Feuerriegel Georg C, Meyer Daniela, Fitze Daniel P, Hanimann Jonas, Stern Christoph, Schürmann Flavia, Fröhlich Stefan, Scherr Johannes, Spörri Jörg, Sutter Reto
Department of Radiology, Balgrist University Hospital, Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Am J Sports Med. 2025 Jan;53(1):202-209. doi: 10.1177/03635465241295384.
Overuse-related intersegmental abnormalities in the spine of competitive alpine skiers are common findings. However, longitudinal changes in intersegmental abnormalities and symptoms throughout adolescence have not been assessed.
To longitudinally assess and compare overuse-related spinal intersegmental abnormalities in adolescent competitive alpine skiers over 48 months and to compare magnetic resonance imaging (MRI) findings in asymptomatic and symptomatic skiers.
Case series; Level of evidence, 4.
Adolescent competitive alpine skiers were prospectively recruited between November 2108 and February 2019 and underwent 3-T MRI of the lumbar spine at baseline and after 48 months. All MRI scans were assessed for intersegmental changes of the intervertebral disk, vertebral body, and facet joints. At both time points, athletes' low back pain (LBP) symptoms were assessed via retrospective interviews relating to the 12-month period before the MRI study. Athletes were classified as symptomatic if at least 1 substantial episode of health problems related to back overuse had occurred in the 12 months before the MRI examination. The Wilcoxon signed-rank test and Pearson chi-square test were used to compare the measurements.
A total of 63 athletes (mean age at follow-up, 19.6 ± 1.2 years; 25 female) were included in the study. A significant increase in LBP affecting training and competition was observed at follow-up, with only 2 athletes reporting a history of spinal trauma (baseline, n = 13; follow-up, n = 20; = .04). Of the athletes with LBP (n = 27), 59% (n = 16) reported recurrent LBP, 15% (n = 4) reported permanent LBP, and 26% (n = 7) reported 1-time LBP since baseline. Assessment of intersegmental changes revealed a significant increase in the number of athletes with disk signal reduction (baseline, n = 10; follow-up, n = 21; = .001), disk bulging (baseline, n = 7; follow-up, n = 19; = .002), or disk herniation (follow-up, n = 2; = .04). Overall, intersegmental abnormalities did not correlate with LBP within the last year ( = .53).
Overuse-related intersegmental abnormalities of the lumbar spine are common in adolescent competitive alpine skiers and are often clinically silent at this age. These abnormalities may persist throughout skeletal maturation and even worsen during adolescence.
竞技高山滑雪运动员脊柱中与过度使用相关的节段间异常是常见的发现。然而，整个青春期节段间异常和症状的纵向变化尚未得到评估。
纵向评估和比较48个月内青少年竞技高山滑雪运动员与过度使用相关的脊柱节段间异常，并比较无症状和有症状滑雪者的磁共振成像（MRI）结果。
病例系列；证据等级，4级。
2018年11月至2019年2月前瞻性招募青少年竞技高山滑雪运动员，在基线和48个月后接受腰椎3-T MRI检查。所有MRI扫描均评估椎间盘、椎体和小关节的节段间变化。在两个时间点，通过回顾性访谈评估运动员在MRI研究前12个月期间的腰痛（LBP）症状。如果在MRI检查前12个月内至少发生过1次与背部过度使用相关的严重健康问题发作，则将运动员分类为有症状。使用Wilcoxon符号秩检验和Pearson卡方检验比较测量结果。
共有63名运动员（随访时平均年龄19.6±1.2岁；25名女性）纳入研究。随访时观察到影响训练和比赛的LBP显著增加，只有2名运动员报告有脊柱创伤史（基线时，n = 13；随访时，n = 20；P = 0.04）。在有LBP的运动员（n = 27）中，59%（n = 16）报告复发性LBP，15%（n = 4）报告持续性LBP，26%（n = 7）报告自基线以来有1次LBP。节段间变化评估显示，椎间盘信号降低（基线时，n = 10；随访时，n = 21；P = 0.001）、椎间盘膨出（基线时，n = 7；随访时，n = 19；P = 0.002）或椎间盘突出（随访时，n = 2；P = 0.04）的运动员数量显著增加。总体而言，节段间异常与过去一年的LBP无关（P = 0.53）。
与过度使用相关的腰椎节段间异常在青少年竞技高山滑雪运动员中很常见，且在这个年龄段通常临床上无症状。这些异常可能在骨骼成熟过程中持续存在，甚至在青春期恶化。
