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Nakagawa Y, Mukai S, Miyata M, Minami K, Hattori Y, Yamagishi H. Radiological Findings of the Lumbar Spine in High School and Collegiate Sumo Wrestlers. Orthop J Sports Med 2023; 11:23259671231206712. [PMID: 37941889 PMCID: PMC10629334 DOI: 10.1177/23259671231206712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/19/2023] [Indexed: 11/10/2023] Open
Abstract
Background Sumo wrestling is a traditional sport in Japan and becoming popular worldwide. Risk factors for lower back injuries in sumo wrestlers are heavier weight and larger body mass index (BMI). The mawashi (loincloth belt) worn by sumo wrestlers has been shown to restrict motion of the lumbar spine. Purpose To study the effects of sumo wrestling on the lumbar spine of high school and freshmen collegiate wrestlers, investigating the relationship between radiological findings, wearing of the mawashi during training, and lower back symptoms. Study Design Case series; Level of evidence, 4. Methods From 2001 to 2017, a total of 197 members of the Japanese Sumo Federation (55 high school and 142 college freshman students) underwent routine radiographic examination of their lumbar spines and answered a questionnaire regarding lumbar symptoms. Wrestlers were classified as symptomatic and asymptomatic based on responses to a custom questionnaire. We used the unpaired t test to evaluate patient demographics and the chi square test to analyze radiographic lumbar spine abnormalities between symptomatic and asymptomatic wrestlers. Results The wrestlers' mean height, weight, BMI, and duration in the sport were 174.0 ± 6.7 cm, 107.1 ± 22.4 kg, 35.2 ± 6.4, and 8.0 ± 3.2 years, respectively. There were 91 participants in the symptomatic group (46.2%) and 106 (53.8%) in the asymptomatic group. Ten wrestlers (5.1%) had osteophyte formations in the lumbar body; 8 of the 11 osteophytes (72.7%) appeared in the upper lumbar spine. Of the total, 48 wrestlers (24.4%) had deformities (Schmorl nodules) in the lumbar body, and 23 of 50 (46.0%) and 10 of 16 (62.5%) deformities were found in the upper lumbar spine of collegiate and high school wrestlers, respectively. Five wrestlers of the total 197 athletes (2.5%) had disc space narrowing in the lumbar body, with 3 of the 5 cases of disc space narrowing (60.0%) found in the upper lumbar spine. Spondylolysis in the lumbar body was found in 25 wrestlers (12.7%); 19 of the 91 symptomatic wrestlers (20.9%) had spondylolysis, compared with 6 of the 106 (5.7%) asymptomatic wrestlers (P = .0028). Conclusion Almost one-third of sumo wrestlers had ≥1 abnormal radiological finding in the lumbar spine. There was a significant relationship between symptomatic wrestlers and spondylolysis.
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Affiliation(s)
- Yasuaki Nakagawa
- Clinical Research Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of Orthopaedic Surgery, Japan Baptist Medical Foundation, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Masahiko Miyata
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Kazufumi Minami
- Department of Orthopedic Surgery, International University of Health and Welfare, Tokyo, Japan
| | | | - Hiroya Yamagishi
- Department of Chest Surgery, Japanese Red Cross Fukui Hospital Fukui, Japan
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Ross R, Han J, Slover J. Chronic Lower Back Pain in Weight Lifters: Epidemiology, Evaluation, and Management. JBJS Rev 2023; 11:01874474-202306000-00011. [PMID: 37315158 DOI: 10.2106/jbjs.rvw.22.00228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
» Chronic lower back pain (LBP) is common in both nonathletes and weight lifters, but the diagnosis and treatment should be approached differently in these 2 populations based on the unique movement patterns causing the pain.» Injury rates of weight lifters are far less than those of contact sports, ranging from 1.0 to 4.4 injuries per 1,000 workout hours. However, the lower back was consistently one of the top 2 injury sites for weight lifters, accounting for anywhere from 23% to 59% of all injuries. LBP was most often associated with the squat or deadlift.» Guidelines for evaluating general LBP are applicable to weight lifters, including a thorough history and physical examination. However, the differential diagnosis will change based on the patient's lifting history. Of the many etiologies of back pain, weight lifters are most likely to be diagnosed with muscle strain or ligamentous sprain, degenerative disk disease, disk herniation, spondylolysis, spondylolisthesis, or lumbar facet syndrome.» Traditional recommended therapies include nonsteroidal anti-inflammatory drugs, physical therapy, and activity modification, which are often insufficient to resolve pain and prevent injury recurrence. Because most athletes will want to continue to lift weights, lifting-specific behavior modifications focused on improved technique and correcting mobility and muscular imbalances are important aspects of management in this patient population.
