Decisions concerning the rehabilitation process and return to play (RTP) after cervical spine surgery in a general sporting population can be difficult and may be influenced by several factors. Moreover, no guidelines are present for this. The aim of this study was to create a consensus on this topic.

A 5-step Delphi analysis with panels of neurosurgeons, orthopaedic surgeons, physiotherapists and physical and rehabilitation medicine practitioners in Belgium was conducted. The first round (R1) was a brainstorm phase. A comprehensive list of answers from R1 was validated in round 2 (R2). In round 3 (R3) experts ranked these items in a chronological order. Next, contraindications and criteria to start each rehabilitation step were linked by experts in round 4 (R4). In round 5 (R5) panellists ranked theses about contraindications and criteria on a 5-point Likert scale.

The response rate was 100% (n=15) for R1, 93% (n=14) for R2, 73% (n=11) for R3, 53% (n=8) for R4 and 67% (n=10) for R5. In R5, 25 theses on absolute and relative contraindications and criteria were endorsed.

This Delphi analysis resulted in contraindications and criteria for the rehabilitation process and return to play after cervical surgery. Tentative guidelines and timetable are proposed.