Department of Surgical and Perioperative Sciences, Sports Medicine Unit Umeå University, Umeå, Sweden.
Int J Sports Med. 2013 Mar;34(3):263-7. doi: 10.1055/s-0032-1321723. Epub 2012 Oct 1.
Symptomatic spondylolysis is a stress reaction caused by microtrauma during physical exercise, an imaging diagnostic subgroup of Adolescent Low Back Pain (ALBP), found in adolescent athletes. Early diagnosis increases the possibility of healing. Thus, it is important to divide ALBP into subgroups. The aim of this study was to evaluate clinical tests that can distinguish symptomatic spondylolysis from other forms of ALBP in order to facilitate early referral for diagnostic imaging. The investigation subjects were a prospective case series with a control group, 25 subjects with ALBP and 13 subjects that had no history of LBP. The 2 groups were examined using the same clinical protocol. MRI of the whole lumbar spine was performed in both the case and control groups and CT investigations of the L4 and L5 vertebrae were performed in the case group. Significant differences between the 2 groups were found in 8 of our clinical tests. No clinical test, alone or in combination, could distinguish between spondylolysis and other forms of ALBP. As 88% of the subjects in the case group had MRI findings and almost 50% had spondylolysis, MRI should be performed at an early age in young athletes with ALBP.
症状性脊椎裂是运动中微创伤引起的一种应激反应，是青少年下腰痛（ALBP）的影像学诊断亚组，在青少年运动员中发现。早期诊断可增加治愈的可能性。因此，将 ALBP 分为亚组很重要。本研究旨在评估可以将症状性脊椎裂与其他形式的 ALBP 区分开来的临床检查，以便更方便地进行诊断性影像学检查。研究对象为前瞻性病例系列对照研究，共 25 例 ALBP 患者和 13 例无下腰痛病史的患者。两组均采用相同的临床方案进行检查。对病例组和对照组进行了整个腰椎的 MRI 检查，对病例组的 L4 和 L5 椎体进行了 CT 检查。在我们的 8 项临床检查中，两组有 8 项存在显著差异。没有任何一项临床检查（单独或联合使用）可以区分脊椎裂和其他形式的 ALBP。由于病例组 88%的患者有 MRI 发现，几乎 50%的患者有脊椎裂，因此，对于有 ALBP 的年轻运动员，应在早期进行 MRI 检查。