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Affiliation(s)
- Ruby Ross
- NYU Grossman School of Medicine, New York, New York
| | - Julie Han
- NYU Grossman School of Medicine, New York, New York
| | - James Slover
- NYU Grossman School of Medicine, New York, New York
- Lenox Hill Hospital, New York, New York
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Wan ZY, Zhang J, Shan H, Liu TF, Song F, Samartzis D, Wang HQ. Epidemiology of Lumbar Degenerative Phenotypes of Children and Adolescents: A Large-Scale Imaging Study. Global Spine J 2023; 13:599-608. [PMID: 33843321 DOI: 10.1177/21925682211000707] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE Recently, there has been a rise in children and adolescents developing low back pain and/or sciatica. Degenerative lumbar spine MRI phenotypes can occur in this population but reports have been sporadic and the true incidence of such spine changes remains debatable. As such, the study aimed to address the epidemiology of MRI phenotypes of the lumbar spine in this young population. METHODS 597 children and adolescents with lumbar MRIs were included in the study. T1- and T2-weighted lumbar images from L1/2 to L5/S1 were analyzed in axial and sagittal planes. Global phenotype assessment was performed of each level and based on established nomenclature protocols. RESULTS The cohort consisted of 57.3% (342) boys and 42.7% (255) girls, with a mean age of 10.75 ± 5.25 years (range: 0 to 18 years). The prevalence of imaging findings of lumbar disc degeneration (LDD) and lumbar disc herniation (LDH) were 2.2% (95% CI: 0.93-3.43) and 5.8% (95%CI: 2.58-8.99), respectively. There was significant difference between each disc segment from L1/2 to L5/S1 for both LDD and LDH. Schmorl's nodes were noted in 16 cases (2.7%, youngest case as 15 years), with 11 boys (68.8%) and most frequent segment as L3/4. Modic changes and high-intensity zones were absent in this cohort. CONCLUSIONS LDD can emerge as early as the first decade of life with Schmorl's nodes, without additional specific phenotypes, including Modic changes and high-intensity zones. The study provides valuable information of a unique age group that is often under-represented but equally important as adults.
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Affiliation(s)
- Zhong-Yuan Wan
- Department of Orthopedics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Jun Zhang
- Department of Orthopedics, Baoji Central Hospital, Baoji, Shaanxi Province, People's Republic of China
| | - Hua Shan
- Institute of Integrative Medicine, 107652Shaanxi University of Chinese Medicine, Xi'an, Shaanxi Province, People's Republic of China
| | - Tang-Fen Liu
- Institute of Integrative Medicine, 107652Shaanxi University of Chinese Medicine, Xi'an, Shaanxi Province, People's Republic of China
| | - Fang Song
- Department of Stomatology, PLA Rocket Force Characteristic Medical Center, Beijing, People's Republic of China
| | - Dino Samartzis
- Department of Orthopaedic Surgery, 2468Rush University Medical Center, Chicago, IL, USA
| | - Hai-Qiang Wang
- Institute of Integrative Medicine, 107652Shaanxi University of Chinese Medicine, Xi'an, Shaanxi Province, People's Republic of China
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Identeg F, Lagerstrand K, Hedelin H, Senorski EH, Sansone M, Hebelka H. Low occurrence of MRI spinal changes in elite climbing athletes; a cross-sectional study. BMC Sports Sci Med Rehabil 2023; 15:29. [PMID: 36895033 PMCID: PMC9999554 DOI: 10.1186/s13102-023-00637-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVES To examine the occurrence of magnetic resonance imaging (MRI) changes in the thoracolumbar spine among elite climbing athletes. METHODS All climbers of the Swedish national sport climbing team (n = 8), and individuals having trained for selection to the national team (n = 11), were prospectively included. A control group, matched in age and sex, were recruited. All participants underwent a thoracolumbar MRI (1.5 T, T1- and T2-weighted imaging), evaluated according to Pfirrmann classification, modified Endplate defect score, Modic changes, apophyseal injuries and spondylolisthesis. Pfirrmann ≥ 3, Endplate defect score ≥ 2 and Modic ≥ 1 was defined as degenerative findings. RESULTS Fifteen individuals, 8 women, participated in both the climbing group (mean age 23.1, SD 3.2 years) and the control group respectively (mean age 24.3, SD 1.5 years). In the climbing group, 6.1% of the thoracic and 10.6% of the lumbar intervertebral discs showed signs of degeneration according to Pfirrmann. One disc with a grade above 3 was present. Modic changes in the thoracic/lumbar spine were prevalent in 1.7%/1.3% of the vertebrae. Degenerative endplate changes according to the Endplate defect score were found in 8.9% and 6.6% of the thoracic and lumbar spinal segments of the climbing group, respectively. Two apophyseal injuries were found, while no participants displayed signs of spondylolisthesis. There was no difference in point-prevalence of radiographic spinal changes between climbers and controls (0.07 < p < 1.0). CONCLUSION In this small cross-sectional study, only a low proportion of elite climbers displayed changes of the spinal endplates or intervertebral discs, as opposed to other sports with high spinal loads. Most observed abnormalities were low grade degenerative changes and did not differ statistically compared to controls.
