• Vishal Sarwahi, Stephen Wendolowski, Rachel Gecelter, Kathleen Maguire, Melanie Gambassi, Dana Orlando, Yungtai Lo, and Terry Amaral.
• Department of Pediatric Orthopaedics, Cohen Children's Medical Center, Northwell Health System, New Hyde Park, NY.
• Spine. 2018 Feb 1; 43 (3): 167-171.

Study DesignA retrospective chart review with a survey.ObjectivesThis study seeks to determine time of return to normal, physical and athletic activities, and delaying factors after all pedicle screw fixation.Summary Of Background DataReturn 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.MethodsThe 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.ResultsNinety 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.ConclusionPatients 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."Level Of Evidence3.

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