Alyas F, Turner M, Connell D
Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, London, UK.
Br J Sports Med. 2007 Nov;41(11):836-41; discussion 841. doi: 10.1136/bjsm.2007.037747. Epub 2007 Jul 19.
OBJECTIVE: To describe magnetic resonance imaging (MRI) findings in the lumbar spine in asymptomatic elite adolescent tennis players, to serve as the baseline for a future prospective longitudinal cohort study. DESIGN: Observational study. SETTING: Institutional, national tennis centre. PARTICIPANTS: 33 asymptomatic elite adolescent tennis players, mean (SD) age, 17.3 (1.7) years (18 male, 15 female). METHODS: Sagittal T1, T2, STIR, and axial T2 weighted MRI images were reviewed for the presence of abnormalities by two radiologists in consensus. Abnormalities included disc degeneration, disc herniation, pars lesions (fracture or stress reaction), and facet joint arthropathy. RESULTS: Five players (15.2%) had a normal MRI examination and 28 (84.8%) had an abnormal examination. Nine players showed pars lesions (10 lesions; one at two levels) predominately at the L5 level (9/10, L5; 1/10, L4). Three of the 10 lesions were complete fractures; two showed grade 1 and one grade 2 spondylolisthesis, both of which resulted in moderate narrowing of the L5 exit foramen. There were two acute and five chronic stress reactions of the pars. Twenty three patients showed signs of early facet arthropathy occurring at L5/S1 (15/29 joints) and L4/5 (12/29 joints). These were classified as mild degeneration (20/29) and moderate degeneration (9/29), with 20/29 showing sclerosis and 24/29 showing hypertrophy of the facet joint. Synovial cysts were identified in 14 of the 29 joints. Thirteen players showed disc desiccation and disc bulging (mild in 13; moderate in two) most often at L4/5 and L5/S1 levels (12 of 15 discs). CONCLUSIONS: Abnormalities were frequent, predominately in the lower lumbar spine, almost exclusively at L4/5 and L5/S1 levels. Pars injuries and facet joint arthroses were relatively common.
目的:描述无症状青少年精英网球运动员腰椎的磁共振成像(MRI)表现,为未来的前瞻性纵向队列研究提供基线数据。 设计:观察性研究。 地点:机构性国家网球中心。 参与者:33名无症状青少年精英网球运动员,平均(标准差)年龄17.3(1.7)岁(男性18名,女性15名)。 方法:由两名放射科医生共同对矢状面T1、T2、短T1反转恢复(STIR)序列及横断面T2加权MRI图像进行审查,以确定是否存在异常。异常包括椎间盘退变、椎间盘突出、椎弓峡部病变(骨折或应力反应)以及小关节病。 结果:5名运动员(15.2%)MRI检查正常,28名(84.8%)检查异常。9名运动员显示椎弓峡部病变(10处病变;2处为两个节段),主要位于L5水平(10处中有9处;10处中有1处位于L4)。10处病变中有3处为完全骨折;2处显示I度、1处显示II度椎体滑脱,两者均导致L5神经根管中度狭窄。有2处急性和5处慢性椎弓峡部应力反应。23例患者显示L5/S1(15/29个关节)和L4/5(12/29个关节)出现早期小关节病迹象。这些被分类为轻度退变(20/29)和中度退变(9/29),其中20/29显示硬化,24/29显示小关节肥大。29个关节中有14个发现滑膜囊肿。13名运动员显示椎间盘脱水和椎间盘膨出(13例为轻度;2例为中度),最常发生于L4/5和L5/S1水平(15个椎间盘中有12个)。 结论:异常情况很常见,主要位于下腰椎,几乎均发生在L4/5和L5/S1水平。椎弓峡部损伤和小关节病相对常见。
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