Comparison of symptomatic spondylolysis in young soccer and baseball players

Abstract

Background: Spondylolysis is the main cause of low back pain (LBP) in young athletes. There are few studies analyzing the difference of spondylolysis among young athletes with different sports activities. The purpose of this study was to compare the clinical factors and distribution of the lesions of spondylolysis on magnetic resonance imaging (MRI) scans in young soccer and baseball players with symptomatic spondylolysis. Methods: The medical records of 267 young athletes aged 7 to 18 years old who underwent MRI to evaluate the cause of LBP between 2017 and 2020 were retrospectively reviewed to identify patients with spondylolysis. Of the young athletes with symptomatic spondylolysis, clinical factors and MRI findings in soccer and baseball players were retrospectively evaluated. The clinical factors were age, sex, interval from onset of LBP to MRI, and side of the dominant leg in the sports field. MRI findings included number, lumbar level, and side of the lesions. Results: A total of 33 soccer players (mean age, 15.4 ± 1.4 years) and 49 baseball players (mean age, 15.4 ± 1.6 years) with symptomatic spondylolysis were enrolled. All patients were male. No significant differences were noted in age and the interval from onset of LBP to MRI between the groups. Soccer players had greater numbers of multiple (p < 0.001) and bilateral (p < 0.001) lesions than baseball players. The dominant side of the hand for pitching or batting was correlated with the contralateral-side lesions in baseball players (p = 0.001). Conclusions: The distribution of the lesions of spondylolysis differed in young soccer and baseball players. Pitching or batting with the dominant-side hand would be associated with contralateral-side lesions in baseball players. Sports-specific movements and the side of the dominant leg should be considered when treating young athletes with symptomatic spondylolysis.

Characteristics of Adult-Onset Acute Lumbar Spondylolysis Treated Conservatively

“…The high incidence of midlumbar lesions in the present study might be related to the sports discipline practiced by the patients. However, L5 is the most affected vertebral level reported in soccer 13,14) and track and field 15) . Therefore, the sports discipline is less likely to explain this finding.…”

Proposed Musculoskeletal Examination of Youth and Adolescent Baseball Players

“…Yokoe et al 2020 retrospectively reviewed 267 young athletes who underwent MRI scans to evaluate low back pain following negative radiographic findings for spondylolysis. One hundred and thirty-three of these athletes were positive for spondylolysis with 49 of these athletes defined as baseball players (mean age 15.4 ± 1.6 years) with reported pain with extension-based movement patterns (28). Of these 49 baseball players, 60 lesions were identified in total with spondylolysis located at L5 in 55.4% of these individuals, and players pitching or batting with their dominant hand were associated with lesions located at the contralateral side of the pars interarticularis (28).…”

Lumbar spondylolysis - Current concepts review

“…5,9 Lumbar pars defect is also prevalent in soccer players, cricketers, baseball players, rowers, swimmers and divers. 7,25 Repetitive hyperextension leads to stress on the inferior articular facet e.g. fast bowling in cricket and many gymnastic exercises.…”

“…One recent study suggested sports-specific movements and lower limb dominance should be considered in young sporting subjects with symptomatic spondylolysis. 25 Cortical fatigue resulting in PI stress fractures has been reproduced in vitro. 26 One must remember that a physiological stress reaction within PI precedes the fatigue failure.…”