87）返回跑步，37%（30/81）返回健身房。6 个月时，54%（27/50）返回非接触运动，63%（21/33）返回接触运动。79%和 53%的患者分别恢复到术前接触和非接触运动的水平。较高的体重指数（BMI）是延迟返回学校和健身房的风险因素（P<0.05），而融合在 L2 以下和年龄较小是影响跑步、弯曲和背包的风险因素（P<0.05）。相反，没有与运动相关的患者/曲线特征延迟。最低的固定椎骨（LIV）、Lenke 类型不是危险因素。没有矫正丢失、植入物失败或并发症。
患者恢复体育活动的时间比预期的要早得多；四分之一的患者在 3 个月内恢复，超过一半的患者在 6 个月内恢复。年龄和 LIV 是恢复“体育活动”的决定因素。
3 级。