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Affiliation(s)
- Fredrik Identeg
- Department of Orthopaedics, Gothenburg, Sweden. .,Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Kerstin Lagerstrand
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Hedelin
- Department of Orthopaedics, Gothenburg, Sweden.,Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eric Hamrin Senorski
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Sansone
- Department of Orthopaedics, Gothenburg, Sweden.,Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hanna Hebelka
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Letter to the Editor concerning "The influence of spinal position on imaging findings: an observational study of thoracolumbar spine upright MRI in elite gymnasts" by Fawcett L, et al. (Eur Spine J [2022]; 31(2):225-232). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:746. [PMID: 36574071 DOI: 10.1007/s00586-022-07503-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 03/30/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022]
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Answer to the Letter to the Editor of V. Kumar et al. concerning "The influence of spinal position on imaging findings: an observational study of thoracolumbar spine upright MRI in elite gymnasts" by Fawcett L, et al. (Eur Spine J [2022]; 31(2):225-232). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:747-748. [PMID: 36595135 DOI: 10.1007/s00586-022-07511-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/04/2023]
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Enoki S, Kuramochi R, Takigawa H, Nakayama K, Mitsuyama H. Comparison of maximum joint angles during pole vaulting between male pole vaulters with and without lumbar disc degeneration or lumbar spondylolysis. J Back Musculoskelet Rehabil 2022; 36:629-636. [PMID: 36530070 DOI: 10.3233/bmr-210331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pole vaulting involves trunk flexion, extension, and rotation, which may place the lumbar spine under stress. Repeated pole vaulting may cause lumbar disc degeneration (DD) and lumbar spondylolysis (LS); however, this phenomenon is yet to be established. OBJECTIVE This study aimed to determine the difference in the maximum joint angles of the shoulder, hip, and trunk during pole vaulting between male pole vaulters with and without lumbar DD or LS. METHODS This retrospective study included 17 male pole vaulters. Four high-speed cameras were used to record the pole vaulters at 240 Hz. Radiography and magnetic resonance imaging were used to examine the lumbar spine in all athletes. Differences in the data between two sets of groups were analyzed using the unpaired t-test or the Mann-Whitney U test. RESULTS There was a significant difference in the maximum joint angle of hip flexion between pole vaulters with and without lumbar DD (p= 0.03). CONCLUSION Pole vaulters with lumbar DD may use lumbar flexion instead of hip flexion during the rock-back movement. Moreover, LS may occur due to repeated failed vaulting. Therefore, trunk stability and functional movements should be prioritized to prevent organic changes in the lower back.
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Affiliation(s)
- Shota Enoki
- School of Health and Sport Sciences, Chukyo University, Toyota, Aichi, Japan
| | - Rieko Kuramochi
- School of Health and Sport Sciences, Chukyo University, Toyota, Aichi, Japan.,Graduate School of Health and Sport Sciences, Chukyo University, Toyota, Aichi, Japan
| | - Hiroko Takigawa
- School of Health and Sport Sciences, Chukyo University, Toyota, Aichi, Japan
| | - Koichi Nakayama
- Graduate School of Health and Sport Sciences, Chukyo University, Toyota, Aichi, Japan
| | - Hirohito Mitsuyama
- School of Health and Sport Sciences, Chukyo University, Toyota, Aichi, Japan.,Graduate School of Health and Sport Sciences, Chukyo University, Toyota, Aichi, Japan.,Department of Orthopedic Surgery, Yoshida Orthopedic Hospital, Toyota, Aichi, Japan
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Yokoe T, Tajima T, Yamaguchi N, Nagasawa M, Morita Y, Chosa E. The Results of Orthopaedic Medical Examinations in Adolescent Amateur Weightlifters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13947. [PMID: 36360830 PMCID: PMC9657830 DOI: 10.3390/ijerph192113947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Few studies have reported injuries and physical characteristics in adolescent weightlifters. The purpose of this study was to report the results of orthopaedic medical examinations in adolescent amateur weightlifters that were performed cross-sectionally from 2012 to 2019. The orthopaedic medical examination included physical examinations, generalized joint laxity, muscle and joint tightness, static alignment, muscle volume of the lower extremities, and medial longitudinal arch of the foot (the height from the tip of the navicular tubercle to the ground surface). A questionnaire survey regarding pain in the spine and lower extremities was also performed. A total of 99 adolescent weightlifters were included (male/female, 71/28; mean age, 16.2 ± 0.2 years). A total of 9.1% had received orthopaedic treatments, with spine injuries being the most prevalent. Of those who had not received orthopaedic treatments, 31.1% had pain in the spine or lower extremities (for >4 weeks). There were no significant gender differences in the incidence of pain or positive findings of physical examinations. Female weightlifters had a more reduced dorsiflexion of the ankle joint than male weightlifters (p = 0.02). Male weightlifters had a lower flexibility of the quadriceps than female weightlifters. The results of orthopaedic medical examinations in this study may help clinicians and young weightlifters to prevent injuries in competitive weightlifting.
