Radiographic Changes in the Lumbar Spine in Former Elite Athletes

Abstract

The authors conducted a retrospective cohort study. The objective of this study was to clarify the occurrence of radiographic changes (vertebral osteophytes, heights of lumbar discs, concavity index) of the lumbar spine in former elite athletes of different track and field disciplines. The influence of physical activity on occurrence of radiographic changes in the lumbar spine is not well known and seems to be contradictory. The loadings in the different track and field disciplines seem to play an important role in the development of radiographic changes. One hundred fifty-nine former male elite track and field athletes were selected for a radiologic study. The heights of lumbar discs, the concavity index, the presence of anterior vertebral osteophytes, a radiographic evaluation according to Kellgren and Lawrence, and the FFbH-R score for the assessment of functional limitations in activities of daily living (ADLs) were determined. The influence of age, body mass index, current physical activity, and training history was also examined. In high jumpers and throwers, the absolute heights of lumbar discs increased from level T12/L1 to a maximum at L4/L5 and decreased again from level L4/L5-L5/S1. In endurance athletes and other jumpers, the absolute heights increased linearly from level T12/L1 to a maximum at L5/S1. The concavity index did not yield any significant differences between athlete categories. Shot putters, discus throwers, and high jumpers showed a significantly higher prevalence of osteophytes after adjustment for possible confounders. According to Kellgren and Lawrence, the highest prevalence of radiographic changes in the lumbar spine is seen in javelin throwers. Significant differences in the assessment of functional limitations in ADLs are not found between the disciplines. In throwing disciplines, the lumbar spine is more highly loaded than in jumpers and runners. Despite the observation of evident degenerative changes in some former athletes, there were only minor changes seen in ADLs. Even if body constitution is taken as a preselection factor, athletes in throwing disciplines as well as high jumpers have a higher risk of developing vertebral osteophytes of the lumbar spine.