Adolescent Idiopathic Scoliosis and Young Athletes

Adapted from the Winter 2011 issue of Pediatric Connection


Roger F. Widmann, MD

Chief, Pediatric Orthopaedic Surgery, Hospital for Special Surgery
Attending Orthopaedic Surgeon, Hospital for Special Surgery
Professor of Clinical Orthopaedic Surgery, Weill Cornell Medical College

Peter D. Fabricant, MD
Orthopaedic Surgery, Hospital for Special

Adolescent idiopathic scoliosis (AIS) is a common musculoskeletal disorder. Although it is thought to be genetic, its true cause is unknown and thought to be a combination of many factors. It is characterized by a curvature of the spine measuring greater than 10°, and has no other symptoms or pain. At 25°, bracing is recommended in growing adolescents, and if the curve progresses to greater than 50°, becomes cosmetically unacceptable, or rapidly progresses, surgery may be recommended to correct the deformity and fuse the spine. Although 2% to 3% of the adolescent population is diagnosed with AIS, less than 10% of these patients require any surgical intervention.

Because AIS is a painless condition, affected adolescents frequently are athletic and participate in physical activities alongside their unaffected peers. In the event that surgery is required, one common concern is the ability to return to athletic activity postoperatively.

After evaluating a group of 42 patients who underwent curve correction and spinal fusion at HSS over an average of 5.5 years after surgery, most (60%) had returned to sports at an equal or higher level of physical activity. Postoperative athletic participation included a wide variety of sports and ranged from recreational to university varsity-level. The only variable studied that correlated with return to activity at the same or higher level after surgery was the lowest level of spinal fusion, which is determined by the size and extent of the spinal curvature.

While patients are typically allowed to return to sports 6-12 months after surgery, this study indicated that the lowest level of fusion might predict the patientís actual likelihood of returning to play at or above the preoperative level. Further ongoing research at HSS will elucidate why this is the case, but the data collected here may help guide patient and family expectations regarding return to athletic activity.

Learn more about Pediatric Connection, the HSS pediatric musculoskeletal newsletter.


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