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Affiliation(s)
- Takuji Yokoe
- Correspondence: ; Tel.: +81-985-85-0986; Fax: +81-985-84-2931
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Carmody S, Rajeswaran G, Mitchell A, Kryger KO, Ahmad I, Gill M, Rushton A. Lumbar spine MRI findings in asymptomatic elite male academy footballers: a case series. BMC Sports Sci Med Rehabil 2022; 14:184. [PMID: 36280886 PMCID: PMC9590204 DOI: 10.1186/s13102-022-00576-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/15/2022] [Indexed: 11/20/2022]
Abstract
Background Understanding common MRI findings may allow clinicians to appreciate the sport-specific effects on the lumbar spine, and to discern clinically significant pathology. Prevalence data regarding radiological abnormalities seen during the surveillance of asymptomatic elite footballers is, therefore, important to help understand injury mechanisms and to prevent associated injuries. The purpose of this study was to evaluate the magnetic resonance imaging (MRI) findings in the lumbar spines of asymptomatic elite male adolescent footballers. Methods A prospective case-series study was carried out. MRI was performed using a 3T Siemens Prisma scanner including a 3D VIBE sequence in 18 asymptomatic male elite adolescent footballers recruited from a professional academy in England (mean age 17.8, range 16.9–18.6 years). The images were independently reported by two consultant musculoskeletal radiologists to achieve consensus opinion. Standardised classification criteria were used to assess and report abnormalities descriptively. Results Fifteen players (15/18, 83%) showed ≥1 abnormalities, included facet degeneration, synovial cysts, disc degeneration, disc herniation, and pars injury. One player (1/18, 6%) had mild (Grade 1) facet joint arthropathy at L4/L5 and 3/18 (16.7%) showing evidence of bilateral facet joint effusions. Three synovial cysts were identified in 2/18 players (11%), 4/18 players (22%) presented asymptomatic pars injuries, with 4 showing a grade 2 subtotal stress fracture and 1 player a grade 4 chronic stress fracture seen on 3D VIBE sequencing. Disc degeneration at one or more levels was demonstrated in 7/18 players (38%). Disc herniation was present in 5/18 players (27%). Conclusion A range of unsuspected findings on MRI of the lumbar spine are common in elite adolescent footballers.
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Affiliation(s)
- Sean Carmody
- grid.6572.60000 0004 1936 7486School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK ,grid.7177.60000000084992262Amsterdam UMC location, University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, Amsterdam, The Netherlands
| | | | | | - Katrine Okholm Kryger
- grid.417907.c0000 0004 5903 394XFaculty of Sport, Allied Health and Performance Science, St Mary’s University, Twickenham, London, UK
| | - Imtiaz Ahmad
- Medical Department, Queens Park Rangers Football and Athletic Club, London, UK
| | - Munraj Gill
- grid.411616.50000 0004 0400 7277Croydon University Hospital, Croydon, UK
| | - Alison Rushton
- grid.6572.60000 0004 1936 7486School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK ,grid.6572.60000 0004 1936 7486Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Wall J, Meehan WP, Trompeter K, Gissane C, Mockler D, van Dyk N, Wilson F. Incidence, prevalence and risk factors for low back pain in adolescent athletes: a systematic review and meta-analysis. Br J Sports Med 2022; 56:1299-1306. [PMID: 36150752 DOI: 10.1136/bjsports-2021-104749] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate the incidence, prevalence, risk factors and morphological presentations of low back pain (LBP) in adolescent athletes. DESIGN Systematic review with meta-analysis. DATA SOURCES Medline, Embase, CINAHL via EBSCO, Web of Science, Scopus. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies evaluating the incidence and/or prevalence of LBP in adolescent athletes across all sports. RESULTS There were 80 studies included. The pooled incidence estimate of LBP in adolescent athletes was 11% (95% CI 8% to 13%, I2=0%) for 2 years, 36.0% (95% CI 4% to 68%, I2=99.3%) for 12 months and 14% (95% CI 7% to 22%, I2=76%) for 6 months incidence estimates. The pooled prevalence estimate of LBP in adolescent athletes was 42% (95% CI 29% to 55%, I2=96.6%) for last 12 months, 46% (95% CI 41.0% to 52%, I2=56%) for last 3 months and 16% (95% CI 9% to 23%, I2=98.3%) for point prevalence. Potential risk factors were sport participation, sport volume/intensity, concurrent lower extremity pain, overweight/high body mass index, older adolescent age, female sex and family history of LBP. The most common morphology reported was spondylolysis. Methodological quality was deemed high in 73% of cross-sectional studies and in 30% of cohort studies. Common reasons for downgrading at quality assessment were use of non-validated survey instruments and imprecision or absence of LBP definition. SUMMARY/CONCLUSION LBP is common among adolescent athletes, although incidence and prevalence vary considerably due to differences in study methodology, definitions of LBP and data collection. PROSPERO REGISTRATION NUMBER CRD42020157206.
