{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:07:00Z","timestamp":1787065620449,"version":"build-2736575974"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Return to physical activity is a primary concern for adolescents with idiopathic scoliosis who are indicated for spinal fusion surgery. Preoperative counseling often addresses questions regarding ability to return to sport, postoperative restrictions, time away from play, and the safety of returning to activities. Previous works have shown that flexibility can noticeably decrease after surgery, and that the ability to return to the same level of play may be impacted by the levels of the spine included in the fusion. Equipoise remains on when patients should be allowed to return to non-contact, contact, and collision play; however, there is a trend toward earlier release to activities over the last few decades. Sources agree, though, that returning to play is safe, with rare instances of complications reported for patients with spinal fusion. Here, we review the literature on the function of spinal fusion levels on flexibility and biomechanics, address factors that may influence one's recovery of sports performance, and discuss safety considerations regarding return play following spine surgery.<\/jats:p>","DOI":"10.3389\/fped.2023.1176563","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T01:59:05Z","timestamp":1681696745000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Return to play following spine surgery"],"prefix":"10.3389","volume":"11","author":[{"given":"Tyler A.","family":"Tetreault","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumeet","family":"Garg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1001\/jama.289.5.559","article-title":"Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study","volume":"289","author":"Weinstein","year":"2003","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1512","DOI":"10.1056\/NEJMoa1307337","article-title":"Effects of bracing in adolescents with idiopathic scoliosis","volume":"369","author":"Weinstein","year":"2013","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"447","DOI":"10.2106\/00004623-198365040-00004","article-title":"Curve progression in idiopathic scoliosis","volume":"65","author":"Weinstein","year":"1983","journal-title":"J Bone Jt Surg Am"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3027","DOI":"10.1097\/01.brs.0000249555.87601.fc","article-title":"A review of quality of life and psychosocial issues in scoliosis","volume":"31","author":"Tones","year":"2006","journal-title":"Spine"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/14651858.CD003683.pub2","article-title":"Exercise to improve self-esteem in children and young people. Cochrane developmental, psychosocial and learning problems group, editor","volume":"2004","author":"Ekeland","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/14651858.CD004691.pub2","article-title":"Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane common mental disorders group, editor","volume":"2006","author":"Larun","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"B7","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/1748-7161-4-12","article-title":"Towards an understanding of the information and support needs of surgical adolescent idiopathic scoliosis patients: a qualitative analysis","volume":"4","author":"MacCulloch","year":"2009","journal-title":"Scoliosis"},{"key":"B8","volume-title":"Clinical biomechanics of the spine. 2nd ed","author":"Panjabi","year":"1990"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.2106\/00004623-200108000-00006","article-title":"Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis","volume":"83","author":"Lenke","year":"2001","journal-title":"J Bone Jt Surg Am"},{"key":"B10","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1007\/s43390-020-00044-1","article-title":"Fusions ending at the thoracolumbar junction in adolescent idiopathic scoliosis: comparison of lower instrumented vertebrae","volume":"8","author":"Group","year":"2020","journal-title":"Spine Deform"},{"key":"B11","doi-asserted-by":"publisher","first-page":"E1405","DOI":"10.1097\/BRS.0b013e3182a4038b","article-title":"Loss in spinal motion from inclusion of a single midlumbar level in posterior spinal fusion for adolescent idiopathic scoliosis","volume":"38","author":"Lee","year":"2013","journal-title":"Spine"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e3289","DOI":"10.1097\/MD.0000000000003289","article-title":"Comparison of functional outcome and quality of life in patients with idiopathic scoliosis treated by spinal fusion","volume":"95","author":"Fan","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"B13","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1097\/BRS.0000000000003373","article-title":"The benefits of sparing lumbar motion segments in spinal fusion for adolescent idiopathic scoliosis are evident at 10 years postoperatively","volume":"45","author":"Ohashi","year":"2020","journal-title":"Spine"},{"key":"B14","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1097\/BSD.0b013e3182318622","article-title":"Does the lower instrumented vertebra have an effect on lumbar mobility, subjective perception of trunk flexibility, and quality of life in patients with idiopathic scoliosis treated by spinal fusion?","volume":"25","author":"Sanchez-Raya","year":"2012","journal-title":"J Spinal Disord