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Pre-Season MRI Scan Predictability of Lumbar Spinal Injury in High School, College and Professional Basketball Player Populations 2006

General Spine

Kent B. Remley, MD, ASSR Member
Kimberly M. Fitzpatrick, MS, Non ASSR Member
Eric A. Thomas, MD, Non ASSR Member
Kenneth E. Davis, MS, Non ASSR Member
Robert H. Dorwart, MD, Non ASSR Member
Michael F. Coscia, MD, Non ASSR Member

Scientific Paper

Purpose

To determine the degree to which a pre-season MRI scan of the lumbosacral spine could predict subsequent injury and/or pain complaints in the lower back during that following season in populations of male/female high school, college and professional basketball players.

Methods & Materials

Seventy players were initially enrolled in this study. A standardized MRI scan of the lumbosacral spine and a medical history form were obtained on each athlete. A standardized evaluation of each player was attempted weekly by each team's athletic trainer. Fifty-nine players completed the full study. The MR scans were reviewed by two experienced neuroradilogists. Each study was evaluated for spondylolysis/spondylolisthesis, disc degeneration, disc herniation, spinal stenosis, facet joint abnormalites, and the presence of juvenile discogenic disease.

Results

The MRI scans were eventually categorized into three progressive grades of severity. These revealed:

A) High school and college players were almost equivalent with 63% and 68% respectively being normal. Pro players had much higher proportions in both the mid-range (53%) and severe (26%) categories.
B) When viewed as <18 y.o. (35 players) compared to >19 y.o. (35 players), the percentages of abnormal increased significantly in the older population, but not as severely as in the pro players.
C) The MRI severity grade increased as the lumbar lordosis decreased (p=.0019).
D) The players in the "mid-grade" had 4.9 times the odds of developing new low back pain during the season when compared to normal (p=0.0272).

Regarding low back pain:

A) High school players had 6 times the odds of new pain (p=.0097) and 8 times the odds of any pain (p=.0072) compared to college players.
B) Pro players had 21.8 times the odds of a college player (p=.0470) and 2.5 times the odds of a high school player (p=.0470) for low back pain during a season.
C) A history of low back pain increased the odds by 5.2 times that pain would occur during the season (p=.0268).

Conclusion

1. Pro basketball players demonstrated significantly increased degrees of degenerative/pathological change on their MRI scans compared to high school or college players, more marked than age alone would appear to explain.
2. High school players had a far greater amount of new and recurrent low back pain during a season than could clearly be explained by MRI scan findings alone.