The decision to allow any young athlete to resume sports participation following injury or surgery must always be individualized. In the case of spinal surgery, whether it is of the decompressive type or involves spinal fusion, the decision to return to full sports participation must take into consideration not only the level of the spine involved but also the extent of spinal fusion. The potential for segmental instability immediately above or below the fusion site as well as any neurologic injury identified at the time of the initial injury or subsequently noted in the course of management must also be taken into account.