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European Spine Journal
Published in: European Spine Journal 9/2016

01-09-2016 | Original Article

The role of intense athletic activity on structural lumbar abnormalities in adolescent patients with symptomatic low back pain

Authors: Gregory D. Schroeder, Cynthia R. LaBella, Marco Mendoza, Erika L. Daley, Jason W. Savage, Alpesh A. Patel, Wellington K. Hsu

Published in: European Spine Journal | Issue 9/2016

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Abstract

Purpose

To determine if adolescent athletics increases the risk of structural abnormalities in the lumbar spine.

Methods

A retrospective review of patients (ages 10–18) between 2004 and 2012 was performed. Pediatric patients with symptomatic low back pain, a lumbar spine MRI, and reported weekly athletic activity were included. Patients were stratified to an “athlete” and “non-athlete” group. Lumbar magnetic resonance and plain radiographic imaging was randomized, blinded, and evaluated by two authors for a Pfirrmann grade, herniated disc, and/or pars fracture.

Results

A total of 114 patients met the inclusion criteria and were stratified into 66 athletes and 48 non-athletes. Athletes were more likely to have abnormal findings compared to non-athletes (67 vs. 40 %, respectively, p = 0.01). Specifically, the prevalence of a spondylolysis with or without a slip was higher in athletes vs. non-athletes (32 vs. 2 %, respectively, p = 0.0003); however, there was no difference in the average Pfirrmann grade (1.19 vs. 1.14, p = 0.41), percentage of patients with at least one degenerative disc (39 vs. 31 %, p = 0.41), or disc herniation (27 vs. 33 %, p = 0.43). Body mass index, smoking history, and pelvic incidence (51.5° vs. 48.7°, respectively, p = 0.41) were similar between the groups.

Conclusion

Adolescents with low back pain have a higher-than-expected prevalence of structural pathology regardless of athletic activity. Independent of pelvic incidence, adolescent athletes with low back pain had a higher prevalence of spondylolysis compared to adolescent non-athletes with back pain, but there was no difference in associated disc degenerative changes or herniation.
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Metadata
Title
The role of intense athletic activity on structural lumbar abnormalities in adolescent patients with symptomatic low back pain
Authors
Gregory D. Schroeder
Cynthia R. LaBella
Marco Mendoza
Erika L. Daley
Jason W. Savage
Alpesh A. Patel
Wellington K. Hsu
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 9/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4647-5

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