Skip to main content
SpringerLink
Log in

Lumbar Spine Injuries

  • Chapter
The Adolescent Athlete

Abstract

As children are increasingly involved in highly competitive sports and training at a greater intensity, new patterns of injury are emerging (1–4). Low back pain is identified in 10–15% of participants in youth sports in general (5,6), with this percentage being even higher in certain sports. Studies reveal that 27% of college football players (7), nearly 50% of young artistic gymnasts (8,9), and up to 86% of rhythmic gymnasts (10) complain of low back pain.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Gross ML, Mandelbaum BR. Spondylolysis and spondylolisthesis. In: Reider B, ed. Sports Medicine: The School Age Athlete. 2nd ed. Philadelphia: W.B. Saunders; 1996:169–184.

    Google Scholar 

  2. Anderson SJ. Sports injuries. Dis Mon 2005;51:438–542.

    Article  Google Scholar 

  3. Yancey RA, Micheli, LJ. Thoracolumbar spine injuries in pediatric sports. In: Stanitski DL, DeLee JC, Drez DD Jr, ed. Pediatric and adolescent sports medicine. Vol 3. Toronto: W.B. Saunders; 1994:162–174.

    Google Scholar 

  4. Kocher MS, Micheli LJ. Upper extremity and trunk injuries. In: Armstrong N, van Mechelen W, eds. Pediatric sport and exercise medicine. Oxford: Oxford University Press; 2000:428–436.

    Google Scholar 

  5. Micheli LJ. Back injuries in gymnastics. Clin Sports Med 1985;4:85–93.

    CAS  PubMed  Google Scholar 

  6. d’Hemecourt PA, Gerbino PG, Micheli LJ. Back injuries in the young athlete. Clin Sports Med 2000;19:663–679.

    Article  PubMed  Google Scholar 

  7. Semon RL, Spengler D. Significance of lumbar spondylolysis in college football players. Spine 1981;6:172–174.

    Article  CAS  PubMed  Google Scholar 

  8. Szot Z, Boron Z, Galaj Z. Overloading changes in the motor system occurring in elite gymnasts. Int J Sports Med 1985;6:36–40.

    Article  CAS  PubMed  Google Scholar 

  9. Kolt GS, Kirkby RJ. Epidemiology of injury in elite and subelite female gymnasts: a comparison of retrospective and prospective findings. Br J Sports Med 1999;33:312–318.

    Article  CAS  PubMed  Google Scholar 

  10. Hutchinson MR. Low back pain in elite rhythmic gymnasts. Med Sci Sports Exerc 1999;31:1686–1688.

    Article  CAS  PubMed  Google Scholar 

  11. Micheli LJ, Wood R. Back pain in young athletes: significant differences from adults in causes and patterns. Arch Pediatr Adolesc Med 1995;149:15–18.

    CAS  PubMed  Google Scholar 

  12. Snell RS. The back. In: Snell RS, ed. Clinical Anatomy for Medical Students. 3rd ed. Toronto: Little, Brown and Company; 1986:919–954.

    Google Scholar 

  13. Kraft DE. Low back pain in the adolescent athlete. Pediatr Clin N Am 2002;49: 643–653.

    Article  Google Scholar 

  14. Baker RJ, Patel D. Lower back pain in the athlete: common conditions and treatment. Prim Care Clin Office Pract 2005;32:201–229.

    Article  Google Scholar 

  15. Patel DR, Nelson TL. Sports injuries in adolescents. Med Clin North Am 2000;84:983–1007.

    Article  CAS  PubMed  Google Scholar 

  16. Clifford SN, Fritz JM. Children and adolescents with low back pain: a descriptive study of physical examination and outcome measurement. J Orthop Sports Phys Ther 2003;33:513–522.

    PubMed  Google Scholar 

  17. Keats TE, Anderson MW. The sacrum. In: Keats TE, Anderson MW, eds. Atlas of Normal Roentgen Variants that May Stimulate Disease. 7th ed. Toronto: Mosby; 2001:333–345.

    Google Scholar 

  18. Anderson JE. The back. In: Anderson JE, ed. Grant’s Atlas of Anatomy. 8th ed. Baltimore: Williams & Wilkins; 1983:5.1–5.5.

    Google Scholar 

  19. Tehranzadeh J, Andrews C, Wong E. Lumbar spine imaging: normal variants, imaging pitfalls, and artifacts. Radiol Clin North Am 2000;38:1207–1253.

