Skoliose und Sport

Zusammenfassung

Seit der Veröffentlichung der ersten Empfehlungen der Deutschen Gesellschaft für Orthopädie und Traumatologie zu Sport bei Skoliose sind mehr als 3 Jahrzehnte vergangen und die Operationsmethoden haben sich in dieser Zeit stärker verändert als dies die nichtoperativen Verfahren getan haben. Das Vertrauen in die modernen Pedikelschraubenkonstrukte bei dorsalen Korrekturspondylodesen hat zu einer deutlich früheren und auch umfangreicheren Freigabe sportlicher Aktivitäten nach Korrekturoperationen geführt, während der intellektuell einleuchtende Vorteil neuerer, beweglichkeitserhaltender Verfahren noch nicht ausreichend bewiesen ist. Zumindest für Leitungssportler scheint auch im kurzfristigen Verlauf nach Operation ein Wiedererreichen der Leistungsfähigkeit vor der Operation möglich. Die Kürze der Nachbeobachtungszeiten vieler Studien zu Sport nach Skolioseoperationen führt aber möglicherweise zu einer Unterschätzung der langfristigen Nachteile von Fusionen bis in die LWS, wie eine japanische Studie mit einem Nachbeobachtungszeitraum von mindestens 10 Jahren nahelegt. Auch eventuelle länger anhaltende Effekte spezifischer Physiotherapierichtungen, wie z.B. der Schroth-Therapie, sind weiterhin nicht untersucht und damit nicht evident.

Abstract

More than three decades have passed since the German Society for Orthopaedics and Traumatology published its first recommendations on sports participation for scoliosis patients. During this period, surgical techniques have changed more substantially than non-surgical procedures. Confidence in modern pedicle screw constructs for posterior spinal correction and fusion has led to an earlier and more extensive return to sporting activities after corrective surgery, whereas the theoretically plausible advantage of newer, mobility-preserving procedures has not yet been sufficiently proven. At least for elite athletes, a return to pre-operative performance appears achievable even in the short term after surgery. However, the short follow-up periods of many studies on sports participation after scoliosis surgery may lead to an underestimation of the long-term disadvantages of fusions extending into the lumbar spine, as suggested by a Japanese study with a follow-up period of at least 10 years. Potential long-term effects of specific physiotherapeutic approaches, such as Schroth therapy, have not yet been investigated and are therefore not evident.

Schlüsselwörter

idiopathische Adoleszentenskoliose - Physiotherapie - Korsett - Korrekturspondylodese - flexible anteriore Skoliosekorrektur - Sportwiederaufnahme

Keywords

adolescent idiopathic scoliosis - physical therapy - brace - corrective spinal arthrodesis - vertebral body tethering - return to sports

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