Connolly Molly, Rotstein Andrew H, Roebert Justin, Grabinski Rafal, Malara Frank, O'Shea Tomas, Wood Tim, Omizzolo Melanie, Kovalchik Stephanie, Reid Machar
Institute for Health and Sport, Victoria University, Melbourne, Australia.
Performance, Tennis Australia, Melbourne, Australia.
Sports Med Open. 2020 Nov 25;6(1):57. doi: 10.1186/s40798-020-00285-4.
Lumbar spine abnormalities, in particular stress fractures to the pars interarticularis, are common in elite junior tennis players, though the difference in prevalence between males and females remains unclear. Further, facet joint orientation appears to be a possible option for recognizing which players might go on to present with a pars stress fracture. Given the link between pars stress fractures and low back pain in tennis players, it appears logical to explore the link between facet joint angle and pars abnormalities. Thus, the purpose of this study was to describe the prevalence of lumbar spine abnormalities and explore the relationship between facet joint orientation and pars abnormalities in elite adolescent tennis players.
Lumbar spine MRI images of 25 elite junior tennis players were obtained and distributed between five radiologists for analysis. Descriptive comparisons and confidence intervals were used to describe the prevalence of the abnormalities. A generalized linear regression model was conducted to investigate the relationship between lumbar pars abnormalities and lumbar facet joint angles.
Sixteen (64%) of 25 players were found to have at least one lumbar spine abnormality. Pars abnormalities affected 36% of players while bone marrow edema was found in 24% of players. Disc herniation, disc degeneration, and facet joint degeneration were diagnosed in 20%, 44%, and 24% of players respectively. Lastly, one player (4%) was diagnosed with spondylolisthesis. Females had significantly larger facet joint angles across L3/4 L5/S1 compared to males (p < 0.01). Further, those who had pars abnormalities had larger facet joint angles compared to those who did not (p < 0.001).
Disc degeneration, pars abnormalities, including bone marrow edema, and facet joint degeneration were common findings among elite adolescent tennis players. Additionally, this study is the first to discover that pars abnormalities are linked to facet joint angle in elite adolescent tennis players. This finding might assist in identifying tennis players at a greater risk of developing lumbar spine pars abnormalities in the future.
腰椎异常，尤其是关节突间部应力性骨折，在青少年精英网球运动员中很常见，不过男女患病率的差异仍不明确。此外，小关节方向似乎是识别哪些运动员可能会出现关节突应力性骨折的一个可行指标。鉴于网球运动员关节突应力性骨折与腰痛之间的联系，探索小关节角度与关节突异常之间的联系似乎是合理的。因此，本研究的目的是描述青少年精英网球运动员腰椎异常的患病率，并探讨小关节方向与关节突异常之间的关系。
获取了25名青少年精英网球运动员的腰椎MRI图像，并分发给五名放射科医生进行分析。采用描述性比较和置信区间来描述异常的患病率。进行广义线性回归模型以研究腰椎关节突异常与腰椎小关节角度之间的关系。
25名运动员中有16名（64%）被发现至少有一处腰椎异常。关节突异常影响了36%的运动员，而24%的运动员发现有骨髓水肿。分别有20%、44%和24%的运动员被诊断为椎间盘突出、椎间盘退变和小关节退变。最后，一名运动员（4%）被诊断为腰椎滑脱。与男性相比，女性在L3/4至L5/S1节段的小关节角度明显更大（p < 0.01）。此外，有关节突异常的运动员比没有关节突异常的运动员小关节角度更大（p < 0.001）。
椎间盘退变、包括骨髓水肿在内的关节突异常以及小关节退变是青少年精英网球运动员中的常见表现。此外，本研究首次发现青少年精英网球运动员的关节突异常与小关节角度有关。这一发现可能有助于识别未来发生腰椎关节突异常风险更高的网球运动员。