    Article  CAS  PubMed  Google Scholar 

  20. Resnick D. Degenerative disease of the spine. In: Resnick D, ed. Bone and Joint Imaging. 2nd ed. Toronto: WB Saunders, 1996:355–377.

    Google Scholar 

  21. Hutson MA. Pelvic injuries. In: Hutson MA, ed. Sports Injuries: Recognition And Managament. 3rd ed. New York: Oxford University Press; 2001:113–123.

    Google Scholar 

  22. Resnick D. Ankylosing spondylitis. In: Resnick D, ed. Bone and Joint Imaging. 2nd ed. Toronto: W.B. Saunders; 1996:246–264.

    Google Scholar 

  23. Manaster BJ. Arthritis. In: Manaster BJ, ed. Handbook of Skeletal Radiology. 2nd ed. Toronto: Mosby; 1997:104–170.

    Google Scholar 

  24. Moeller JL, Rifat SF. Spondylolysis in active adolescents expediting return to play. Phys Sportsmed 2001;29:27–32.

    CAS  PubMed  Google Scholar 

  25. Zetaruk MN. The young gymnast. Clin Sports Med 2000;19:757–780.

    Article  CAS  PubMed  Google Scholar 

  26. Burgos-Vargas R. The juvenile-onset spondyloarthritides. Rheum Dis Clin North Am 2002;28:531–560.

    Article  PubMed  Google Scholar 

  27. Payne WK, Ogilvie JW. Back pain in children and adolescents. Pediatr Clin N Am 1996;43:899–918.

    Article  Google Scholar 

  28. Solomon R, Brown T, Gerbino PG, et al. The young dancer. Clin Sports Med 2000;19:717–739.

    Article  CAS  PubMed  Google Scholar 

  29. Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wrist. 2nd ed. Stanford: Stanford University Press;1959

    Google Scholar 

  30. Goldstein JD, Berger PE, Windier GE, et al. Spine injuries in gymnasts and swimmers: an epidemiologic investigation. Am J Sports Med 1991;19:463–468.

    Article  CAS  PubMed  Google Scholar 

  31. Kaeding CC, Whitehead R. Musculoskeletal injuries in adolescents. Prim Care 1998;25:211–223.

    CAS  PubMed  Google Scholar 

  32. Duri ZAA, Patel DV, Aichroth PM. The immature athlete. Clin Sports Med 2002;21:461–482.

    Article  PubMed  Google Scholar 

  33. Hutchinson MR, Wynn S. Biomechanics and development of the elbow in the young throwing athlete. Clin Sports Med 2004;23:531–544.

    Article  PubMed  Google Scholar 

  34. Sjolie AN. Low-back pain in adolescents is associated with poor hip mobility and high body mass index. Scand J Med Sci Sports 2004;14:168–175.

    Article  PubMed  Google Scholar 

  35. Congeni J, McCulloch J, Swanson K. Lumbar spondylolysis: a study of natural progression in athletes. Am J Sports Med 1997;25:248–253.

    Article  CAS  PubMed  Google Scholar 

  36. Herman MJ, Pizzutillo PD, Cavalier R. Spondylolysis and spondylolisthesis in the child and adolescent athlete. Orthop Clin North Am 2003;34:461–467.

    Article  PubMed  Google Scholar 

  37. Iwamoto J, Abe H, Tsukimura Y, et al. Relationship between radiographic abnormalities of lumbar spine and incidence of low back pain in high school rugby players: a prospective study. Scand J Med Sci Sports 2005;15:163–168.

    Article  CAS  PubMed  Google Scholar 

  38. Gregory PI, Batt ME, Kerslake RW, et al. Single photon emission computerized tomography and reverse gantry computerized tomography findings in patients with back pain investigated for spondylolysis. Clin J Sport Med 2005;15:79–86.

    Article  PubMed  Google Scholar 

  39. d’Hemecourt P, Zurakowski D, Kriemler S, et al. Spondylolysis: returning the athlete to sports participation with brace treatment. Orthopedics 2002;25:653–657

    PubMed  Google Scholar 

  40. Meyerding H. Spondylolisthesis. Surg Gynecol Obstet 1932;54:371–377.

    Google Scholar 

  41. Reid DC. Injuries and conditions of the neck and spine. In: Reid DC, ed. Sports injury assessment and rehabilitation. New York: Churchill Livingston Inc.; 1992: 739–837.

