Return to play for neurosurgical patients

Area of Science:

• Neurosurgery
• Sports Medicine
• Trauma Management

Background:

• Sports-related cranial and spine injuries, including concussion, receive significant public and media attention.
• While concussion is well-researched, data on return to play for structural neurosurgical lesions remain limited.

Purpose of the Study:

• To investigate current neurosurgical practices regarding return to play for athletes with structural neurosurgical lesions.
• To lay the groundwork for establishing evidence-based guidelines for managing these athletes.

Main Methods:

• A survey was distributed to American Association of Neurological Surgeons members.
• The survey collected data on athletes with operative and nonoperative structural neurosurgical lesions, focusing on return-to-play decisions and outcomes.
• Statistical analysis, including the Mann-Whitney U test, was used to compare return times across different injury types and patient demographics.

Main Results:

• Data from 98 respondents covered 189 athletes (118 surgical, 71 nonoperative).
• Surgical cases showed significant differences in return-to-play timelines: spine (88% ≤6 months) vs. cranial (50% >6 months); noninstrumented spine (55% ≤3 months) vs. instrumented spine (92% >3 months); pediatric (52% >6 months) vs. adult (78% ≤6 months).
• Ninety-four percent of athletes with nonoperative lesions returned to play without sequelae; deficit resolution was required before return for most surgical and non-surgical respondents.

Conclusions:

• This study represents the first investigation into current neurosurgical practices for return to play concerning structural lesions.
• The findings provide an initial basis for developing neurosurgical guidelines for athletes with these specific injuries.