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Anterior Limbus Vertebra and Intervertebral Disk Degeneration in Japanese Collegiate Gymnasts.

Koyama K, Nakazato K, Min SK, Gushiken K, Hatakeda Y, Seo K, Hiranuma K - Orthop J Sports Med (2013)

Bottom Line: The prevalence of IDD was significantly higher in gymnasts with ALV than those without ALV, as determined using the chi-square test.Upper IDD had a greater association with ALV (adjusted OR, 33.17; 95% CI, 7.09-155.25) than did lower IDD (adjusted OR, 6.71; 95% CI, 1.57-28.73).Information regarding ALV is important to prevent IDD in Japanese collegiate gymnasts.

View Article: PubMed Central - PubMed

Affiliation: Department of Judotherapy, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan. ; Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo, Japan.

ABSTRACT

Background: Magnetic resonance imaging (MRI) studies have shown that gymnasts have a high prevalence of radiological abnormalities, such as intervertebral disk degeneration (IDD) and anterior limbus vertebra (ALV). These 2 abnormalities may coexist at the same spinal level. However, the relationship between IDD and ALV remains unclear.

Hypothesis: A significant relationship exists between IDD and ALV in Japanese collegiate gymnasts.

Study design: Case-control study.

Methods: A total of 104 Japanese collegiate gymnasts (70 men and 34 women; age, 19.7 ± 1.0 years) with 11.8 ± 3.6 years of sporting experience participated. T1- and T2-weighted MRIs were used to evaluate ALV and IDD.

Results: The prevalence among the gymnasts of IDD and ALV was 40.4% (42/104) and 20.2% (21/104), respectively. The prevalence of IDD was significantly higher in gymnasts with ALV than those without ALV, as determined using the chi-square test. Logistic regression analysis demonstrated a significant association between IDD and ALV (adjusted odds ratio [OR], 6.60; 95% confidence interval [CI], 2.14-20.35). IDD was further grouped by whether it was present in the upper lumbar region (L1-2, L2-3, and L3-4 disks) or in the lower lumbar region (L4-5 and L5-S1 disks). Upper IDD had a greater association with ALV (adjusted OR, 33.17; 95% CI, 7.09-155.25) than did lower IDD (adjusted OR, 6.71; 95% CI, 1.57-28.73).

Conclusion: In Japanese collegiate gymnasts, ALV is a predictor of IDD, especially in the upper lumbar region.

Clinical relevance: Information regarding ALV is important to prevent IDD in Japanese collegiate gymnasts.

No MeSH data available.


Related in: MedlinePlus

Intervertebral disk degeneration and adjacent anterior limbus vertebra. A magnetic resonance imaging scan of the intervertebral disk of a gymnast with grade 3 intervertebral disk degeneration at L4-5 (black arrow). An adjacent anterior limbus vertebra is also present in the upper endplate of L5 (white arrow).
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fig1-2325967113500222: Intervertebral disk degeneration and adjacent anterior limbus vertebra. A magnetic resonance imaging scan of the intervertebral disk of a gymnast with grade 3 intervertebral disk degeneration at L4-5 (black arrow). An adjacent anterior limbus vertebra is also present in the upper endplate of L5 (white arrow).

Mentions: Image interpretation was performed to evaluate 2 MRI abnormalities: ALV and IDD. An ALV was defined as a separate, sclerotic, and triangular ossicle that was adjacent to, but separate from, the vertebral endplate. The affected endplate contains an adjacent, irregular, focal, sclerotic defect that is secondary to chronic herniation of disk material through the attachment of the annulus fibrosus (Figure 1).15,26 The gymnasts were divided into 2 groups: (1) ALV and (2) no ALV. IDD was defined as reduced signal intensity of the intervertebral disks from L1-2 to L5-S1. The grading system for the assessment of IDD was based on the Pfirrmann classification28 in which grades 3, 4, and 5 indicate degeneration (Figure 1).12,16,25 We also grouped IDD by whether it occurred in the upper (L1-2, L2-3, and L3-4 disks) or lower (L4-5 and L5-S1 disks) lumbar regions. Because an orthopaedic spine specialist often makes a diagnosis based on images, the MRI scans from each gymnast were examined by 2 orthopaedic surgeons specializing in spine disorders. Both orthopaedic surgeons were blinded to the injury histories of the gymnasts. If there were any discrepancies, consensus was reached before final grading.


