Asian Journal of Sports Medicine

Published by: Kowsar

Spine Surgery in Athletes With Low Back Pain-Considerations for Management and Treatment

Robert J. Burgmeier 1 , * and Wellington K. Hsu 1 , 2
Authors Information
1 Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, United States
2 Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, United States
Article information
  • Asian Journal of Sports Medicine: December 01, 2014, 5 (4); e24284
  • Published Online: November 10, 2014
  • Article Type: Review Article
  • Received: November 13, 2013
  • Accepted: April 9, 2014
  • DOI: 10.5812/asjsm.24284

To Cite: Burgmeier R J, Hsu W K. Spine Surgery in Athletes With Low Back Pain-Considerations for Management and Treatment, Asian J Sports Med. 2014 ; 5(4):e24284. doi: 10.5812/asjsm.24284.

Copyright © 2014, Sports Medicine Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Lumbar Degenerative Disc Disease
3. Lumbar Disc Herniation
4. Spondylolysis
5. Discussion
  • 1. Dreisinger TE, Nelson B. Management of back pain in athletes. Sports Med. 1996; 21(4): 313-20[PubMed]
  • 2. d'Hemecourt PA, Gerbino PG, 2nd, Micheli LJ. Back injuries in the young athlete. Clin Sports Med. 2000; 19(4): 663-79[PubMed]
  • 3. Burton AK, Clarke RD, McClune TD, Tillotson KM. The natural history of low back pain in adolescents. Spine (Phila Pa 1976). 1996; 21(20): 2323-8[PubMed]
  • 4. McCarroll JR, Miller JM, Ritter MA. Lumbar spondylolysis and spondylolisthesis in college football players. A prospective study. Am J Sports Med. 1986; 14(5): 404-6[PubMed]
  • 5. Lively MW, Bailes JE, Jr. Acute lumbar disk injuries in active patients: making optimal management decisions. Phys Sportsmed. 2005; 33(4): 21-7[DOI][PubMed]
  • 6. Bono CM. Low-back pain in athletes. J Bone Joint Surg Am. 2004; 86-A(2): 382-96[PubMed]
  • 7. Ong A, Anderson J, Roche J. A pilot study of the prevalence of lumbar disc degeneration in elite athletes with lower back pain at the Sydney 2000 Olympic Games. Br J Sports Med. 2003; 37(3): 263-6[PubMed]
  • 8. Sward L, Hellstrom M, Jacobsson B, Nyman R, Peterson L. Disc degeneration and associated abnormalities of the spine in elite gymnasts. A magnetic resonance imaging study. Spine (Phila Pa 1976). 1991; 16(4): 437-43[PubMed]
  • 9. Maffulli N, Longo UG, Gougoulias N, Loppini M, Denaro V. Long-term health outcomes of youth sports injuries. Br J Sports Med. 2010; 44(1): 21-5[DOI][PubMed]
  • 10. Hsu WK. Performance-based outcomes following lumbar discectomy in professional athletes in the National Football League. Spine (Phila Pa 1976). 2010; 35(12): 1247-51[DOI][PubMed]
  • 11. McCleary MD, Congeni JA. Current concepts in the diagnosis and treatment of spondylolysis in young athletes. Curr Sports Med Rep. 2007; 6(1): 62-6[PubMed]
  • 12. Patel AA, Spiker WR, Daubs M, Brodke D, Cannon-Albright LA. Evidence for an inherited predisposition to lumbar disc disease. J Bone Joint Surg Am. 2011; 93(3): 225-9[DOI][PubMed]
  • 13. Hangai M, Kaneoka K, Hinotsu S, Shimizu K, Okubo Y, Miyakawa S, et al. Lumbar intervertebral disk degeneration in athletes. Am J Sports Med. 2009; 37(1): 149-55[DOI][PubMed]
  • 14. Battie MC, Videman T, Gibbons LE, Fisher LD, Manninen H, Gill K. 1995 Volvo Award in clinical sciences. Determinants of lumbar disc degeneration. A study relating lifetime exposures and magnetic resonance imaging findings in identical twins. Spine (Phila Pa 1976). 1995; 20(24): 2601-12[PubMed]
  • 15. Videman T, Leppavuori J, Kaprio J, Battie MC, Gibbons LE, Peltonen L, et al. Intragenic polymorphisms of the vitamin D receptor gene associated with intervertebral disc degeneration. Spine (Phila Pa 1976). 1998; 23(23): 2477-85[PubMed]
  • 16. Siepe CJ, Wiechert K, Khattab MF, Korge A, Mayer HM. Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance. Eur Spine J. 2007; 16(7): 1001-13[DOI][PubMed]
  • 17. Cholewicki J, McGill SM, Norman RW. Lumbar spine loads during the lifting of extremely heavy weights. Med Sci Sports Exerc. 1991; 23(10): 1179-86[PubMed]
  • 18. Gatt CJ, Hosea TM, Palumbo RC, Zawadsky JP Jr. Impact loading of the lumbar spine during football blocking. Am J Sports Med. 1997; 25(3): 317-21[PubMed]
  • 19. Hammouri QM, Haims AH, Simpson AK, Alqaqa A, Grauer JN. The utility of dynamic flexion-extension radiographs in the initial evaluation of the degenerative lumbar spine. Spine (Phila Pa 1976). 2007; 32(21): 2361-4[DOI][PubMed]