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Affiliation(s)
- Julia Wall
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | - William P Meehan
- The Micheli Center for Sports Injury Prevention, Division of Sports Medicine, Boston Children's Hospital, Waltham, Massachusetts, USA
| | - Katharina Trompeter
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit Bochum, Bochum, Nordrhein-Westfalen, Germany.,Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Conor Gissane
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | - David Mockler
- John Stearne Medical Library, Trinity College Dublin, Dublin, Ireland
| | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Fiona Wilson
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
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Ahmed S, Rashid M, Sarkar AS, Islam MJ, Akter R, Rahman M, Islam S, Sheel D, Polash SA, Akter M, Afride S, Kader M. Fitness Trainers' Educational Qualification and Experience and Its Association with Their Trainees' Musculoskeletal Pain: A Cross-Sectional Study. Sports (Basel) 2022; 10:sports10090129. [PMID: 36136384 PMCID: PMC9501401 DOI: 10.3390/sports10090129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/14/2022] [Accepted: 08/25/2022] [Indexed: 12/04/2022] Open
Abstract
This is a cross-sectional study that examined the association between fitness trainers’ educational qualifications and experience, and the risk of their trainees’ musculoskeletal pain. The study included 1177 trainees (aged 15−60 years) from 74 fitness centers in Bangladesh. Data were collected by using the Nordic musculoskeletal questionnaire, including potential confounders such as demographic factors (e.g., age, occupation), and training-related factors (e.g., workout knowledge, overweight lifting). Multiple logistic regression was performed for a binary outcome (pain—yes or no), and a generalized linear model was fitted for the ordinal outcome (pain—sites of the body). The trainers’ lower experience (no or ≤1 year) was associated with higher odds of their trainees’ musculoskeletal pain (OR: 2.53, 95% CI: 1.18−5.44) compared to trainers with >5 years of experience; however, no association was found between the trainers’ education and the risk of their trainees’ musculoskeletal pain, after controlling for potential confounders. Similarly, the trainees trained by trainers with lower experience had more than two-time the risk of having pain in different sites (IRR: 2.04, 95% CI: 1.50−2.79). The trainers’ experience may play a pivotal role in the trainees’ musculoskeletal pain. Further study is warranted in this regard.