    Google Scholar 

  42. Sairyo K, Katoh S, Sasa T, et al. Athletes with unilateral spondylolysis are at risk of stress fracture at the contralateral pedicle and pars interarticularis: a clinical and biomechanical study. Am J Sports Med 2005;33:583–590.

    Article  PubMed  Google Scholar 

  43. Fredrickson BE, Baker D, McHolick WJ, et al. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am 1984;66:699–707.

    CAS  PubMed  Google Scholar 

  44. Smith JA, Hu SS. Management of spondylolysis and spondylolisthesis in the pediatric and adolescent population. Orthop Clin North Am 1999;30:487–499

    Article  CAS  PubMed  Google Scholar 

  45. Perugia L, Rossi F. Spondylolysis and spondylolisthesis in sport: review of a case series. JTRRE 1998;20:209–212.

    Google Scholar 

  46. Trainor TJ, Weisel SW. Epidemiology of back pain in the athlete. Clin Sports Med 2002;21:93–103.

    Article  PubMed  Google Scholar 

  47. Jackson DW, Wiltse LL, Cirincione RJ. Spondylolysis in the female gymnast. Clin Orthop 1976;117:658–673.

    Google Scholar 

  48. Brown T, Micheli LJ. Dance: Where artistry meets injury. Biomechanics 1998;5:12–24.

    Google Scholar 

  49. Weiker GG. Evaluation and treatment of common spine and trunk problems. Clin Sports Med 1989;8:399–417.

    CAS  PubMed  Google Scholar 

  50. Micheli LJ, Curtis C. Stress fractures in the spine and sacrum. Clin Sports Med 2006;25:75–88.

    Article  PubMed  Google Scholar 

  51. Ganju A. Isthmic spondylolisthesis. Neurosurg Focus 2002;13:1–6.

    Article  Google Scholar 

  52. Lipton ME. Is the coned lateral lumbosacral junction radiograph necessary for radiological diagnosis? Br J Radiol 1991;64:420–421.

    Article  CAS  PubMed  Google Scholar 

  53. Saifuddin A, White J, Tucker S, et al. Orientation of lumbar pars defects: implications for radiological and surgical management. J Bone Joint Surg Br 1998;80: 208–211.

    Article  CAS  PubMed  Google Scholar 

  54. Bellah RD, Summerville DA, Treves ST, et al. Low back pain in adolescent athletes: detection of stress injuries to the pars interarticularis with SPECT. Radiology 1991;180:509–512.

    CAS  PubMed  Google Scholar 

  55. Akbarnia BA. Pediatric spine fractures. Orthop Clin North Am 1999;30:521–536

    Article  CAS  PubMed  Google Scholar 

  56. McCormack RG, Athwal G. Isolated fracture of the vertebral articular facet in a gymnast: a spondylolysis mimic. Am J Sports Med 1999;27:104–106.

    CAS  PubMed  Google Scholar 

  57. Shegog MI, Curtis C, d’Hemecourt P, et al. Spondylolysis in athletes: evaluation of the treatment protocol of division of sports medicine, Children’s Hospital Boston. Med Sci Sports Exerc 2005;37:(Supplement)S13 (abstract).

    Article  Google Scholar 

  58. Fellander-Tsai L, Micheli LJ. Treatment of spondylolysis with external electrical stimulation: a report of two cases. Clin J Sport Med 1998;8:232–234.

    Article  CAS  PubMed  Google Scholar 

  59. Saifuddin A. The value of lumbar spine MRI in the assessment of the pars interarticularis. Clin Radiol 1997;52:666–671.

    Article  CAS  PubMed  Google Scholar 

  60. Sherif H, Mahfouz AE. Epidural fat interposition between dura mater and spinous process: a new sign for the diagnosis of spondylolysis on MR imaging of the lumbar spine. Eur Radiol 2004;14:970–973.

    Article  PubMed  Google Scholar 

  61. Campbell RS, Grainger AJ, Hide IG, et al. Juvenile spondylolysis: a comparative analysis of CT, SPECT and MRI. Skeletal Radiol 2005;34:63–73.

    Article  CAS  PubMed  Google Scholar 

  62. Ulmer JL, Elster AD, Mathews VP, et al. Lumbar spondylolysis: reactive marrow changes seen in adjacent pedicles on MR images. AJR Am J Roentgenol 1995;164:429–433.

