Bennett D Lee, Nassar Lawrence, DeLano Mark C
University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Department of Radiology, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Skeletal Radiol. 2006 Jul;35(7):503-9. doi: 10.1007/s00256-006-0083-7. Epub 2006 Mar 7.
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.
以往研究表明，竞技体操女运动员椎间盘退变和脊柱损伤有所增加。然而，也有研究表明，许多这些发现也存在于同龄无症状的运动员中。以往评估体操运动员脊柱的磁共振成像（MRI）研究并未区分有症状和无症状的运动员。我们的假设是，MRI 将在有症状和无症状的体操运动员中显示相同类型的异常。
对奥运水平的女子体操运动员进行腰椎 MRI 前瞻性检查。每位体操运动员在 MRI 检查前由运动医学医生进行体格检查，以记录下背痛情况。对每次 MRI 检查评估前侧骨突环撕脱伤、椎体压缩畸形、椎弓根峡部裂、椎体滑脱、退行性疾病、局灶性椎间盘突出/脱出、肌肉拉伤、硬膜外肿块和骨髓水肿。
本研究前瞻性评估了 19 名奥运水平的女子体操运动员（年龄 12 - 20 岁）。所有这些体操运动员在参加特定训练营期间接受评估。
前环骨突损伤（9/19）和椎间盘退变疾病（12/19）很常见。发现椎弓根峡部裂（3/19）和椎体滑脱（3/19）。一名体操运动员的 L3 双侧椎弓根发现局灶性骨髓水肿。病史和体格检查显示，4 名体操运动员在成像时有当前下背痛。有症状的运动员存在以下情况：椎体滑脱、椎弓根峡部裂、双侧椎弓根骨髓水肿和肌肉拉伤。
我们最初的假设未得到证实，因为存在仅局限于精英水平有症状的女子体操运动员组的发现。