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Affiliation(s)
- Sohel Ahmed
- Department of Physiotherapy & Rehabilitation, Mount Adora Hospital, Akhalia, Sylhet 3100, Bangladesh
- Physiotherapy Research Foundation, Akhalia, Sylhet 3100, Bangladesh
| | - Mamunur Rashid
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen, 80176 Gävle, Sweden
- Correspondence:
| | - Abu-sufian Sarkar
- Bashundhara Kings Football Club, Block: D, Bashundhara R/A, Dhaka 1229, Bangladesh
| | - Mohammad Jahirul Islam
- Department of Physical Medicine and Rehabilitation, M A G Osmani Medical College Hospital, Sylhet 3100, Bangladesh
| | - Rahemun Akter
- Department of Physiotherapy & Rehabilitation, Mount Adora Hospital, Akhalia, Sylhet 3100, Bangladesh
- Physiotherapy Research Foundation, Akhalia, Sylhet 3100, Bangladesh
| | - Masudur Rahman
- Dream Physiotherapy and Rehabilitation Center, Paikpara, Barhmanbaria 3400, Bangladesh
| | - Shahana Islam
- Department of Physiotherapy, CB Hospital Ltd., Polashpole, Satkhira 9400, Bangladesh
| | - Devjanee Sheel
- Department of Physiotherapy, Shiekh Fazilatunnessa Mujib Memorial KPJ Specialized Hospital, Gazipur 1700, Bangladesh
| | - Sarwar Alam Polash
- Gonoshasthay Somajvittik Physiotherapy College, Mirzanagar, Saver, Dhaka 1344, Bangladesh
| | - Mahfuza Akter
- Department of Physiotherapy, Caritas Bangladesh, Ashulia, Saver, Dhaka 1344, Bangladesh
| | - Shayed Afride
- Gonoshasthay Somajvittik Physiotherapy College, Mirzanagar, Saver, Dhaka 1344, Bangladesh
| | - Manzur Kader
- Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institutet, 17176 Stockholm, Sweden
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Incidence and temporal changes in lumbar degeneration and low back pain in child and adolescent weightlifters: A prospective 5-year cohort study. PLoS One 2022; 17:e0270046. [PMID: 35767547 PMCID: PMC9242517 DOI: 10.1371/journal.pone.0270046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 06/02/2022] [Indexed: 11/19/2022] Open
Abstract
This study was conducted to investigate the incidence of lumbar degeneration findings and low back pain (LBP) in children and adolescent weightlifters using magnetic resonance imaging (MRI) and medical questionnaires over a 5-year period. Moreover, we aimed to reveal the temporal changes in the lumbar vertebrae caused by long-term weightlifting training during the growth period. Twelve children and adolescent weightlifters who participated in weightlifting for >2 years (six boys, six girls, 11.4±2.0 years) were enrolled. Participants underwent annual medical questionnaire surveys, including data on practice frequency, competition history, presence of LBP, and lumbar examinations using MRI during the 5-year follow-up. Lumbar disc degeneration was detected in all the participants after 4 years, and lumbar disc herniation findings were detected in 33% of participants after 5 years; one underwent herniotomy during the follow-up period. Lumbar spondylolysis was detected in 58% of patients at 5 years. Although there were three participants who had LBP in the final year, none had LBP that prevented them from returning to weightlifting. This 5-year cohort study of 12 children and adolescent weightlifters detected lumbar degeneration in all participants. High frequency weightlifting training over a long period during the growth period may increase the risk of developing current and future LBP.
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Enoki S, Kuramochi R, Nakajyuku S, Mitsuyama H. The prevalence of spondylolysis and intervertebral disc degeneration in male pole vaulters. J Back Musculoskelet Rehabil 2022; 35:147-151. [PMID: 34092599 DOI: 10.3233/bmr-200296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The lower back is the most common injury location in pole vaulters, but the prevalence of lumbar spondylolysis and intervertebral disc degeneration is not known. OBJECTIVE This study aimed to determine the prevalence of lumbar spondylolysis and intervertebral disc degeneration in pole vaulters. METHODS This cross-sectional study was conducted in the Tokai area of Japan and included 21 pole vaulters (mean ± standard deviation [range]: age, 22.2 ± 3.2 [18-28] years; height, 172.2 ± 4.7 [165.0-182.0] cm; body weight, 67.6 ± 7.3 [54.0- 80.0] kg). The majority of pole vaulters were collegiate athletes. We performed anterior, lateral, and oblique radiography at 45∘ and magnetic resonance imaging in the sagittal and coronal planes of the lumbar spine. The evaluation was performed independently of whether the athletes had lower back pain (LBP). Moreover, we investigated the duration of pole-vaulting experience and history and current presence of LBP using a questionnaire. RESULTS The prevalence of lumbar spondylolysis and intervertebral disc degeneration was 28.6% (6/21) and 38.1% (8/21), respectively. Herniation was found in six discs in four vaulters (19.0%). All athletes had a history of LBP. The prevalence of lumbar spondylolysis was high (28.6%). CONCLUSIONS Sport-specific movements performed by pole vaulters may be a risk factor for lumbar spondylolysis.
