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Morimoto M, Okada R, Sugiura K, Manabe H, Inokuchi T, Tezuka F, Yamashita K, Takao S, Fujitani J, Sairyo K. Low Back Pain and Lumbar Degeneration in Japanese Professional Baseball Players. Orthop J Sports Med 2022; 10:23259671221125513. [PMID: 36250034 PMCID: PMC9561668 DOI: 10.1177/23259671221125513] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/25/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Baseball is one of the most popular sports in Asia. It is known that baseball
can easily lead to back pain. However, there has been no survey of low back
pain (LBP) and lumbar disc degeneration in Japanese professional baseball
players to date. Purpose: To investigate the cause of LBP and lumbar degeneration in professional
Japanese baseball players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We retrospectively reviewed the medical records of Japanese professional
baseball players with LBP who visited our hospital. Data were collected from
July 2018 to April 2021. We also investigated whether the results differed
between players in their 20s and 30s or between pitchers and fielders. Data
analysis was performed using the chi-square test. Results: We surveyed 32 professional baseball players. The most frequent causes of LBP
among players in their 20s (n = 21) were lumbar disc herniation (LDH; 57%)
and spondylolysis (24%). Of the players with spondylolysis, 50% had
adult-onset spondylolysis. Players in their 30s (n = 11) most commonly had
discogenic pain (55%) as well as LDH and facet joint arthritis (each 18%).
The incidence of lumbar intervertebral disc degeneration was significantly
higher in players in their 30s (91%) than those in their 20s (14%), as was
the incidence of Schmorl nodes and Modic type 1 changes. There was no
significant difference in the cause of LBP or the incidence of lumbar
intervertebral disc degeneration between pitchers and fielders
(P = .59). Conclusion: Among professional baseball players in their 20s, lumbar degeneration was
less common, and they most frequently developed diseases less related to
degeneration, such as LDH. However, among players in their 30s, lumbar
degeneration was more advanced, and degenerative diseases such as discogenic
pain occurred more frequently. Research on training methods could lead to
the prevention of LBP. Our data may be applicable to other professional
athletes and will contribute to diagnosis and treatment.
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Affiliation(s)
- Masatoshi Morimoto
- Department of Diagnostic Orthopedics, Graduate School, Institute of
Health Science, Tokushima University, Tokushima, Japan.,Masatoshi Morimoto, MD, PhD, Department of Orthopedics,
Tokushima University, 3-18-15 Kuramoto, Tokushima 770-8503, Japan (
)
| | - Ryo Okada
- Department of Diagnostic Orthopedics, Graduate School, Institute of
Health Science, Tokushima University, Tokushima, Japan
| | - Kosuke Sugiura
- Department of Diagnostic Orthopedics, Graduate School, Institute of
Health Science, Tokushima University, Tokushima, Japan
| | - Hiroaki Manabe
- Department of Diagnostic Orthopedics, Graduate School, Institute of
Health Science, Tokushima University, Tokushima, Japan
| | - Takashi Inokuchi
- Department of Diagnostic Orthopedics, Graduate School, Institute of
Health Science, Tokushima University, Tokushima, Japan
| | - Fumitake Tezuka
- Department of Diagnostic Orthopedics, Graduate School, Institute of
Health Science, Tokushima University, Tokushima, Japan
| | - Kazuta Yamashita
- Department of Diagnostic Orthopedics, Graduate School, Institute of
Health Science, Tokushima University, Tokushima, Japan
| | - Syoichiro Takao
- Department of Diagnostic Radiology, Graduate School, Institute of
Health Science, Tokushima University, Tokushima, Japan
| | - Junzo Fujitani
- Department of Diagnostic Orthopedics, Graduate School, Institute of
Health Science, Tokushima University, Tokushima, Japan
| | - Koichi Sairyo
- Department of Diagnostic Orthopedics, Graduate School, Institute of
Health Science, Tokushima University, Tokushima, Japan