Tech"},{"key":"B15","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/j.jspd.2017.12.008","article-title":"Effects of spinal fusion for idiopathic scoliosis on lower body kinematics during gait*","volume":"6","author":"Kruger","year":"2018","journal-title":"Spine Deform"},{"key":"B16","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.spinee.2017.08.221","article-title":"Spine kinematics exhibited during the stop-jump by physically active individuals with adolescent idiopathic scoliosis and spinal fusion","volume":"18","author":"Kakar","year":"2018","journal-title":"Spine J"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e31824b285f","article-title":"Return to athletic activity after posterior spinal fusion for adolescent idiopathic scoliosis: analysis of independent predictors","volume":"32","author":"Fabricant","year":"2012","journal-title":"J Pediatr Orthop"},{"key":"B18","doi-asserted-by":"publisher","first-page":"S48","DOI":"10.1016\/j.spinee.2014.08.126","article-title":"Level of play: return to sports following surgery for adolescent idiopathic scoliosis","volume":"14","author":"Lonner","year":"2014","journal-title":"Spine J"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1097\/BRS.0000000000000452","article-title":"Timing and predictors of return to short-term functional activity in adolescent idiopathic scoliosis after posterior spinal fusion: a prospective study","volume":"39","author":"Tarrant","year":"2014","journal-title":"Spine"},{"key":"B20","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1097\/BRS.0000000000002284","article-title":"When do patients return to physical activities and athletics after scoliosis surgery?: a validated patient questionnaire based study","volume":"43","author":"Sarwahi","year":"2018","journal-title":"Spine"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1007\/s43390-022-00535-3","article-title":"Return to sport after posterior spinal fusion for adolescent idiopathic scoliosis: what variables actually have an influence? A retrospective study","volume":"10","author":"Ruffilli","year":"2022","journal-title":"Spine Deform"},{"key":"B22","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1007\/s43390-022-00592-8","article-title":"Adolescent athletes return to sports rapidly after posterior spine fusion for idiopathic scoliosis: a prospective cohort study","volume":"11","author":"Tetreault","year":"2023","journal-title":"Spine Deform"},{"key":"B23","doi-asserted-by":"publisher","first-page":"S329","DOI":"10.1016\/j.spinee.2017.10.044","article-title":"Return to activity and sports following posterior correction and fusion for adolescent idiopathic scoliosis","volume":"17","author":"Perkins","year":"2017","journal-title":"Spine J"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000004599","article-title":"High rates of successful return to competitive athletics following posterior spinal fusion for AIS regardless of distal fusion level: a prospective cohort study","author":"Fabricant","year":"2023","journal-title":"Spine"},{"key":"B25","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1097\/00003086-198509000-00022","article-title":"Sports following spinal surgery in the young athlete","volume":"198","author":"Micheli","year":"1985","journal-title":"Clin Orthop"},{"key":"B26","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1097\/00007632-200202150-00019","article-title":"Athletic activity after spine surgery in children and adolescents: results of a survey","volume":"27","author":"Rubery","year":"2002","journal-title":"Spine"},{"key":"B27","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1016\/j.spinee.2013.06.035","article-title":"Return to sports\u00a0after\u00a0surgery to correct adolescent idiopathic scoliosis: a survey of the spinal\u00a0deformity study group","volume":"15","author":"Lehman","year":"2015","journal-title":"Spine J"},{"key":"B28","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1097\/BRS.0b013e31823b4eab","article-title":"Postoperative segmental motion of the unfused spine distal to the fusion in 100 patients with adolescent idiopathic scoliosis","volume":"37","author":"Marks","year":"2012","journal-title":"Spine"},{"key":"B29","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1097\/01.brs.0000197168.11815.ec","article-title":"The effect of scoliosis fusion\u00a0on spinal motion: a comparison of fused and nonfused patients with idiopathic scoliosis","volume":"31","author":"Wilk","year":"2006","journal-title":"Spine"},{"key":"B30","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1123\/ijatt.16.2.8","article-title":"Adolescent idiopathic scoliosis in a college golfer","volume":"16","author":"Cox","year":"2011","journal-title":"Int J Athl Ther Train"},{"key":"B31","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1111\/j.1600-0838.2005.00482.x","article-title":"Why do idiopathic scoliosis patients participate more in gymnastics?","volume":"16","author":"Meyer","year":"2006","journal-title":"Scand J Med Sci Sports"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1176563\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T01:59:07Z","timestamp":1681696747000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1176563\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,17]]},"references-count":31,"alternative-id":["10.3389\/fped.2023.1176563"],"URL":"https:\/\/doi.org\/10.3389\/fped.2023.1176563","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,17]]},"article-number":"1176563"}}