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Affiliation(s)
- Shota Enoki
- Graduate School of Health and Sport Sciences, Chukyo University, Aichi, Japan
| | - Rieko Kuramochi
- Graduate School of Health and Sport Sciences, Chukyo University, Aichi, Japan.,School of Health and Sport Sciences, Chukyo University, Aichi, Japan
| | - Shinya Nakajyuku
- Department of Orthopedic Surgery, Yoshida Orthopedic Hospital, Toyota, Aichi, Japan
| | - Hirohito Mitsuyama
- Graduate School of Health and Sport Sciences, Chukyo University, Aichi, Japan.,School of Health and Sport Sciences, Chukyo University, Aichi, Japan.,Department of Orthopedic Surgery, Yoshida Orthopedic Hospital, Toyota, Aichi, Japan
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Zhang W, Wang H, Yuan Z, Chu G, Sun H, Yu Z, Liang H, Liu T, Zhou F, Li B. Moderate mechanical stimulation rescues degenerative annulus fibrosus by suppressing caveolin-1 mediated pro-inflammatory signaling pathway. Int J Biol Sci 2021; 17:1395-1412. [PMID: 33867854 PMCID: PMC8040478 DOI: 10.7150/ijbs.57774] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/22/2021] [Indexed: 12/29/2022] Open
Abstract
Mechanical loading can induce or antagonize the extracellular matrix (ECM) synthesis, proliferation, migration, and inflammatory responses of annulus fibrosus cells (AFCs), depending on the loading mode and level. Caveolin-1 (Cav1), the core protein of caveolae, plays an important role in cellular mechanotransduction and inflammatory responses. In the present study, we presented that AFCs demonstrated different behaviors when subjected to cyclic tensile strain (CTS) for 24 h at a magnitude of 0%, 2%, 5% and 12%, respectively. It was found that 5% CTS had positive effects on cell proliferation, migration and anabolism, while 12% CTS had the opposite effects. Besides, cells exposed to interleukin-1β stimulus exhibited an increase expression in inflammatory genes, and the expression of these genes decreased after exposure to moderate mechanical loading with 5% CTS. In addition, 5% CTS decreased the level of Cav1 and integrin β1 and exhibited anti-inflammatory effects. Moreover, the expression of integrin β1 and p-p65 increased in AFCs transfected with Cav1 plasmids. In vivo results revealed that moderate mechanical stimulation could recover the water content and morphology of the discs. In conclusion, moderate mechanical stimulation restrained Cav1-mediated signaling pathway and exhibited anti-inflammatory effects on AFCs. Together with in vivo results, this study expounds the underlying molecular mechanisms on the effect of moderate mechanical stimulation on intervertebral discs (IVDs) and may provide a new therapeutic strategy for the treatment of IVD degeneration.
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Affiliation(s)
- Weidong Zhang
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Huan Wang
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Zhangqin Yuan
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Genglei Chu
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Heng Sun
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Zilin Yu
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Huan Liang
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Tao Liu
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Feng Zhou
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Bin Li
- Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China.,China Orthopaedic Regenerative Medicine Group (CORMed), Hangzhou, Zhejiang, China
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Fu F, Bao R, Yao S, Zhou C, Luo H, Zhang Z, Zhang H, Li Y, Yan S, Yu H, Du W, Yang Y, Jin H, Tong P, Sun ZT, Yue M, Chen D, Wu C, Ruan H. Aberrant spinal mechanical loading stress triggers intervertebral disc degeneration by inducing pyroptosis and nerve ingrowth. Sci Rep 2021; 11:772. [PMID: 33437038 PMCID: PMC7804398 DOI: 10.1038/s41598-020-80756-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/28/2020] [Indexed: 01/08/2023] Open
Abstract
Aberrant mechanical factor is one of the etiologies of the intervertebral disc (IVD) degeneration (IVDD). However, the exact molecular mechanism of spinal mechanical loading stress-induced IVDD has yet to be elucidated due to a lack of an ideal and stable IVDD animal model. The present study aimed to establish a stable IVDD mouse model and evaluated the effect of aberrant spinal mechanical loading on the pathogenesis of IVDD. Eight-week-old male mice were treated with lumbar spine instability (LSI) surgery to induce IVDD. The progression of IVDD was evaluated by μCT and Safranin O/Fast green staining analysis. The metabolism of extracellular matrix, ingrowth of sensory nerves, pyroptosis in IVDs tissues were determined by immunohistological or real-time PCR analysis. The apoptosis of IVD cells was tested by TUNEL assay. IVDD modeling was successfully produced by LSI surgery, with substantial reductions in IVD height, BS/TV, Tb.N. and lower IVD score. LSI administration led to the histologic change of disc degeneration, disruption of the matrix metabolism, promotion of apoptosis of IVD cells and invasion of sensory nerves into annulus fibrosus, as well as induction of pyroptosis. Moreover, LSI surgery activated Wnt signaling in IVD tissues. Mechanical instability caused by LSI surgery accelerates the disc matrix degradation, nerve invasion, pyroptosis, and eventually lead to IVDD, which provided an alternative mouse IVDD model.
