Impact of Physical Therapy following Posterior Spinal Fusion: Assessment of Return to Activity and Level of Play

Abstract

Research Question: In a cohort of patients ages 10-18 who undergo posterior spinal fusion (PSF), does participation in physical therapy (PT) lead to faster return to prior level of play, increased psychological readiness, and decreased back pain?

Background and Significance: Scoliosis, or abnormal curvature of the spine, affects 2-3% of the United States population. Scoliosis can affect adolescents who want to participate in physical activity or their sport of choice. However, posterior spinal fusion (PSF) surgery, the most common surgery type for scoliosis patients, has a prolonged recovery time in comparison to other common adolescent orthopedic injuries. Furthermore, the intervention of physical therapy in the post-operative period and the effect on the timeline of return to sport has not been studies after PSF.

Materials and Methods: To answer this question, I prospectively enrolled all patients undergoing PSF surgery who meet the following criteria: between the ages of 10-18, involved in any level of physical activity, prescribed physical therapy as a post-operative recovery intervention, and have undergone PSF surgery at Cook Children¿s Medical Center in Fort Worth, Texas. Once determined as eligible, each potential study participant was administered several surveys (SRS 22, SRS 30, VAS, Psychological readiness scale and an additional functional sports outcome) pre-operatively, 6 months, 12 months, and 24 months following the surgery.

Results: Preliminary results show that adolescents return to the same or higher levels of play with decreased back pain by 1 year following surgery. PT has proven benefits to increase strength, improve range of motion, and decrease back pain following various injuries and procedures and with further data collection, expect this study to influence recommendations for participation in physical therapy after posterior spinal fusion.

Conclusion: Although the question of participation in physical therapy (PT) following PSF was not answerable with our current data set, its value in rehabilitation has been proven. This study can help to inform current guidelines on when adolescents who undergo PSF can expect to return to a similar or higher level of activities as compared to pre-surgery capabilities.