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

Faisal Alyas ¹, Michael Turner ² and David Connell ^1*

¹ Royal National Orthopaedic Hospital, United Kingdom
² The Lawn Tennis Association, United Kingdom

^* To whom correspondence should be addressed. E-mail: david.connell{at}rnoh.nhs.uk.

Accepted 26 May 2007

Abstract

Objective: To describe MRI findings in the Lumbar Spines of a group of asymptomatic, elite, adolescent tennis players. This will serve as the baseline for a future, prospective, longitudinal cohort study.

Design: Observational study.

Setting: Institutional, National Tennis Centre.

Participants: 33 asymptomatic elite adolescent tennis players (17.3+/-1.7 years, 18 males, 15 females).

Interventions: Sagittal T1, T2, STIR, and axial T2 weighted MRI images.

Main Outcome Measurements: Images were reviewed for the presence of abnormalities by two radiologists in consensus. These included: disc degeneration, disc herniation, pars lesions (fracture or stress reaction), and facet joint arthropathy.

Results: 5/33(15.2%) players had a normal and 28/33 (84.8%) an abnormal MRI examination. 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 stress reactions of the pars. 23/33 patients showed signs of early facet arthropathy occurring at the L5/S1 (15/29 joints) and L4/5 (12/29 joints) levels. These were classified as mild degeneration (20/29) and moderate degeneration (9/29), with 20/29 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 and L5/S1 levels (12/15 discs).

Conclusions: Abnormalities occurred commonly, predominately in the lower lumbar spine, almost exclusively at the L4/5 and L5/S1 levels. Pars injuries and facet joint arthrosis are relatively common.

Key Words: Facet joint arthropathy, Lumbar spine, MRI, Spondylolysis, Tennis player

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