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Affiliation(s)
- Fangda Fu
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.,The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310051, Zhejiang, China
| | - Ronghua Bao
- Hangzhou Fuyang Hospital of TCM Orthopedics and Traumatology, Hangzhou, 311400, Zhejiang, China
| | - Sai Yao
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.,The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310051, Zhejiang, China
| | - Chengcong Zhou
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.,The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310051, Zhejiang, China
| | - Huan Luo
- Department of Pharmacy, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Zhiguo Zhang
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.,The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310051, Zhejiang, China
| | - Huihao Zhang
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.,The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310051, Zhejiang, China
| | - Yan Li
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310051, Zhejiang, China
| | - Shuxin Yan
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310051, Zhejiang, China
| | - Huan Yu
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.,Research Center for Human Tissues and Organs Degeneration, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.,The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310051, Zhejiang, China
| | - Weibin Du
- Research Institute of Orthopedics, the Affiliated JiangNan Hospital of Zhejiang Chinese Medical University, Hangzhou, 311200, Zhejiang, China
| | - Yanping Yang
- Longhua Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Hongting Jin
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
| | - Peijian Tong
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
| | - Zhi-Tao Sun
- Department of Orthopedics, Shenzhen Traditional Chinese Hospital, Guangzhou University of Chinese Medicine, Shenzhen, 518055, China
| | - Ming Yue
- Department of Physiology, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Di Chen
- Research Center for Human Tissues and Organs Degeneration, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Chengliang Wu
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.
| | - Hongfeng Ruan
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China. .,Longhua Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
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IONITE C, ROTARIU M, CONDURACHE I. Systematic review on the incidence of low back pain as well as on the rehabilitation treatment methods used. BALNEO RESEARCH JOURNAL 2020. [DOI: 10.12680/balneo.2020.371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. Low back pain is a growing condition both in terms of sampling and incidence, reaching to affect any of us at some point. Material and method. In order to write the article, four international libraries were used, where search criteria were used such as: "low back pain", "low back pain incidence" and "low back pain treatment". The articles used in this paper were carefully selected according to their relevance for this study, but only considered articles published in 2020. Results and discussions. The obtained results indicated that both physical therapy and physiotherapy have beneficial effects in ameliorating the symptoms generated by low back pain, but due to the lack of an optimal protocol patients turn to alternative therapies that have shown greater efficacy than physical therapy in amelioration. symptoms generated by low back pain. Conclusions. The lack of an optimal physiotherapeutic treatment protocol causes patients to turn to alternative therapies that are more effective, as well as a lower cost per treatment.
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Affiliation(s)
- Catalin IONITE
- 1. Faculty of Medical Bioengineering, “University of Medicine and Pharmacy Grigore T Popa”, Iasi, Romania
| | - Mariana ROTARIU
- 1 University of Medicine and Pharmacy “Grigore T. Popa, 16 University Street, Iasi, Romania
| | - Iustina CONDURACHE
- 1 University of Medicine and Pharmacy “Grigore T. Popa, 16 University Street, Iasi, Romania
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Peterhans L, Fröhlich S, Stern C, Frey WO, Farshad M, Sutter R, Spörri J. High Rates of Overuse-Related Structural Abnormalities in the Lumbar Spine of Youth Competitive Alpine Skiers: A Cross-sectional MRI Study in 108 Athletes. Orthop J Sports Med 2020; 8:2325967120922554. [PMID: 32528992 PMCID: PMC7263161 DOI: 10.1177/2325967120922554] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/31/2020] [Indexed: 12/11/2022] Open
Abstract
Background: 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. Purpose: 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. Study Design: Cross-sectional study; Level of evidence, 3. Methods: 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. Results: 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 (P = .018; R2 = 0.116) and end plate changes (P = .024; R2 = 0.096). Overall, the occurrence of abnormal MRI findings in the lumbar spine increased with age (P = .034; R2 = 0.054). Disc degeneration (particularly disc dehydration and disc protrusion) were significantly more prevalent in symptomatic versus asymptomatic athletes (P < .05 for all). Conclusion: 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.
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Affiliation(s)
- Loris Peterhans
- 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
| | - Stefan Fröhlich
- 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
| | - Christoph Stern
- Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Walter O Frey
- University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Mazda Farshad
- Spine Surgery, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Spine Centre, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Reto Sutter
- Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- 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
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Boado A, Nagy A, Dyson S. Ultrasonographic features associated with the lumbosacral or lumbar 5–6 symphyses in 64 horses with lumbosacral‐sacroiliac joint region pain (2012–2018). EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13236] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- A. Boado
- Monte Hijedo 56 Boadilla del Monte Madrid Spain
| | - A. Nagy
- Centre for Equine Studies Animal Health Trust Newmarket Suffolk UK
| | - S. Dyson
- Centre for Equine Studies Animal Health Trust Newmarket Suffolk UK
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Raghu ALB, Wiggins A, Kandasamy J. Surgical management of lumbar disc herniation in children and adolescents. Clin Neurol Neurosurg 2019; 185:105486. [DOI: 10.1016/j.clineuro.2019.105486] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/15/2019] [Accepted: 08/08/2019] [Indexed: 11/27/2022]
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