MRI findings in the lumbar spine of asymptomatic adolescent elite tennis players

Faisal Alyas, Michael Turner and David Connell

The purpose of this study was to describe the MRI (Magnetic Resonance Imaging) findings in the lumbarspines of a group of asymptomatic, elite, adolescent tennis players. The authors state that these findings will serve as a baseline for a future longitudinal study. 

The sample consisted of 33 adolescents who had Sagittal T1, T2, STIR, and axial T2 weighted MRI images taken. These images were then reviewed for abnormalities such as disc degeneration, facet joint athropathy,and herniation by two radiologists in consensus. Results showed that 15.2% had a normal image however 84.8% hadabnormalities. In detail, 9/33 players showed pars lesions (one at two levels) predominately at the L5 level(9/10-L5, 1/10-L4). 3/10 lesions were complete fractures, two demonstrated grade 1 and one grade 2 spondylolisthesis,both of which resulted in moderate narrowing of the L5 exit foramen. 2/10 had acute and 5/10 chronic stressreactions of the pars. 23/33 patients showed signs of early facet arthropathy occurring at the L5/S1 (15/29 joints) andL4/5 (12/29 joints) levels. These were classified as mild degeneration (20/29) and moderate degeneration (9/29), with20/29 showing sclerosis and 24/29 showing hypertrophy of the facet joint. Synovial cysts were identified in 14/29 patients.13/33 players showed disc desiccation and a disc bulge (mild-13/15 and moderate-2/15) most frequently at the L4/5 andL5/S1 levels (12/15 discs).

In conclusion, abnormalities occurred commonly, predominately in the lower lumbar spine and almost exclusivelyat the L4/5 and L5/S1 levels. Pars injuries and facet joint arthrosis are relatively common. 

British Journal Sports Medicine Pubished Online 19 July 2007

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