Disc Degeneration and Associated Abnormalities of the Spine in Elite Gymnasts

Swärd, Leif; Hellström, Mikael; Jacobsson, Bo; Nyman, Rickard; Peterson, Lars

doi:10.1097/00007632-199104000-00009

Cited by 259 publications

(226 citation statements)

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“…In a cross-sectional study of 142 athletes aged 17-25 years, Swärd et al [57] found a correlation between the severity of low back pain (defined by the interruption of competitive sport or of training) and the presence of multiple radiological abnormalities (P < 0.01), particularly nonapophysial Schmorl's nodes (P < 0.05). Among 20 gymnasts and controls, the same authors [58] showed that signs of disk degeneration visible by MRI are more frequent among athletes (73%) than among controls (31%) (P < 0.01). The same was true concerning the number of degenerated disks (P < 0.05) and the degree of reduction of disk signal intensity (P < 0.01).…”

Section: Physical and Sports Activitiesmentioning

confidence: 92%

“…In a crosssectional case-control study, the same authors [58] showed that the frequency of low back pain was higher among male gymnasts (79%) than among males not involved in sports (38%) (P < 0.001).…”

Section: Physical and Sports Activitiesmentioning

confidence: 94%

“…Young athletes show an increased frequency of radiographic or MRI abnormalities of the thoraco-lumbar spine in several cross-sectional case-control studies [19,23,58]; however, the correlation between radiological signs and low back pain remains controversial [29,57,58,60]. In the study by Hellstrom et al [23], the prevalence of multiple radiological abnormalities was higher among athletes, particularly male gymnasts, than among non-athletes (P < 0.01).…”

Section: Physical and Sports Activitiesmentioning

confidence: 99%

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Non-specific low back pain in children and adolescents: risk factors

Balagué¹,

Troussier

Salminen

1999

European Spine Journal

338

291

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IntroductionBackache in children and adolescents has traditionally been considered a rare and serious condition, causing one to suspect an organic, infectious, inflammatory or neoplastic origin. Several surveys, however, have revealed a high prevalence of backache, and particularly of lumbar pain, in these age groups, indeed sometimes similar to that reported for adults. The purpose of this article is to review the recent literature, published since 1992 [6], on this topic. Epidemiological dataThe prevalence of back pain in children varies according to the age of the population studied and, particularly, according to the methodology of the studies themselves, viz.:1. Cross-sectional studies by means of a questionnaire, with or without the participation of an investigator, looking at subjective morbidity [4,5,8,9,13,18,26,35,41,48,50,59,62,64,69]. 2. Cross-sectional studies based on physical examination of the subjects, to evaluate the measurable morbidity [4,13,35,48,50,69]. 3. Longitudinal studies (cohort studies) to measure the yearly incidence of spinal pain [12,15].Moreover, studies differ in terms of the definition of backache selected (any localisation of spinal pain versus pain limited to the lumbar area, radicular pain), and also according to the type of prevalence studied (lifetime prevalence or point prevalence of back pain). Several approaches are used in evaluating the intensity of pain: relapsing or permanent pain, need for medical care, or disability due to pain. Furthermore, in studying risk factors, it is important from a methodological point of view to distinguish cross-sectional studies without either a control group or multiple analysis of variance [2, 9, 13, 18, 22, Abstract Low back pain (LBP) among children and adolescents has become the subject of an increasing amount of literature over the last 15 years. This topic, which was considered almost insignificant less than two decades ago, was the focus of a recent international meeting organised in Grenoble (France) in March 1999. This review paper is the result of an literature update search performed by members of three groups which have been active in this field for many years. Current epidemiological data on LBP is summarized as well as the role of the major risk factors according to studies published in the principal peer reviewed journals interested in the topic.Key words Non-specific low back pain · Schoolchildren · Risk factors · Epidemiology Eur Spine J (1999) 8 : 429-438 REVIEW

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Section: Physical and Sports Activitiesmentioning

confidence: 92%

Section: Physical and Sports Activitiesmentioning

confidence: 94%

Section: Physical and Sports Activitiesmentioning

confidence: 99%

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Non-specific low back pain in children and adolescents: risk factors

Balagué¹,

Troussier

Salminen

1999

European Spine Journal

338

291

View full text Add to dashboard Cite

show abstract

“…It also known that falls often produce axial loading on the spine [18]. Interestingly, a study comparing vertebral abnormalities in elite gymnasts versus non-athletes [19] found SNs in 71 % (17 out of 24) of gymnasts and only 44 % (7 out of 17) of non-athletes. Gymnasts experience greater-than-average axial forces on their vertebrae.…”

Section: Axial Load (Trauma)mentioning

confidence: 99%

Schmorl’s nodes

et al. 2012

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Introduction First described in 1927, a Schmorl's node (SN) is the herniation of nucleus pulposus (NP) through the cartilaginous and bony end plate into the body of the adjacent vertebra. SNs are common findings on imaging, and although most SNs are asymptomatic, some have been shown to become painful lesions. In this manuscript, we review the literature regarding the epidemiology, clinical presentation, pathogenesis, imaging, and management of SNs. Materials and methods Using databases from the US National Library of Medicine and the National Institutes of Health, relevant articles were identified. Results While several theories regarding the pathogenesis of SNs have been proposed, an axial load model appears to have the greatest supporting evidence. Symptomatic SNs are thought to be due to the inflammatory response solicited by the herniation of NP into the wellvascularized vertebral body. Management options for symptomatic SNs vary, ranging from medical management to surgical fusion. Conclusion SNs are common lesions that are often asymptomatic. In certain cases, SNs can cause back pain. No consensus on pathogenesis exists. There is no established treatment modality for symptomatic SNs.

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“…Among juvenile and adolescent athletes, back pain is common [4] with one study reporting a 79% rate of back pain compared with 38% in age-matched control subjects [28]. Despite the absence of worrisome hallmarks (eg, neurologic or constitutional symptoms), children often undergo extensive, costly, and time-consuming diagnostic workups that ultimately reveal no treatable organic disorder [7,8,29].…”

Section: Introductionmentioning

confidence: 99%

Streamlining the Evaluation of Low Back Pain in Children

Auerbach

Ahn

Zgonis

et al. 2008

Clin Orthop Relat Res

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The workup of low back pain in children often results in overimaging so as not to miss organic back pain. The primary goal of this study was to identify which combination of imaging modalities provides the most sensitive and specific screening protocol for children with low back pain. Medical records from 100 consecutive patients between 2 and 18 years of age presenting with low back pain, without night pain or constitutional symptoms, were evaluated. A hyperextension test combined with a radiograph showed a negative predictive value of 0.81 and sensitivity of 0.90. The addition of a bone scan was highly effective in achieving good negative predictive value and sensitivity. Bone scans had perfect negative predictive value and sensitivity when symptom duration was less than 6 weeks. We identified a set of factors that is highly predictive for distinguishing organic back pain from mechanical back pain. Painless hyperextension combined with negative anteroposterior, lateral, and oblique lumbar radiographs and magnetic resonance images predicts mechanical back pain. For patients with nonneurologic back pain of less than 6 weeks duration, bone scan is the most useful screening test because it is accurate, accessible, inexpensive, and unlikely to require sedation.

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Disc Degeneration and Associated Abnormalities of the Spine in Elite Gymnasts

Cited by 259 publications

References 0 publications

Non-specific low back pain in children and adolescents: risk factors

Non-specific low back pain in children and adolescents: risk factors

Schmorl’s nodes

Streamlining the Evaluation of Low Back Pain in Children

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