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| 2. |
- Todd, Carl, et al.
(författare)
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Pelvic Retroversion is Associated with Flat Back and Cam Type Femoro-Acetabular Impingement in Young Elite Skiers
- 2016
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Ingår i: Journal of spine. - : OMICS Publishing Group. - 2165-7939. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The spino-pelvic complex in humans helps to maintain an upright posture, by balancing the spinal sagittal alignment with the hip joints and pelvic girdle. The extent of how the hip joint may influence the spino-pelvic alignment is not fully understood. Hip joint cam femoro-acetabular impingement is a common source of hip and groin disability in young athletes and has been linked to abnormal joint morphology from repetitive loading of the proximal femoral head abutting against the acetabulum. The aim of this study was to compare the radiological parameters of spino-pelvic sagittal alignment and spinal types according to Roussouly’s classification in relation to hip joint cam femoro-acetabular impingement. Methods: The sample group (n=102), mean age (17.7 ± 1.4) years, consisted of elite skiers (n=75) and nonathletes (n=27). Hip joints were examined for increased morphological cam deformity, (alpha angle greater than 55o) with Magnetic Resonance Imaging and standing lateral plain radiographs were taken for measurements of the spinopelvic sagittal alignment. Results: A significant difference was shown in a mixed population (skiers and non-athletes) for an increased Pelvic Tilt angle (13°, SD 10.2) in the presence of morphological hip joint cam deformity compared with participants without cam deformity (8.5°, SD 7.1, P=0.036). Type II Roussouly spines occurred more frequently in skiers in the presence of increased cam (67%) compared with no cam (33%), however, this was not significant (P=0.19). Secondary findings highlighted significant differences shown for the prevalence of cam in a mixed-population for gender; males 60% (n=26) shown to have significantly more cam deformity compared with females 22% (n=10, P=0.001). Similar for height, with taller participants being shown to have significantly more cam deformity >177cm (SD 7.6) compared with no cam deformity <170 cm (SD 7.5, P=0.001). Conclusion: A significant difference was shown with an increased Pelvic Tilt angle for an age-matched mixedgroup of elite skiers and non-athletes in the presence of increased morphological hip joint cam type femoro-acetabular impingement. Moreover, Elite skiers were shown to have an increased distribution of spinal Type II classification according to Roussouly in the presence of an increased frequency of cam femoro-acetabular impingement.
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| 3. |
- Witwit, Wisam, et al.
(författare)
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Disc degeneration on MRI is more prevalent in young elite skiers compared to controls.
- 2018
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Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 26:1, s. 325-332
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Tidskriftsartikel (refereegranskat)abstract
- Evidence-based facts regarding spine abnormalities and back pain are needed in order to develop rehabilitation programs and prevent spine injuries in young skiers. The aim therefore is to identify MRI changes in the thoraco-lumbar spine and the lifetime prevalence of back pain, as well as the association between them, in young skiers compared to non-athletes.Seventy-five young elite alpine and mogul skiers, age range 16-20years, were compared with 27 non-athletic controls. All subjects underwent spinal MRI and answered back pain questionnaires.Fifty-six percent of skiers had at least one disc Pfirrmann grade ≥3 compared to 30% of controls (p=0.027). Schmorl's nodes (46%) and disc height reduction (37%) were significantly more prevalent in skiers compared to controls (0%) (p<0.001). When all parameters were combined together, skiers had significantly higher rate of radiological changes than controls, 82% compared to 54% (p=0.007). The mean number of discs with Pfirrmann grade ≥3 was 1.1 per individual in skiers (median 1, range 0-6) versus 0.6 in controls (median 0, range 0-3). There was no significant difference in lifetime prevalence of back pain between skiers (50%) and controls (44%) (n.s.). MRI abnormalities in skiers did not correlate with lifetime prevalence of back pain. Skiers had a better health perception than controls (p=0.026).Alpine skiers have more degenerative disc changes compared to non-athletes, but these changes do not correlate with the lifetime prevalence of back pain. Lifetime prevalence of back pain is not significantly different between the groups; however, skiers report more severe pain on VAS score.II.
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| 4. |
- Witwit, Wisam, et al.
(författare)
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No Significant Change in MRI Abnormalities or Back Pain Prevalence in the Thoraco-Lumbar Spine of Young Elite Skiers Over a 2-Year Follow-Up
- 2022
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Ingår i: Open Access Journal of Sports Medicine. - 1179-1543. ; 13, s. 69-76
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Tidskriftsartikel (refereegranskat)abstract
- Background: Young athletes are at increasing risk for spinal column injuries due to overloading the spine with excessive sports activities, with potential development of complications later in life.Purpose: The purpose of this 2-year follow-up study of young elite skiers and non-athletes was to investigate any potential change in the thoraco-lumbar findings on MIRI and to outline any change in back pain prevalence with continuing sporting activity and age. Study Design: Longitudinal cross-sectional study.Methods: MIRI of the thoraco-lumbar spine was performed on 30 skiers (mean age 20 years, female 43%) and 16 non-athletes (mean age 19, female 75%), available for the 2-year follow-up. The intervertebral discs were evaluated for signal, height, bulge/herniation, and additionally according to Pfirrmann classification, and the endplates were graded according to endplate defect score. Any of the following disc findings was defined as disc degenerative change: reduced signal, reduced height, bulge, or herniation. All participants answered a specific back pain questionnaire.Results: No significant difference in spinal column abnormalities, nor back pain, was found between baseline and 2-year follow-up in neither skiers nor controls. There was significantly higher prevalence of disc degenerative changes in skiers (73%) than in non-athletes (44%, p=0.05). Skiers (63%) had significantly more Pfirrmann grade >= 3 discs compared to non-athletes (25%) (p=0.03). There was no significant difference in number of endplates with score >= 4 between skiers and non-athletes (50% vs 38%, p=0.40) nor in lifetime prevalence of back pain between skiers (46%) and non-athletes (40%).Conclusion: There was no significant change over time of the spinal column MIRI abnormalities, nor back pain prevalence, during a 2-year follow-up of skiers and non-athletes. Young skiers had significantly higher prevalence of spine abnormalities compared with non-athletes. There was no significant difference of the back pain lifetime prevalence in skiers compared with non-athletes.
