Adolescent idiopathic scoliosis (AIS) is a common condition in which the spine develops a sideways curve. The term "adolescent" is used because it typically appears during the teenage years, and "idiopathic" means that its cause is not known. For individuals with large spinal curves, a surgical procedure called spinal fusion is a common treatment. This surgery involves permanently joining together some of the bones of the spine, called vertebrae, to correct the curve and prevent it from progressing.
After spinal fusion surgery, the process of recovery and rehabilitation is not standardized. The care a patient receives can differ greatly depending on the medical professional, hospital, or even the geographic location. A previous international study used a method called an "e-Delphi consensus," where experts answer questions over several online rounds to reach a collective agreement. This earlier work produced a wide set of agreed-upon statements covering patient care from before the surgery up to one year after.
However, that study found that guidance for the period between 3 and 12 months after surgery is still unclear, particularly concerning rehabilitation and a gradual, safe return to sports. This new research project is being conducted to gain a better understanding of this intermediate and later phase of recovery. The main goal is to determine what rehabilitation should consist of and what key recovery milestones patients should reach between 3 and 12 months after their operation. This information will be used to develop future guidelines for returning to sports, exercise, and physical activity.
To achieve this, the researchers will use a structured method for reaching group agreement called the "nominal group technique" (NGT). The plan for this study follows specific reporting standards called the Accurate Consensus Reporting Document guidelines. The study will bring together a group of national experts on AIS, including surgeons, physiotherapists, and nurses.
The NGT process will be conducted online and will involve six distinct stages. First, the experts will individually generate ideas. Second, these ideas will be shared with the entire group, one by one. Third, the group will discuss the ideas to make sure everyone understands them clearly. Fourth, the experts will vote on the ideas anonymously. Fifth, the results of this vote will be shared with the group. Finally, there will be a concluding discussion and a final round of voting to solidify the group's agreement.
Before this meeting occurs, the researchers will conduct a "scoping review," which involves gathering and summarizing all existing research on the topic. This review will be shared with the expert panel in advance to help them generate informed ideas during the first stage of the NGT. The review will be organized using a "population, concept, context" framework to explore rehabilitation after any type of spinal surgery with a focus on returning to sports, exercise, or physical activities.
A committee that oversees the research, known as the study steering group, and a patient and public involvement representative have been involved in planning this study from its beginning. They will continue to contribute until the final results are shared.
The University of Birmingham has granted formal ethical approval for this research. The findings of the study will be shared through presentations at academic conferences and by publishing them in scientific journals that are reviewed by other experts in the field.
