General Session: Pediatric Spine
Presented by: K. Yamashita - View Audio/Video Presentation (Members Only)
K. Yamashita(1), K. Higashino(1), T. Sakai(1), Y. Takata(1), F. Tezuka(1), T. Chikawa(1), A. Nagamachi(1), Y. Mase(2), K. Sairyo(1)
(1) Tokusihma University Graduate School, Department of Orthopedics, Tokushima, Japan
(2) Hachioji Sports Clinic, Department of Orthopedics, Tokyo, Japan
Introduction: The non-specific low back pain (NSLBP) means the low back pain that the cause is not clear. Generally, it is said that about 85 % of low back pain fall into NSLBP. However, owing to the improvement of the image processing, there may be fewer low back pain that cannot to be diagnosed, especially in the adolescent athlete.
Purpose: The purposes of this study are to reveal a ratio of NSLBP in adolescent athletes and to clarify the pathology that falls into NSLBP.
Material and Method: Sixty nine adolescent athletes with low back pain, younger than 20 years old, had been consulted to our sports spine clinic from the previous doctor, from January 2013 to November 2015. Age, sex, the kind of sports activity, the diagnosis of the previous doctor (general orthopedist), the diagnosis after the spine specialist's medical examination, and the findings of CT scan and MRI were investigated using medical record retrospectively.
Result: The mean age was 15.2 years old. Fifty-four boys and fifteen girls. The high-ranking sports activity was baseball, football, and tennis. The diagnosis of the previous doctor was lumbar spondylolysis 47 cases, lumbar disc herniation 5 cases, disc related low back pain 2 cases, arthritis of facet joint 1 case, fracture of inferior articular process 1 case, and unidentified 13 cases. The diagnosis after the spine specialist's medical examination was lumbar spondylolysis 51 cases, lumbar disc herniation 6 cases, disc related low back pain 5 cases, arthritis of facet joint 4 cases, fracture of inferior articular process 1 case, lumbar apophyseal ring fracture 1 case, and unidentified 1 case. The details of the 12 cases, who were able to be disclosed the cause of low back pain only after the spine specialist's medical examination, were lumbar spondylolysis (early stage) 5 cases, disc related low back pain (high signal intensity zone; HIZ) 3 cases, arthritis of facet joint 2 cases, lumbar disc herniation 1 case, and lumbar apophyseal ring fracture 1 case.
Discussion and Conclusion: The ratio of NSLBP in adolescent athlete diagnosed by general orthopedist was 18.9 %. The accuracy of diagnosis improved by the spine specialist and the ratio of NSLBP decreased to 1.4 %. The sufficient medical interview, careful physical examination, and appropriate diagnostic imaging such as STIR-MRI are important not to overlook the cause of low back pain.