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| 5. |
- Witwit, Wisam
(författare)
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Spinal column and hip joint changes, and their correlation to back pain in young athletes - Radiological and Clinical Studies
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Young athletes are at increasing risk for spinal column injuries and back pain due to excessive sporting activities, with potential development of complications like spinal canal stenosis and chronic back pain later in life. Increased knowledge is necessary in order to make the correct diagnosis and to be able to adapt the appropriate preventive measures, rehabilitation programs, and treatments accordingly. Purpose: The aim of this project was to identify MRI changes in the thoraco-lumbar spine and the lifetime prevalence of back pain at baseline and with continuing sporting activity, as well as the association between them, in young athletes compared with non-athletes. Another purpose was to investigate the relationship between the pelvic morphology and the hip cam change in young elite skiers compared with non-athletes. Material and Methods: Seventy-five young elite alpine and mogul skiers (mean age 18), and 31 young elite football (soccer) players (mean age 17) were compared with 27 non-athletes (mean age 16). All subjects were invited to undergo MRI of the thoraco-lumbar spine. The MRI images were evaluated for vertebral changes and disc abnormalities such as Pfirrmann grade, disc desiccation, disc height loss, bulging, herniation, and Schmorl’s nodes. All participants answered standardized questionnaires with questions related to back pain, training hours, spinal injuries, and health perception. The skiers hip joints were examined for cam morphology (defined as α-angle >55°) with MRI, and sagittal spinal alignment measurements including Pelvic Incidence (PI) on standing lateral plain radiographs. All participants were invited to participate in a 2-year follow-up, but 35 skiers and 10 non-athletes dropped out due to personal reasons. Results: The spinal column abnormalities were significantly higher in athletes than non-athletes. Fifty-six percent of skiers had at least one disc of Pfirrmann grade≥3 compared with 30% of non-athletes (p= 0.03). Schmorl’s nodes (46%) and disc height reduction (37%) were significantly more prevalent in skiers compared with non-athletes (0%) (p < 0.001). The football players had significantly higher rate of MRI changes than non-athletes, 89% compared with 54% when all disc degenerative changes were combined (p = 0.006). There was no significant difference in lifetime prevalence of back pain between athletes (50%) and non-athletes (44%). No significant correlation between MRI abnormalities and back pain was identified. Athletes had better health perception than non- athletes (p = 0.03). Skiers had significantly greater prevalence of cam morphology (49%) compared with non-athletes (19%, p=0.009). No correlation was shown be- tween a low Pelvic Incidence (PI) and hip cam morphology. No significant interval difference in spinal column abnormalities, neither for skiers nor non-athletes, and no significant difference in terms of back pain was found between baseline and 2-year follow-up. Conclusion: Young elite athletes demonstrated significantly more spinal column abnormalities than non-athletes, while lifetime prevalence of back pain was not different between the groups. Skiers had greater prevalence of hip cam morphology compared with non-athletes. A low Pelvic Incidence (PI) was not correlat- ed with abnormal cam morphology. Between baseline and 2-year follow-up, there was no significant interval difference in spinal column findings on MRI, nor back pain prevalence, neither for skiers nor non-athletes.
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| 6. |
- Witwit, Wisam, et al.
(författare)
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Young soccer players have significantly more spinal changes on MRI compared to non-athletes.
- 2020
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Ingår i: Translational Sports Medicine. - : Hindawi Limited. - 2573-8488. ; 3:4, s. 288-295
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Evidence-based facts regarding spinal abnormalities and back pain in young athletes are needed in order to be able to adapt rehabilitation programs and preventive measures accordingly. The aim of this study was therefore to identify MRI changes in the thoracolumbar spine and the lifetime prevalence of back pain in young football players compared to non-athletes. Methods Young elite football players (n = 27) and non-athletes (n = 26) completed MRI examinations of the thoracolumbar spine. MRI images were evaluated for disk signal, height, bulging, herniation, Schmorl's nodes, spondylolisthesis, and vertebral wedging. All participants answered questionnaires regarding training hours and back pain. Results Disk degenerative changes were more commonly displayed by 89% of the football players compared to 54% of the controls (P = .006). Schmorl's nodes (22%), disk herniation (30%), and reduced disk height (37%) were more prevalent in football players compared to controls (0%) (P = .023 and P = .001, respectively). The lifetime prevalence of back pain was reported by 52% of football players and 44% of controls, a difference that was not statistically significant. Conclusion Young male football (soccer) players have more degenerative disk changes compared to non-athletes. Both groups displayed high lifetime prevalence of back pain.
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