Spine and Sport

Abstract

The spine, in athletes is a relatively frequent origin of problems. Chronic spine problems are much more common compared to acute injuries. Chronic injuries to the spine most often occur in low-contact sports like gymnastics and are most commonly the result of overuse. Acute injuries are more common in high-speed and full contact sports and are traumatic in origin. Injuries to the spinal cord can be devastating but are fortunately very uncommon. Although imaging of the spine appears to be straightforward, any radiologist will acknowledge that the optimal imaging strategy is often unclear due to several reasons. For the cervical spine much has improved since the NEXUS and CCR studies appeared in which clear rules were defined when to image the C-spine in acute trauma situations. For the thoracic and lumbar spines such rules are not defined. Although conventional imaging has long been the primary imaging modality of choice there is ample evidence that this should be abandoned in favor of multidetector CT for the C-spine. This is reflected in the ACR criteria in which conventional imaging of tile C-spine in trauma is rated as the least appropriate imaging method. However, this is not true in children and adolescents although a strict age criterion is not defined. It is also not true for injuries to the thoracic and lumbar spine in which conventional imaging still plays a large role as primary imaging modality followed by evaluation by CT in trauma situations. The role for MRI in acute situations is increasing especially with the increasing use of the TLICS system to classify injuries of the thoracic and lumbar spine in which the evaluation of the integrity of the posterior ligamentous structures is included. For the evaluation of chronic complaints, the roles of CT and MRI are basically reversed in which MRI will become the prime imaging modality of choice after conventional imaging after which CT can be reserved for a selected patient group. The merit of the different imaging modalities will be discussed together with a spectrum of acute and chronic injuries often encountered in the spine in athletes.

Localized cervical pain: advantages and limits of ultrasound evaluation

“…Second, a comparison with other imaging exams was not performed. In this regard, MRI is considered the ''gold standard'' modality for spine visualization [8] because of its excellent tissue resolution and superior visualization of intervertebral discs [26]. Third, the US was not performed immediately in acute cases.…”

“…Moreover, the pain may depend on conditions directly affecting the neck musculature, such as postural disorders (also work related), fibromyalgia, and/or polymyalgia rheumatica [6]. In the clinical practice, diagnosis is usually based on clinical examination and plain X-ray, whereas computed tomography (CT) and magnetic resonance imaging (MRI), which are costly and time-consuming, are reserved for specific conditions when a major damage is suspected or when the functional recovery is delayed or unsatisfactory [7,8]. Ultrasonography (US) could be an attractive adjuvant method in the investigation of some cervical pathologies because of the broad availability and affordability of the equipment [9].…”

Emerging trends and research foci of deep learning in spine: bibliometric and visualization study

“…8 showed the consequence presented three clusters which consisted of "segmentation", "area", and "neural network". Spine, as the axial skeleton, can be divided into cervical, thoracic, lumbar and sacral parts, and meanwhile, each part constitutes of vertebrae, disc and related level of spine cord [33]. Precise segmentation and anatomical identi cation of the spine provides the basis for automatic analysis of the spine [34].…”

Which typical floor movements of men’s artistic gymnastics result in the most extreme lumbar lordosis and ground reaction forces?

“…The repetition of stressful movements, which alternatively stress the spine in flexion and in extension, leads successively to traction and compression forces at the level of the articular apophyses which is a risk factor for isthmic lysis and spondylolisthesis (Adams, 2004;De Jonge & Kramer, 2014;Kruse & Lemmen, 2009). In addition, forces are transmitted through vertebral bodies thanks to intervertebral discs (IVDs), which evenly distribute the forces on the vertebral bodies (Adams, 2004).…”

“…But the repetition of compression forces can lead to micro-fractures, mostly at vertebral endplates or even to fractures (Adams, 2004) and shear forces within IVDs may also result in progressive IVD degeneration (De Jonge & Kramer, 2014;Kruse & Lemmen, 2009;Xia et al, 2015).…”