Lumbar spine MRI in the elite-level female gymnast with low back pain
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Previous studies have shown increased degenerative disk changes and spine injuries in the competitive female gymnast. However, it has also been shown that many of these findings are found in asymptomatic athletic people of the same age. Previous magnetic resonance imaging (MRI) studies evaluating the gymnastic spine have not made a distinction between symptomatic and asymptomatic athletes. Our hypothesis is that MRI will demonstrate the same types of abnormalities in both the symptomatic and asymptomatic gymnasts.
Olympic-level female gymnasts received prospectively an MRI exam of the lumbar spine. Each of the gymnasts underwent a physical exam by a sports medicine physician just prior to the MRI for documentation of low back pain. Each MRI exam was evaluated for anterior apophyseal ring avulsion injury, compression deformity of the vertebral body, spondylolysis, spondylolisthesis, degenerative disease, focal disk protrusion/extrusion, muscle strain, epidural mass, and bone-marrow edema.
Nineteen Olympic-level female gymnasts (age 12–20 years) were evaluated prospectively in this study. All of these gymnasts were evaluated while attending a specific training camp.
Anterior ring apophyseal injuries (9/19) and degenerative disk disease (12/19) were common. Spondylolysis (3/19) and spondylolisthesis (3/19) were found. Focal bone-marrow edema was found in both L3 pedicles in one gymnast. History and physical exam revealed four gymnasts with current low back pain at the time of imaging. There were findings confined to those athletes with current low back pain: spondylolisthesis, spondylolysis, bilateral pedicle bone-marrow edema, and muscle strain.
Our initial hypothesis was not confirmed, in that there were findings that were confined to the symptomatic group of elite-level female gymnasts.
KeywordsMagnetic resonance imaging Elite gymnasts Spine
- 2.Appendix B NCAA Injury Surveillance System Summary. In: NCAA Sports Medicine Handbook 2004-2005. Indianapolis, Ind: National Collegiate Athletic Association. 2004:99–108Google Scholar
- 5.Weiker GG. Injuries in club gymnastics. Phys Sportsmed. 1985;13:63–66Google Scholar
- 9.Swärd L, Hellström M, Jacobsson B, Nyman R, Pëterson L. Acute injury of the vertebral ring apophysis and intervertebral disc in adolescent gymnasts. Spine. 1990;15:144–148Google Scholar
- 10.Rogers LF, Daffner RH. The thoracic and lumbar spine. In: Rogers LF, ed. Radiology of Skeletal Trauma, 3rd ed. Edinburgh: Churchill Livingstone; 2002:453–540Google Scholar
- 11.El-Khoury GY, Melhem ER. Imaging of low back pain. In: El-Khoury GY, Bennett DL, Stanley MD, eds. Essentials of musculoskeletal imaging. Edinburgh: Churchill Livingstone; 2003:320–350Google Scholar
- 14.Boutin RD. Muscle disorders. In: Resnick D, Kransdorf MJ, eds. Bone and joint imaging, 3rd ed. Philadelphia: Elsevier Saunders; 2005:1374–1397Google Scholar
- 15.Glantz SA. Primer of biostatistics, 5th ed. McGraw Hill, New York 2001Google Scholar
- 16.Armitage P, Berry G. Statistical methods in medical research. Oxford: Blackwell, 1994Google Scholar