    CAS  PubMed  Google Scholar 

  63. Anderson K. Quantitative assessment with SPECT imaging of stress injuries of the pars interarticularis and response to bracing. J Pediatr Orthop 2000;20:28–33

    Article  CAS  PubMed  Google Scholar 

  64. Standaert CJ, Herring SA. Spondylolysis: a critical review. Br J Sports Med 2000;34:415–422.

    Article  CAS  PubMed  Google Scholar 

  65. Miller RA, Hardcastle P, Renwick SE. Lower spinal mobility and external immobilization in the normal and pathologic condition. Orthop Rev 1992;21: 753–757.

    CAS  PubMed  Google Scholar 

  66. Stasinopoulos D. Treatment of spondylolysis with external electrical stimulation in young athletes: a critical literature review. Br J Sports Med 2004;38: 352–354.

    Article  CAS  PubMed  Google Scholar 

  67. Evans RW, Wilberger JE. Traumatic disorders. In: Goetz CG, ed. Textbook of Clinical Neurology. 2nd ed. Philadelphia: W.B. Saunders; 2003:1129–1154.

    Google Scholar 

  68. Harvey J, Tanner S. Low back pain in young athletes: a practical approach. Sports Med 1991;12:394–406.

    Article  CAS  PubMed  Google Scholar 

  69. Kujala UM, Taimela S, Oksanen A, et al. Lumbar mobility and low back pain during adolescence: a longitudinal three-year follow-up study in athletes and controls. Am J Sports Med 1997;25:363–368.

    Article  CAS  PubMed  Google Scholar 

  70. Watkins RG. Lumbar disc injury in the athlete. Clin Sports Med 2002;21: 147–165.

    Article  PubMed  Google Scholar 

  71. Fredericson M, Salamancha L, Beaulieu C. Sacral stress fractures: tracking down nonspecific pain in distance runners. Physiciansportsmed 2003;31:31–32, 38, 40–42.

    Google Scholar 

  72. Rheumatology and miscellaneous clinical conditions. Adolesc Med 2003;14:499

    Google Scholar 

  73. Gregersen PK. Genetics of rheumatic diseases. In: Harris ED, Budd RC, Genovese MC, et al, editors. Kelly’s Textbook Of Rheumatology. 7th ed. Philadelphia: W.B. Saunders; 2005:276–294.

    Google Scholar 

  74. Rumball JS, Lebrun CM, Di Ciacca SR, et al. Rowing injuries. Sports Med 2005;35:537–555.

    Article  PubMed  Google Scholar 

  75. Scheuermann H: Kyfosis dorsalis juvenilis. Ugeskr Laeger 1920;82:385–393.

    Google Scholar 

  76. Lowe TG. Scheuermann’s disease. Orthop Clin North Am 1999;30:475–485.

    Article  CAS  PubMed  Google Scholar 

  77. Resnick D. Osteochondroses. In: Resnick D, ed. Bone and joint imaging. 2nd ed. Toronto: W.B. Saunders, 1996:960–977.

    Google Scholar 

  78. Simon LM, Jih W, Buller JC. Back pain and injuries. In: Birrer RB, Griesemer BA, Cataletto MB, eds. Pediatric Sports Medicine for Primary Care. Philadelphia: Lippincott Williams & Wilkins; 2002:306–325.

    Google Scholar 

  79. Sward L, Hellstrom M, Jacobsson B, et al. Vertebral ring apophysis injury in athletes: is the etiology different in the thoracic and lumbar spine? Am J Sports Med 1993;21:841–845.

    Article  CAS  PubMed  Google Scholar 

  80. d’Hemecourt PA, Micheli LJ. Back injuries in the young athlete. J Sports Traumatol Allied Sports Sci 1999;1:1–11.

    Google Scholar 

  81. King HA. Back pain in children. Orthop Clin North Am 1999;30:467–474.

    Article  CAS  PubMed  Google Scholar 

  82. DeBeliso MA, O’Shea JP, Harris C, et al. The relationship between trunk strength measures and lumbar disc deformation during stoop type lifting. Med Sci Sports Exerc 2003;35:(supplement) S134 (abstract).

    Google Scholar 

  83. Micheli LJ, Hall JE, Miller ME. Use of modified Boston back brace for back injuries in athletes. Am J Sports Med 1980;8:351–356.

    Article  CAS  PubMed  Google Scholar 

  84. Kothari NA. Imaging of musculoskeletal infections. Radiol Clin North Am 2001;39:653–671.

    Article  CAS  PubMed  Google Scholar 

  85. Frank G. Musculoskeletal infections in children. Pediatr Clin North Am 2005;52:1083–1106.

    Article  PubMed  Google Scholar 

  86. Thompson GH. The spine. In: Behrman RE, Kliegman RM, Jenson HB, eds. Behrman. Nelson Textbook of Pediatrics. 17th ed. Philadelphia: W.B. Saunders; 2004:2280–2288.

