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Sports after single-suture synostosis surgery: a survey of Synostosis Research Group members
Christopher M Bonfield1, Allyson L Alexander2, Craig B Birgfeld3
11Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Insights
Most surgeons permit sports for children with healed single-suture craniosynostosis (SSC) surgery. However, nearly half advise against high-contact sports for those needing cranioplasty, with plastic surgeons more restrictive than neurosurgeons.
Area of Science:
- Neurosurgery
- Craniofacial Surgery
- Pediatric Surgery
Background:
- Children with a history of single-suture craniosynostosis (SSC) surgery often desire to participate in sports.
- Current guidelines for sports participation post-SSC surgery are lacking for neurosurgeons and craniofacial surgeons.
- This study addresses the need for expert recommendations on athletic activities for these patients.
Purpose of the Study:
- To evaluate the attitudes and practice patterns of experienced neurosurgeons and craniofacial surgeons.
- To understand surgeon recommendations regarding sports participation for children with a history of SSC surgery.
- To identify differences in counseling based on surgical history (ideal healing vs. cranioplasty).
Main Methods:
- A survey was distributed to neurosurgeons and craniofacial plastic surgeons from the Synostosis Research Group (SynRG).
- The survey anonymously collected data on attitudes toward sports participation for patients with prior SSC surgery.
- Recommendations were sought for patients with ideal healing versus those requiring cranioplasty, excluding syndromic cases or those with specific anomalies.
Main Results:
- 18 out of 20 (90%) surgeons completed the survey.
- Only 1 surgeon advised against any sports for patients with ideal healing.
- For patients requiring cranioplasty, 39%-50% recommended against high-contact sports (e.g., football, boxing).
- Plastic surgeons were more likely than neurosurgeons to restrict sports participation for patients needing cranioplasty.
Conclusions:
- Surgeons generally permit sports, including contact sports, for children with well-healed SSC surgery.
- A significant portion of surgeons recommend avoiding high-contact sports for patients who underwent cranioplasty.
- Divergent opinions exist between neurosurgeons and plastic surgeons regarding sports restrictions post-cranioplasty.
Objective:
Patients with a history of surgery for single-suture craniosynostosis (SSC) as an infant often wish to participate in sports later in childhood. However, there are no established guidelines from neurosurgeons and craniofacial surgeons to guide parents in which sports their child should or should not participate. Therefore, this study aimed to evaluate the attitudes and practice patterns of experienced neurosurgeons and craniofacial surgeons regarding the counseling of caregivers of these patients about sports participation.
Methods:
A survey was administered to neurosurgeons and craniofacial plastic surgeons of the Synostosis Research Group (SynRG), a group of 9 North American institutions, to identify attitudes toward sports participation in patients with past SSC surgery. Survey responses were collected anonymously in REDCap. Questions regarding specific sports participation recommendations for patients who underwent surgery as an infant for SSC with ideal healing and for those who required a delayed cranioplasty were answered. Questions pertained to patients with nonsyndromic SSC without associated Chiari malformation, syrinx, or other intracranial/intraspinal anomalies.
Results:
Overall, 20 surgeons were invited to participate in the survey, with 18 (90%) (9 neurosurgeons and 9 craniofacial plastic surgeons) fully completing it. Only 1 (5.6%) surgeon counseled against any sports participation for patients with ideal healing. If cranioplasty was required, 39%-50% of surgeons counseled against some participation (most commonly restricting football/rugby, boxing, ice hockey, lacrosse, and wrestling), depending on the extent of the cranioplasty. Overall, more plastic surgeons (56%-67%) counseled against sports participation (including lower-contact sports such as baseball/softball, basketball, gymnastics, and soccer) than neurosurgeons (22%-33%) in patients who required cranioplasty.
Conclusions:
SynRG surgeons generally did not counsel against sports participation (including contact sports) for children with a history of SSC surgery as an infant who had ideal healing. In patients requiring cranioplasty, 39%-50% of surgeons recommended against high-contact sports participation.
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