Return to Sport and Functional Outcomes Following Spine Surgery in Hockey Players: A Scoping Review

This scoping review was conducted in accordance with PRISMA guidelines to synthesize available literature evaluating return-to-sport rates, timing of return, functional recovery, performance outcomes, and career durability following spine surgery in ice hockey players. Ice hockey is a high-velocity collision sport associated with substantial axial loading, repetitive flexion-extension, and rotational forces across the spinal column, making spine injuries that require surgical intervention potentially career-altering. Despite this, hockey-specific postoperative outcome data remain fragmented and are often extrapolated from mixed-sport cohorts. Electronic database searches identified studies reporting postoperative outcomes following spine surgery in hockey athletes, with extracted variables including return-to-sport rates, time to return, performance outcomes, functional recovery metrics, surgical characteristics, complications, and career longevity. Among 441 hockey athletes, return-to-sport rates following spine surgery ranged from 75% to 90% across cervical and lumbar procedures. Lumbar microdiscectomy permitted earlier return compared with fusion procedures, whereas anterior cervical discectomy and fusion demonstrated return timelines approaching 9-12 months. Despite high return participation rates, several studies demonstrated postoperative declines in games played, scoring productivity, and performance indices. Career longevity following lumbar pathology averaged approximately three to four years, while cervical-specific longevity data remain limited, with mixed-sport cohorts suggesting similar durations. Overall, available evidence suggests that lumbar and cervical spine surgery can permit return to hockey participation in a majority of athletes; however, existing data are predominantly retrospective and frequently derived from mixed-sport cohorts. Performance decline and variable recovery timelines are commonly observed, and standardized criteria guiding return-to-play clearance, particularly following spinal fusion, are poorly defined and inconsistently reported. Prospective, sport-specific investigations incorporating standardized functional, radiographic, and performance metrics are needed to better guide surgical decision-making and postoperative rehabilitation.