Micheli L J, Wood R
Department of Orthopaedic Surgery, Harvard Medical School, Boston, Mass.
Arch Pediatr Adolesc Med. 1995 Jan;149(1):15-8. doi: 10.1001/archpedi.1995.02170130017004.
To determine whether there are significant differences in the causes of back pain in young athletes compared with the general adult population and to review the diagnosis and assessment of young athletic adolescent patients who present with this complaint.
Retrospective randomized case comparison study with two cohorts segregated by age and type of activity.
The adolescent sports medicine clinic of a children's hospital compared with the acute low back pain clinic of an orthopedic hospital.
One hundred adolescent athletes (aged 12 to 18 years; mean age, 15.8 years) with a chief complaint of low back pain were compared with 100 adults (aged 21 to 77 years; mean age, 31.9 years) with acute low back pain.
None.
MAIN OUTCOME MEASURES/RESULTS: Sixty-two percent of the adolescents had derangements of their posterior elements associated with the onset of back pain. Forty-seven percent of the 100 adolescents were ultimately shown to have a spondylolysis stress fracture of the pars interarticularis. By contrast, 5% of adult subjects were found to have spondylolysis associated with low back pain. Similarly, discogenic back pain was the final diagnosis in 48 of the 100 subjects in the adult group, while 11 of the 100 in the adolescent group had back pain attributable to disc abnormalities. Muscle-tendon strain accounted for back pain in 27% of the adults, while only 6% of the adolescents were diagnosed as having muscle-tendon strain. These differences were significant. Spinal stenosis and osteoarthritis as causes of back pain were encountered in 10% of the adults, while these conditions were not encountered in the children.
There is a significant differences in the major causes of low back pain in young athletes compared with causes of low back pain in the general adult population. Physicians diagnosing back pain in young athletes must have a specific understanding of these differences to avoid incorrect diagnosis and harmful delays in proper treatment.
确定与普通成年人群相比，年轻运动员背痛的病因是否存在显著差异，并回顾出现该症状的年轻运动青少年患者的诊断和评估情况。
回顾性随机病例对照研究，按年龄和活动类型将两个队列分开。
儿童医院的青少年运动医学诊所与骨科医院的急性腰痛诊所。
100名以腰痛为主诉的青少年运动员（年龄12至18岁；平均年龄15.8岁）与100名急性腰痛的成年人（年龄21至77岁；平均年龄31.9岁）进行比较。
无。
主要观察指标/结果：62%的青少年背痛发作与后部结构紊乱有关。100名青少年中最终有47%被证实存在关节突间部峡部裂应力性骨折。相比之下，5%的成年受试者被发现患有与腰痛相关的峡部裂。同样，椎间盘源性背痛是成年组100名受试者中48人的最终诊断，而青少年组100人中只有11人因椎间盘异常导致背痛。肌肉 - 肌腱劳损在27%的成年人中导致背痛，而只有6%的青少年被诊断为肌肉 - 肌腱劳损。这些差异具有统计学意义。10%的成年人因脊柱狭窄和骨关节炎导致背痛，而儿童中未发现这些情况。
与普通成年人群相比，年轻运动员腰痛的主要病因存在显著差异。诊断年轻运动员背痛的医生必须对这些差异有具体的认识，以避免错误诊断和适当治疗的有害延误。
