Peterhans Loris, Fröhlich Stefan, Stern Christoph, Frey Walter O, Farshad Mazda, Sutter Reto, Spörri Jörg
Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Orthop J Sports Med. 2020 May 29;8(5):2325967120922554. doi: 10.1177/2325967120922554. eCollection 2020 May.
Alpine ski racing is known as a sport with unfavorable spinal loads and high rates of back overuse injuries at the elite level. However, little is known about overuse-related structural abnormalities occurring in the spine of youth athletes.
To describe the prevalence of abnormal magnetic resonance imaging (MRI) findings in the lumbar spine of youth competitive alpine skiers within the U16 category (under 16 years) with respect to sex, height growth, multifidus size, increasing age, and clinical relevance.
Cross-sectional study; Level of evidence, 3.
A total of 108 youth competitive alpine skiers aged 13 to 15 years underwent MRI examination of the lumbar spine and measurement of the multifidus cross-sectional area on a 3-T Magnetom Prisma scanner. Complementary assessments included the determination of anthropometrics and biological maturation. Athletes were classified as symptomatic when, pursuant to the Oslo Sports Trauma Research Center questionnaire on health problems, at least 1 substantial back overuse-related health problem episode had been registered during the 12 months before the MRI examination.
Of the analyzed youth skiers, 37.0% presented with ≥1 abnormal MRI finding in the lumbar spine. The most prevalent findings in both sexes were disc degeneration (23.1%), Schmorl nodes (19.4%), end plate changes (10.2%), and pars interarticularis anomalies (10.2%); the pars interarticularis anomalies occurred exclusively in males. A smaller relative lumbar multifidus cross-sectional area was related to more frequent occurrence of disc protrusions ( = .018; = 0.116) and end plate changes ( = .024; = 0.096). Overall, the occurrence of abnormal MRI findings in the lumbar spine increased with age ( = .034; = 0.054). Disc degeneration (particularly disc dehydration and disc protrusion) were significantly more prevalent in symptomatic versus asymptomatic athletes ( < .05 for all).
As early as age 15 years or younger, competitive alpine skiers demonstrated distinct overuse-related structural abnormalities in the lumbar spine, with some of them being clinically relevant and restrictive of sports participation. As sex, height growth, multifidus size, and increasing age seem to play an important role for the occurrence of such abnormalities, considering these factors might be essential for prevention.
高山滑雪比赛是一项脊柱负荷不利且在精英水平上背部过度使用损伤发生率较高的运动。然而，对于青少年运动员脊柱中与过度使用相关的结构异常却知之甚少。
描述16岁以下（U16组）青少年竞技高山滑雪运动员腰椎磁共振成像（MRI）异常表现的患病率，涉及性别、身高增长、多裂肌大小、年龄增长以及临床相关性。
横断面研究；证据等级，3级。
总共108名年龄在13至15岁的青少年竞技高山滑雪运动员接受了腰椎MRI检查，并在3T Magnetom Prisma扫描仪上测量了多裂肌的横截面积。补充评估包括人体测量学和生物成熟度的测定。根据奥斯陆运动创伤研究中心关于健康问题的问卷，如果运动员在MRI检查前12个月内至少记录到1次与背部过度使用相关的严重健康问题发作，则被归类为有症状。
在分析的青少年滑雪运动员中，37.0%的人腰椎MRI有≥1项异常表现。男女最常见的表现是椎间盘退变（23.1%）、施莫尔结节（19.4%）、终板改变（10.2%）和关节突间部异常（10.2%）；关节突间部异常仅发生在男性中。相对较小的腰椎多裂肌横截面积与椎间盘突出（P = 0.018；r = 0.116）和终板改变（P = 0.024；r = 0.096）的更频繁发生有关。总体而言，腰椎MRI异常表现的发生率随年龄增长而增加（P = 0.034；r = 0.054）。有症状的运动员与无症状的运动员相比，椎间盘退变（特别是椎间盘脱水和椎间盘突出）明显更普遍（所有P < 0.05）。
早在15岁及以下，竞技高山滑雪运动员就表现出腰椎明显的与过度使用相关的结构异常，其中一些在临床上具有相关性并限制运动参与。由于性别、身高增长、多裂肌大小和年龄增长似乎对这些异常的发生起重要作用，考虑这些因素可能对预防至关重要。