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Morimoto M, Sugiura K, Higashino K, Manabe H, Tezuka F, Wada K, Yamashita K, Takao S, Sairyo K. Association of spinal anomalies with spondylolysis and spina bifida occulta. 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 2022; 31:858-864. [PMID: 35237865 DOI: 10.1007/s00586-022-07139-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 01/08/2022] [Accepted: 01/31/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the association of spinal anomalies with lumbar spondylolysis and spina bifida occulta (SBO). METHODS A total of 1190 patients with thoracic, abdominal, and pelvic computed tomography scans available were categorized according to the number of presacral (thoracic and lumbar) mobile vertebrae and the presence or absence of lumbosacral transitional vertebrae (LSTV). The prevalence of spondylolysis and SBO and the association of spinal anomalies with these disorders were evaluated. RESULTS Normal morphology (17 mobile vertebra with no LSTV) was found in 607 men (86.5%) and 419 women (85.9%) and about 14% of patients had anomalies. Spondylolysis was found in 74 patients (6.2%), comprising 54 men (7.7%) and 20 women (4.1%). SBO involving the lumbar spine was found in 9 men (1.3%) and 2 women (0.4%). Spondylolysis was significantly more common in men with 18 vertebrae without LSTV (21.1%) than in those with 17 vertebrae without LSTV (7.2%) (p = 0.002). The prevalence of spinal anomalies was 55.6% in men and 50.0% in women with SBO that included a lumbar level was significantly higher than in both men (13.5%, p < 0.001) and women (4.8%, p = 0.003) without SBO. CONCLUSION These findings indicate that there is a relationship between spinal anomalies and both spondylolysis and SBO, which may lead to elucidation of the mechanism of onset of spondylolysis and improve its treatment and prognosis. Awareness that patients with SBO involving the lumbar spine have an increased likelihood of a spinal anomaly may help to prevent level errors during spinal surgery.
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Affiliation(s)
- Masatoshi Morimoto
- Department of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health Sciences, 3-18-15 Kuramoto, Tokushima, 770-8501, Japan.
| | - Kosuke Sugiura
- Department of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health Sciences, 3-18-15 Kuramoto, Tokushima, 770-8501, Japan
| | - Kosaku Higashino
- Department of Orthopedics, Shikoku Medical Center for Children and Adults, 2-1-1 Senyu-cho, Zentsuji-shi, Kagawa, 765-8507, Japan
| | - Hiroaki Manabe
- Department of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health Sciences, 3-18-15 Kuramoto, Tokushima, 770-8501, Japan
| | - Fumitake Tezuka
- Department of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health Sciences, 3-18-15 Kuramoto, Tokushima, 770-8501, Japan
| | - Keizo Wada
- Department of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health Sciences, 3-18-15 Kuramoto, Tokushima, 770-8501, Japan
| | - Kazuta Yamashita
- Department of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health Sciences, 3-18-15 Kuramoto, Tokushima, 770-8501, Japan
| | - Shoichiro Takao
- Department of Diagnostic Radiology, Tokushima University Graduate School, Institute of Health Sciences, 3-18-15 Kuramoto, Tokushima, 770-8501, Japan
| | - Koichi Sairyo
- Department of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health Sciences, 3-18-15 Kuramoto, Tokushima, 770-8501, Japan
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Abstract
Repetitive stress on the lumbosacral spine during sporting activity places the athletic patient at risk of developing symptomatic pars defect. Clinical history, physical examination, and diagnostic imaging are important to distinguish spondylolysis from other causes of lower back pain. Early pars stress reaction can be identified with advanced imaging, before the development of cortical fracture or vertebral slip progression to spondylolisthesis. Conservative management is first-line for low-grade injury with surgical intervention indicated for refractory symptoms, severe spondylolisthesis, or considerable neurologic deficit. Prompt diagnosis and management of spondylolysis leads to good outcomes and return to competition for most athletes.
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Affiliation(s)
- Christopher C Chung
- Department of Orthopaedic Surgery, University of Virginia, PO Box 800159, Charlottesville, VA 22908, USA
| | - Adam L Shimer
- Department of Orthopaedic Surgery, University of Virginia, PO Box 800159, Charlottesville, VA 22908, USA.
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