Radiologic abnormalities and low back pain in elite skiers

Lumbar radiographs of 120 adolescent elite skiers were evaluated for radiol ogic abnormalities by two independent observers. All athletes had no sympto ms before the study. Radiographs were taken before enrollment of the studen ts in elite level training. To determine the clinical significance of these abnormalities, all athletes were observed prospectively during the subsequ ent 2-year period for development of low back pain under high performance t raining. Anterior end plate lesions, Schmorl's nodes, posterior end plate l esions, spondylolysis, scoliosis, and spina bifida occulta were found. The depth of anterior end plate lesions showed a two-peak distribution, with pe aks at 11% and 22% and a valley at 18% vertebral body height. The overall l ow back pain incidence was 12.5%. Students with severe anterior lesions (gr eater than 18% vertebral body height, n = 25) had significantly more low ba ck pain (incidence, 32%) than did students without severe anterior lesions (incidence, 7.4%). Accordingly, students with severe anterior lesions had a significantly higher risk of having low back pain develop. Moderate end pl ate lesions and other abnormalities were not related to an increased incide nce of low back pain. Adolescent students of elite sports with severe lumba r anterior end plate lesions have an increased risk of having low back pain develop under high performance training.