The role of intense athletic activity on structural lumbar abnormalities in adolescent patients with symptomatic low back pain

Gregory D. Schroeder*, Cynthia R. LaBella, Marco Mendoza, Erika L. Daley, Jason W. Savage, Alpesh A. Patel, Wellington K. Hsu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Purpose: To determine if adolescent athletics increases the risk of structural abnormalities in the lumbar spine. Methods: A retrospective review of patients (ages 10–18) between 2004 and 2012 was performed. Pediatric patients with symptomatic low back pain, a lumbar spine MRI, and reported weekly athletic activity were included. Patients were stratified to an “athlete” and “non-athlete” group. Lumbar magnetic resonance and plain radiographic imaging was randomized, blinded, and evaluated by two authors for a Pfirrmann grade, herniated disc, and/or pars fracture. Results: A total of 114 patients met the inclusion criteria and were stratified into 66 athletes and 48 non-athletes. Athletes were more likely to have abnormal findings compared to non-athletes (67 vs. 40 %, respectively, p = 0.01). Specifically, the prevalence of a spondylolysis with or without a slip was higher in athletes vs. non-athletes (32 vs. 2 %, respectively, p = 0.0003); however, there was no difference in the average Pfirrmann grade (1.19 vs. 1.14, p = 0.41), percentage of patients with at least one degenerative disc (39 vs. 31 %, p = 0.41), or disc herniation (27 vs. 33 %, p = 0.43). Body mass index, smoking history, and pelvic incidence (51.5° vs. 48.7°, respectively, p = 0.41) were similar between the groups. Conclusion: Adolescents with low back pain have a higher-than-expected prevalence of structural pathology regardless of athletic activity. Independent of pelvic incidence, adolescent athletes with low back pain had a higher prevalence of spondylolysis compared to adolescent non-athletes with back pain, but there was no difference in associated disc degenerative changes or herniation.

Original languageEnglish (US)
Pages (from-to)2842-2848
Number of pages7
JournalEuropean Spine Journal
Issue number9
StatePublished - Sep 1 2016


  • Athletes
  • Disc degeneration
  • Herniated disc
  • Pelvic incidence
  • Spondylolysis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


Dive into the research topics of 'The role of intense athletic activity on structural lumbar abnormalities in adolescent patients with symptomatic low back pain'. Together they form a unique fingerprint.

Cite this