Lumbar Spine Injuries in Athletes

Ian F. Dunn, MD; Mark R. Proctor, MD; Arthur L. Day, MD.


Neurosurg Focus. 2006;21(4) 

In This Article

Abstract and Introduction


Lumbar spine injuries in athletes are not uncommon and usually take the form of a mild muscle strain or sprain. More severe injuries sustained by athletes include disc herniations, spondylolistheses, and various types of fracture. The recognition and management of these injuries in athletes involve the additional consideration that to return to play, the lumbar spine must be able to withstand forces similar to those that were injurious. The authors consider common lumbar spine injuries in athletes and discuss management principles for neurosurgeons that are relevant to this population.


The increased number of adults and adolescents who regularly participate in athletic activity has raised the collective awareness of common low-back in juries (bruising, overstretching, or mild to moderate tearing of the paraspinal soft tissues). A smaller percentage of injuries pose legitimate threats to the continued participation of the athlete in sport; these include such disorders as disc herniation, spondylolysis, and minor fractures. Be cause lumbar spine injuries usually do not affect the spinal cord, symptoms are milder, typically cause only pain and/ or single-level nerve root impingement, and continued participation in athletics is generally possible.

For the recreational athlete, from the "weekend warrior" to advanced amateur, his or her livelihood is usually obtained through means other than in the athletic arena, and cessation of play may be an unfortunate yet acceptable outcome after conservatively or surgically managed lumbar spine injury. For the elite athlete whose subsistence demands unencumbered physical performance, lumbar spine injury is a daunting prospect. The elite performer must attain an excellent functional outcome to treatment to be able to continue at the same level of performance. When surgery is required, the neurosurgeon must disturb tissue to the minimum amount necessary for a successful outcome, while remaining mindful that the athlete will continue to face the same physical stresses and dangers that were injurious in the first place. We review four common injuries to the lumbar spine in athletes (soft-tissue injuries, disc herniations, pars defects and their sequelae, and other minor fractures) and discuss their management and return-to-play guidelines.


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