Prevalence and clinical features of sports-related lumbosacral stress injuries in the young

Kaneko, Hideto; Murakami, Mototsune; Nishizawa, Kazuya

doi:10.1007/s00402-017-2686-y

Cited by 18 publications

(14 citation statements)

References 20 publications

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“…In a study of adolescent athlete patients with low back pain, Selhorst et al 43 found that approximately 48% of soccer players had lumbar spondylolysis. Kaneko et al 22 found that 53% had lumbar BSI, and both studies showed that soccer players had a higher prevalence compared with bet players of other sports. In our study, the incidence of symptomatic bilateral lumbar BSI occurred in 26.3% of adolescent soccer players.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Symptomatic Bilateral Lumbar Bone Stress Injury in Adolescent Soccer Players: A Prospective Cohort Study

et al. 2023

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Background: Lumbar bone stress injury (BSI) is a high-risk long time—loss injury for adolescent soccer players. However, the risk factors for lumbar BSI are unclear. Purpose: To identify the risk factors for bilateral lumbar BSI for adolescent soccer players. Study Design: Case-control study; Level of evidence, 3. Methods: Adolescent soccer players underwent orthopaedic examination, whole-body dual energy x-ray scan, lumbar magnetic resonance imaging (MRI), and muscle tightness testing at baseline. Lumbar lordosis (LL), sacral slope, maturity stage of lumbar vertebral body, and bone marrow edema (BME) at the L5 were examined via MRI. In addition, bone mineral density and content; trunk lean body mass via dual energy x-ray scan; and bilateral muscle tightness including the iliopsoas, hamstrings, and quadriceps were measured. Lumbar BSI was diagnosed as positive bilateral BME and extension-based lumbar pain. All participants were examined twice, one at 6 months and one at 1 year, after the baseline examination. Multivariate logistic regression analysis was performed to identify the risk factors for bilateral lumbar BSI. Results: A total of 69 (26.3%) players were diagnosed with bilateral lumbar BSI. Asymptomatic BME (odds ratio [OR], 4.260; 95% CI, 2.153-8.431), apophyseal stage of the lumbar vertebral body (OR, 3.438; 95% CI, 1.698-6.959), sacral slope relative to LL ≥5° (OR, 4.067; 95% CI, 2.021-8.181), and hamstring tightness ≥50° (OR, 3.221; 95% CI, 1.385-7.489) were significantly associated with bilateral lumbar BSI. Conclusion: The incidence of bilateral lumbar BSI was common at 26.2%. Asymptomatic BME, sacral anterior tilt relative to LL, immature lumbar epiphyses, and hamstring tightness were found to be risk factors for bilateral lumbar BSI. The results of this study suggest that regular MRI examination could facilitate the early detection of BME, and improvement in hamstring flexibility and lumbosacral alignment may prevent bilateral lumbar BSI in young athletes.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Symptomatic Bilateral Lumbar Bone Stress Injury in Adolescent Soccer Players: A Prospective Cohort Study

et al. 2023

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“…Saver's disease has also been shown to be more likely to occur at stage 2 (stages are indicated from 0 to 5), defined as when the apophysis covers > 50% of the metaphysis but does not extend to the plantar edge [22]. Kaneko et al [23] reported that the incidence of lumbar stress injury at L5, which is considered a precursor to lumbar spondylolysis, was > 30% at the age of ≥ 13 years. This corresponded to the age older than T2 (12.98 ± 0.03 years) in our study.…”

Section: Table 1 Participant Characteristics At Different Timesmentioning

confidence: 99%

Growth pattern of lumbar maturity stage at L1 to L5 during adolescent growth spurt

et al. 2023

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Purpose This study aimed to clarify the order of the lumbar maturity stage, each at L1 to L5, and the relationships between age at peak height velocity (APHV) and the lumbar maturity stage. Methods A total of 120 male first-grade junior high school soccer players were enrolled and followed for two years, and measurements were performed five times (T1 to T5). The lumbar maturity stage was assessed according to the degree of lesion of the epiphyseal from L1 to L5 using magnetic resonance imaging and classified into three stages: cartilaginous stage, apophyseal stage, and epiphyseal stage. The relationships between T1 and T5 temporal changes and developmental stages divided by 0.5 year increments based on APHV and the lumbar maturity stage at L1 to L5 were examined. For the apophyseal stage, developmental age calculated based on the difference between APHV and chronological age between each lumbar vertebra was compared. Results We found that part of the cartilaginous stages decreased as time progressed, while that of the apophyseal and epiphyseal stages increased at L1 to L5 (chi-square test, p < 0.01). L5 matured earlier with the apophyseal stage than L1 to L4 (p < 0.05). The lumbar maturity stage was attained toward L1 from L5, comparing different lumbar levels. Conclusion The lumbar maturity stage progresses from L5 toward L1, and the apophyseal and epiphyseal stages would replace the cartilaginous stage at approximately 14 years of age or after APHV.

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“…Lumbar spondylolysis is a stress fracture of the pars interarticularis and that typically occurs in adolescent athletes [1]. Kaneko et al [2] reported that 33% of young patients that complained of sports-related low back pain lasting more than 7 days had lumbar stress injuries. The L5 pars interarticularis is the spinal level most affected and sus-Asian Spine J. December 28, 2020 [Epub ahead of print] ceptible to mechanical stress [3].…”

Section: Introductionmentioning

confidence: 99%

Bone Healing in Adolescents with Bilateral L5 Spondylolysis with and without Preexisting Contralateral Terminal Spondylolysis

et al. 2021

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To examine bone healing with conservative treatment in cases of adolescent bilateral L5 spondylolysis. Overview of Literature: We classified bilateral L5 spondylolysis, which is the most affected spinal level, by fracture stage and aimed to compare the bone healing rate according to the fracture stage and evaluate the presence of a preexisting contralateral terminal fracture at the diagnosis of fresh spondylolysis. Methods: We evaluated 48 patients (38 boys and 10 girls) with bilateral L5 spondylolysis diagnosed during or before high school. L5 spondylolysis was classified into two groups: fresh group (bilateral fresh spondylolysis cases), and terminal group (cases wherein one side had fresh spondylolysis and the contralateral side had terminal spondylolysis). We investigated the age of examination and bone healing rate in both groups. We investigated progressive-stage lesions and bone healing rate with or without progressive-stage lesions. Results:The bone healing rate in the fresh group was significantly higher than that in the terminal group 72.0% vs. 26.1%, p=0.003). In both the groups, the bone healing rate was significantly higher in patients without progressive-stage lesions than in those with progressive-stage lesions. Conclusions: Bone healing of progressive-stage fresh spondylolysis was not achieved by conservative treatment when contralateral terminal spondylolysis was present in adolescents with bilateral L5 spondylolysis. Our results suggest that bilateral L5 spondylolysis treatment strategies must be determined based on the combination of the stages present.

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Prevalence and clinical features of sports-related lumbosacral stress injuries in the young

Cited by 18 publications

References 20 publications

Risk Factors for Symptomatic Bilateral Lumbar Bone Stress Injury in Adolescent Soccer Players: A Prospective Cohort Study

Risk Factors for Symptomatic Bilateral Lumbar Bone Stress Injury in Adolescent Soccer Players: A Prospective Cohort Study

Growth pattern of lumbar maturity stage at L1 to L5 during adolescent growth spurt

Bone Healing in Adolescents with Bilateral L5 Spondylolysis with and without Preexisting Contralateral Terminal Spondylolysis

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