Bony stress in the lumbar spine is associated with intervertebral disc degeneration and low back pain: a retrospective case–control MRI study of patients under 25 years of age

Chepurin, Daniel; Chamoli, Uphar; Sheldrick, Kyle; Lapkin, Samuel; Scott, David; Kuan, Jeff; Diwan, Ashish D.

doi:10.1007/s00586-019-06148-1

Cited by 12 publications

(13 citation statements)

References 37 publications

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“…none supported a negative correlation. Outcomes were consistent throughout the clinical studies that showed a positive correlation, with all studies using MRI to diagnose bony stress and IVD degeneration (6,7,(18)(19)(20)(21) (7), which may suggest the importance of diagnosing early signs of bony stress even if the healing occurs in subsequent follow-up scans. Bony stress may also be a contributing factor to the non-speci c LBP, due to its association with IVD degeneration or due to the microtrabecular injury alone or both.…”

Section: Discussionsupporting

confidence: 70%

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confidence: 98%

“…) Chepurin et al (2019). found that in a group of 55 patients with bony stress, 38 (69%) had IVD degeneration; whereas in a control group of 75 patients without bony stress, 37 (49%) had IVD degeneration(21). Sharma et al (2014) compared IVDs adjacent to segments with bony stress with non-adjacent IVDs and found an increased burden of AF tears (0.6 versus 0.28) and NP degeneration (13% versus 2%) in IVDs adjacent to the stressed segments(6).…”

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confidence: 99%

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Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: a Review of Clinical and Basic Science Studies

Chepurin

Chamoli

Diwan

2020

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BackgroundMultiple components of the lumbar spine interact during the normal and pathological function. Bony stress in the lumbar spine is recognised as a factor in the development of pars defects and stress fractures, but its relationship with intervertebral disc (IVD) degeneration is not well understood. Therefore, a translational review encompassing basic science and clinical evidence was conducted to examine the relationship between bony stress in the lumbar spine and IVD degeneration.MethodsOnline databases Scopus, PubMed and MEDLINE via OVID were searched for relevant studies published between January 1980 – February 2020, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Two authors independently analysed the data, noting study characteristics and bias.ResultsThirty-two articles were included in the review: eight human studies, nine finite element analysis studies, three in-vivo biomechanical testing studies, and twelve in-vitro biomechanical testing studies. Of the 32 articles, 19 supported, four rejected and nine made no conclusion on the hypothesis that there is a positive associative relationship between IVD degeneration and bony stress. However, not enough evidence was available to confirm or reject a causal relationship.ConclusionMost studies suggest that the prevalence of IVD degeneration increases with the presence of bony stress, but whether a causal relationship exists is unclear. The literature recommends early diagnosis and clinical suspicion of IVD degeneration and bony stress. Longitudinal studies are required to explore causal relationships between IVD degeneration bony stress.

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Section: Discussionsupporting

confidence: 70%

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confidence: 98%

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confidence: 99%

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Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: a Review of Clinical and Basic Science Studies

Chepurin

Chamoli

Diwan

2020

Preprint

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“…Edema in the lumbar spine can present after repeated trauma in sports but may also be present when adolescents present themselves with incorrect postures and carry excessive weight. Here, the presence of lesions was not significantly different, which may suggest that the groups did not differ in relation to other possible exposure factors [31].…”

Section: Discussionmentioning

confidence: 59%

Lesions of the Lumbar Region in Asymptomatic Young Soccer Players: A Cross-Sectional Study

Júnior

Amorim

Vidal

et al. 2020

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Purpose To assess abnormalities frequency of the lumbar region in asymptomatic young soccer players. Methods Cross-sectional study. Male adolescents from schools of grassroots soccer clubs and non-practicing activity controls were included by convenience. The abnormalities frequency of the lumbar region was evaluated by magnetic resonance imaging (MRI), performed using 1.5T devices with multi-channel coils in model equipment models. The types of lesions evaluated were general, warning signs, instituted, anterior and posterior, and of the column. Comparisons between groups and the relative percentage of each lesion type were compared by Pearson’s chi-squared test and Fischer’s exact test. The inter and intra-observer analyses were compared by the Kappa test. Results Forty-five adolescents were included, of whom 25 (56%) were soccer-practicing teenagers. No significant differences were identified between the variables age (P = 0.960) and the body mass index (BMI) Z-score (P = 0.540) between the group of soccer players and the controls. However, the percentages of lesions (general, instituted, anterior and posterior, and in the spinal column) were significantly higher in the practicing football group than in the control group (P = 0.002, P < 0.001, P = 0.012, and P = 0.006, respectively). Conclusion Young adolescent asymptomatic soccer players have more lumbar spine lesions than less active controls who do not practice sports regularly.

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“…Edema in the lumbar spine can present after repeated trauma in sports but may also be present when adolescents present themselves with incorrect postures and carry excessive weight. Here, the presence of lesions was not signi cantly different, which may suggest that the groups did not differ in relation to other possible exposure factors [31].…”

Section: Discussionmentioning

confidence: 60%

Lesions of the Lumbar Region in Asymptomatic Young Soccer Players: A Cross-Sectional Study

Júnior

Amorim

Vidal

et al. 2020

Preprint

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Background: Athletes generally exceed the limits of the body, which can result in various lesions. The pediatric musculoskeletal system is particularly susceptible to lesions through overuse for various reasons including an immature growth plate. While spinal column lesions are relatively rare, they can lead to permanent disability. Studies on spinal lesions in young athletes are rare. To assess abnormalities frequency of the lumbar region in asymptomatic young soccer players.Methods: Cross-sectional study. Male adolescents from schools of grassroots soccer clubs and non-practicing activity controls were included by convenience. The abnormalities frequency. of the lumbar region was evaluated by magnetic resonance imaging (MRI), performed using 1.5T devices with multi-channel coils in model equipment models. The types of lesions evaluated were general, warning signs, instituted, anterior and posterior, and of the column. Comparisons between groups and the relative percentage of each lesion type were compared by Pearson’s chi-squared test and Fischer’s exact test. The inter and intra-observer analyses were compared by the Kappa test.Results: Forty-five adolescents were included, of whom 25 (56%) were soccer-practicing teenagers. No significant differences were identified between the variables age (P=0.960) and the body mass index (BMI) Z-score (P=0.540) between the group of soccer players and the controls. However, the percentages of lesions (general, instituted, anterior and posterior, and in the spinal column) were significantly higher in the practicing football group than in the control group (P=0.002, P<0.001, P= 0.012, and P=0.006, respectively).Conclusion: Young adolescent asymptomatic soccer players have more lumbar spine lesions than less active controls who do not practice sports regularly.

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Bony stress in the lumbar spine is associated with intervertebral disc degeneration and low back pain: a retrospective case–control MRI study of patients under 25 years of age

Cited by 12 publications

References 37 publications

Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: a Review of Clinical and Basic Science Studies

Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: a Review of Clinical and Basic Science Studies

Lesions of the Lumbar Region in Asymptomatic Young Soccer Players: A Cross-Sectional Study

Lesions of the Lumbar Region in Asymptomatic Young Soccer Players: A Cross-Sectional Study

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