    Google Scholar 

  87. Mahboubi S, Morris MC. Imaging of spinal infections in children. Radiol Clin North Am 2001;39:215–222.

    Article  CAS  PubMed  Google Scholar 

  88. Fernandez M, Carrol C, Baker C. Discitis and vertebral osteomyelitis in children: an 18-year review. Pediatrics 2000;105:1299–1304.

    Article  CAS  PubMed  Google Scholar 

  89. Lampe RM. Osteomyelitis and suppurative arthritis. In: Behrman RE, Kliegman RM, Jenson HB, eds. Behrman. Nelson Textbook of Pediatrics. 17th ed. Philadelphia: W.B. Saunders; 2004:2297–2302.

    Google Scholar 

  90. Sassmannshausen G, Smith BG. Back pain in the young athlete. Clin Sports Med 2002;21:121–132.

    Article  PubMed  Google Scholar 

  91. Kaplan SL. Osteomyelitis in children. Infect Dis Clin North Am 2005;19:787–797.

    Article  PubMed  Google Scholar 

  92. Leeson MC, Makley JR, Carter JR. Metastatic skeletal disease in the pediatric population. J Pediatr Orthop 1985;5:261–267.

    CAS  PubMed  Google Scholar 

  93. Neff JR. Sarcomas of bone. In: Abeloff MD, Armitage JO, Niederhuber JE, et al., eds. Clinical Oncology. 3rd ed. Philadelphia: Churchill Livingston; 2004: 2471–2572.

    Google Scholar 

  94. Eismont FJ, Kitchel SH. Thoracolumbar spine. In: Delee JC, Drez DD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 2nd ed. Philadelphia: W.B. Saunders; 2003:1525–1576.

    Google Scholar 

  95. Micheli LJ, Mintzer CM. Overuse injuries of the spine. In: Harries M, Williams C, Stanish WD, et al, eds. Oxford Textbook of Sport Medicine. 2nd ed. New York: Oxford University Press; 1998:709–720.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Medicine, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada

    Merrilee Zetaruk MD, FRCPC (Associate Professor)

Authors
  1. Merrilee Zetaruk MD, FRCPC
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Harvard Medical School, USA

    Lyle J. Micheli MD (Clinical Professor, Director) (Clinical Professor, Director)

  2. Division of Sports Medicine, Children’s Hospital Boston, USA

    Lyle J. Micheli MD (Clinical Professor, Director) (Clinical Professor, Director)

  3. O’Donnell Family Professor of Orthopaedic Sports Medicine, Children’s Hospital Boston, Boston, Massachusetts, USA

    Lyle J. Micheli MD (Clinical Professor, Director) (Clinical Professor, Director)

  4. Departments of Internal Medicine, Pediatrics, and Family Medicine, Schulich School of Medicine at the University of Western Ontario, Canada

    Laura Purcell MSc, MD, FRCPC, FAAP, Dip Sport Med (Assistant Professor, Pediatric Emergency Consultant, Pediatric Sport Medicine Physician) (Assistant Professor, Pediatric Emergency Consultant, Pediatric Sport Medicine Physician)

  5. Children’s Hospital of Western Ontario, Canada

    Laura Purcell MSc, MD, FRCPC, FAAP, Dip Sport Med (Assistant Professor, Pediatric Emergency Consultant, Pediatric Sport Medicine Physician) (Assistant Professor, Pediatric Emergency Consultant, Pediatric Sport Medicine Physician)

  6. Fowler Kennedy Sport Medicine Clinic London, Ontario, Canada

    Laura Purcell MSc, MD, FRCPC, FAAP, Dip Sport Med (Assistant Professor, Pediatric Emergency Consultant, Pediatric Sport Medicine Physician) (Assistant Professor, Pediatric Emergency Consultant, Pediatric Sport Medicine Physician)

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Zetaruk, M. (2007). Lumbar Spine Injuries. In: Micheli, L.J., Purcell, L. (eds) The Adolescent Athlete. Springer, New York, NY. https://doi.org/10.1007/978-0-387-49825-6_6

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-49825-6_6

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-35964-9

  • Online ISBN: 978-0-387-49825-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation