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MRI 显示,与对照组相比,年轻精英滑雪运动员的椎间盘退变更为普遍。

Disc degeneration on MRI is more prevalent in young elite skiers compared to controls.

机构信息

Department of Radiology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, 41345, Gothenburg, Sweden.

Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2018 Jan;26(1):325-332. doi: 10.1007/s00167-017-4545-3. Epub 2017 Apr 13.

Abstract

PURPOSE

Evidence-based facts regarding spine abnormalities and back pain are needed in order to develop rehabilitation programs and prevent spine injuries in young skiers. The aim therefore is to identify MRI changes in the thoraco-lumbar spine and the lifetime prevalence of back pain, as well as the association between them, in young skiers compared to non-athletes.

METHODS

Seventy-five young elite alpine and mogul skiers, age range 16-20 years, were compared with 27 non-athletic controls. All subjects underwent spinal MRI and answered back pain questionnaires.

RESULTS

Fifty-six percent of skiers had at least one disc Pfirrmann grade ≥3 compared to 30% of controls (p = 0.027). Schmorl's nodes (46%) and disc height reduction (37%) were significantly more prevalent in skiers compared to controls (0%) (p < 0.001). When all parameters were combined together, skiers had significantly higher rate of radiological changes than controls, 82% compared to 54% (p = 0.007). The mean number of discs with Pfirrmann grade ≥3 was 1.1 per individual in skiers (median 1, range 0-6) versus 0.6 in controls (median 0, range 0-3). There was no significant difference in lifetime prevalence of back pain between skiers (50%) and controls (44%) (n.s.). MRI abnormalities in skiers did not correlate with lifetime prevalence of back pain. Skiers had a better health perception than controls (p = 0.026).

CONCLUSION

Alpine skiers have more degenerative disc changes compared to non-athletes, but these changes do not correlate with the lifetime prevalence of back pain. Lifetime prevalence of back pain is not significantly different between the groups; however, skiers report more severe pain on VAS score.

LEVEL OF EVIDENCE

II.

摘要

目的

为了制定康复计划和预防年轻滑雪者脊柱损伤,需要了解脊柱异常和背痛的循证事实。因此,本研究旨在确定年轻滑雪者与非运动员相比,胸腰椎 MRI 改变以及背痛的终身患病率及其之间的关联。

方法

将 75 名年龄在 16-20 岁的年轻高山和障碍滑雪精英运动员与 27 名非运动员对照组进行比较。所有受试者均接受脊柱 MRI 检查并回答背痛问卷。

结果

与对照组(30%)相比,56%的滑雪者至少有一个椎间盘 Pfirrmann 分级≥3(p=0.027)。与对照组(0%)相比,滑雪者的 Schmorl 结节(46%)和椎间盘高度降低(37%)更为常见(p<0.001)。当所有参数组合在一起时,与对照组相比,滑雪者的放射学改变发生率明显更高,为 82%比 54%(p=0.007)。滑雪者个体中 Pfirrmann 分级≥3 的椎间盘平均数量为 1.1 个(中位数 1,范围 0-6),而对照组为 0.6 个(中位数 0,范围 0-3)。滑雪者(50%)和对照组(44%)的背痛终身患病率无显著差异(n.s.)。滑雪者的 MRI 异常与背痛的终身患病率无相关性。滑雪者的健康感知优于对照组(p=0.026)。

结论

与非运动员相比,高山滑雪者的退行性椎间盘变化更多,但这些变化与背痛的终身患病率无关。两组之间背痛的终身患病率无显著差异;然而,滑雪者的 VAS 评分疼痛更严重。

证据等级

II。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9a/5754419/ed90d5e4f4b8/167_2017_4545_Fig1_HTML.jpg

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