Anterior Limbus Vertebra and Intervertebral Disk Degeneration in Japanese Collegiate Gymnasts.

Koyama K, Nakazato K, Min SK, Gushiken K, Hatakeda Y, Seo K, Hiranuma K - Orthop J Sports Med (2013)

Intervertebral disk degeneration and adjacent anterior limbus vertebra. A magnetic resonance imaging scan of the intervertebral disk of a gymnast with grade 3 intervertebral disk degeneration at L4-5 (black arrow). An adjacent anterior limbus vertebra is also present in the upper endplate of L5 (white arrow).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4555487&req=5

fig1-2325967113500222: Intervertebral disk degeneration and adjacent anterior limbus vertebra. A magnetic resonance imaging scan of the intervertebral disk of a gymnast with grade 3 intervertebral disk degeneration at L4-5 (black arrow). An adjacent anterior limbus vertebra is also present in the upper endplate of L5 (white arrow).
Mentions: Image interpretation was performed to evaluate 2 MRI abnormalities: ALV and IDD. An ALV was defined as a separate, sclerotic, and triangular ossicle that was adjacent to, but separate from, the vertebral endplate. The affected endplate contains an adjacent, irregular, focal, sclerotic defect that is secondary to chronic herniation of disk material through the attachment of the annulus fibrosus (Figure 1).15,26 The gymnasts were divided into 2 groups: (1) ALV and (2) no ALV. IDD was defined as reduced signal intensity of the intervertebral disks from L1-2 to L5-S1. The grading system for the assessment of IDD was based on the Pfirrmann classification28 in which grades 3, 4, and 5 indicate degeneration (Figure 1).12,16,25 We also grouped IDD by whether it occurred in the upper (L1-2, L2-3, and L3-4 disks) or lower (L4-5 and L5-S1 disks) lumbar regions. Because an orthopaedic spine specialist often makes a diagnosis based on images, the MRI scans from each gymnast were examined by 2 orthopaedic surgeons specializing in spine disorders. Both orthopaedic surgeons were blinded to the injury histories of the gymnasts. If there were any discrepancies, consensus was reached before final grading.

Bottom Line: The prevalence of IDD was significantly higher in gymnasts with ALV than those without ALV, as determined using the chi-square test.Upper IDD had a greater association with ALV (adjusted OR, 33.17; 95% CI, 7.09-155.25) than did lower IDD (adjusted OR, 6.71; 95% CI, 1.57-28.73).Information regarding ALV is important to prevent IDD in Japanese collegiate gymnasts.

View Article: PubMed Central - PubMed

Affiliation: Department of Judotherapy, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan. ; Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo, Japan.

ABSTRACT

Background: Magnetic resonance imaging (MRI) studies have shown that gymnasts have a high prevalence of radiological abnormalities, such as intervertebral disk degeneration (IDD) and anterior limbus vertebra (ALV). These 2 abnormalities may coexist at the same spinal level. However, the relationship between IDD and ALV remains unclear.

Hypothesis: A significant relationship exists between IDD and ALV in Japanese collegiate gymnasts.

Study design: Case-control study.

Methods: A total of 104 Japanese collegiate gymnasts (70 men and 34 women; age, 19.7 ± 1.0 years) with 11.8 ± 3.6 years of sporting experience participated. T1- and T2-weighted MRIs were used to evaluate ALV and IDD.

Results: The prevalence among the gymnasts of IDD and ALV was 40.4% (42/104) and 20.2% (21/104), respectively. The prevalence of IDD was significantly higher in gymnasts with ALV than those without ALV, as determined using the chi-square test. Logistic regression analysis demonstrated a significant association between IDD and ALV (adjusted odds ratio [OR], 6.60; 95% confidence interval [CI], 2.14-20.35). IDD was further grouped by whether it was present in the upper lumbar region (L1-2, L2-3, and L3-4 disks) or in the lower lumbar region (L4-5 and L5-S1 disks). Upper IDD had a greater association with ALV (adjusted OR, 33.17; 95% CI, 7.09-155.25) than did lower IDD (adjusted OR, 6.71; 95% CI, 1.57-28.73).

Conclusion: In Japanese collegiate gymnasts, ALV is a predictor of IDD, especially in the upper lumbar region.

Clinical relevance: Information regarding ALV is important to prevent IDD in Japanese collegiate gymnasts.

No MeSH data available.


Related in: MedlinePlus