  • 20. Modic MT, Steinberg PM, Ross JS, Masaryk TJ, Carter JR. Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology. 1988; 166(1 Pt 1): 193-9[DOI][PubMed]
  • 21. Carragee EJ, Paragioudakis SJ, Khurana S. 2000 Volvo Award winner in clinical studies: Lumbar high-intensity zone and discography in subjects without low back problems. Spine (Phila Pa 1976). 2000; 25(23): 2987-92[PubMed]
  • 22. Cooke PM, Lutz GE. Internal disc disruption and axial back pain in the athlete. Phys Med Rehabil Clin N Am. 2000; 11(4): 837-65[PubMed]
  • 23. Eddy D, Congeni J, Loud K. A review of spine injuries and return to play. Clin J Sport Med. 2005; 15(6): 453-8[PubMed]
  • 24. Krabak B, Kennedy DJ. Functional rehabilitation of lumbar spine injuries in the athlete. Sports Med Arthrosc. 2008; 16(1): 47-54[DOI][PubMed]
  • 25. Carreon LY, Glassman SD, Howard J. Fusion and nonsurgical treatment for symptomatic lumbar degenerative disease: a systematic review of Oswestry Disability Index and MOS Short Form-36 outcomes. Spine J. 2008; 8(5): 747-55[DOI][PubMed]
  • 26. Pearcy MJ. Artificial lumbar intervertebral disc replacement: accepted practice or experimental surgery? Expert Rev Med Devices. 2010; 7(6): 855-60[DOI][PubMed]
  • 27. Tumialan LM, Ponton RP, Garvin A, Gluf WM. Arthroplasty in the military: a preliminary experience with ProDisc-C and ProDisc-L. Neurosurg Focus. 2010; 28(5)[DOI][PubMed]
  • 28. Schroeder GD, McCarthy KJ, Micev AJ, Terry MA, Hsu WK. Performance-based outcomes after nonoperative treatment, discectomy, and/or fusion for a lumbar disc herniation in National Hockey League athletes. Am J Sports Med. 2013; 41(11): 2604-8[DOI][PubMed]
  • 29. Baker RJ, Patel D. Lower back pain in the athlete: common conditions and treatment. Prim Care. 2005; 32(1): 201-29[DOI][PubMed]
  • 30. Mall NA, Buchowski J, Zebala L, Brophy RH, Wright RW, Matava MJ. Spine and axial skeleton injuries in the National Football League. Am J Sports Med. 2012; 40(8): 1755-61[DOI][PubMed]
  • 31. Hsu WK, McCarthy KJ, Savage JW, Roberts DW, Roc GC, Micev AJ, et al. The Professional Athlete Spine Initiative: outcomes after lumbar disc herniation in 342 elite professional athletes. Spine J. 2011; 11(3): 180-6[DOI][PubMed]
  • 32. Deyo RA, Loeser JD, Bigos SJ. Herniated lumbar intervertebral disk. Ann Intern Med. 1990; 112(8): 598-603[PubMed]
  • 33. Krych AJ, Richman D, Drakos M, Weiss L, Barnes R, Cammisa F, et al. Epidural steroid injection for lumbar disc herniation in NFL athletes. Med Sci Sports Exerc. 2012; 44(2): 193-8[DOI][PubMed]
  • 34. Weinstein JN, Lurie JD, Tosteson TD, Tosteson AN, Blood EA, Abdu WA, et al. Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976). 2008; 33(25): 2789-800[DOI][PubMed]
  • 35. Nair R, Kahlenberg CA, Hsu WK. Outcomes of Lumbar Discectomy in Elite Athletes: The Need for High-level Evidence. Clin Orthop Relat Res. 2014; [DOI][PubMed]
  • 36. Fleisig GS, Hsu WK, Fortenbaugh D, Cordover A, Press JM. Trunk axial rotation in baseball pitching and batting. Sports Biomech. 2013; 12(4): 324-33[DOI][PubMed]
  • 37. Micheli LJ, Wood R. Back pain in young athletes. Significant differences from adults in causes and patterns. Arch Pediatr Adolesc Med. 1995; 149(1): 15-8[PubMed]
  • 38. Sakai T, Sairyo K, Suzue N, Kosaka H, Yasui N. Incidence and etiology of lumbar spondylolysis: review of the literature. J Orthop Sci. 2010; 15(3): 281-8[DOI][PubMed]
  • 39. Rossi F, Dragoni S. Lumbar spondylolysis: occurrence in competitive athletes. Updated achievements in a series of 390 cases. J Sports Med Phys Fitness. 1990; 30(4): 450-2[PubMed]
  • 40. Campbell RS, Grainger AJ, Hide IG, Papastefanou S, Greenough CG. Juvenile spondylolysis: a comparative analysis of CT, SPECT and MRI. Skeletal Radiol. 2005; 34(2): 63-73[DOI][PubMed]
  • 41. Raby N, Mathews S. Symptomatic spondylolysis: correlation of CT and SPECT with clinical outcome. Clin Radiol. 1993; 48(2): 97-9[PubMed]
  • 42. Miglioretti DL, Johnson E, Williams A, Greenlee RT, Weinmann S, Solberg LI, et al. The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr. 2013; 167(8): 700-7[DOI][PubMed]
  • 43. Saha S, Burke C, Desai A, Vijayanathan S, Gnanasegaran G. SPECT-CT: applications in musculoskeletal radiology. Br J Radiol. 2013; 86(1031): 20120519[DOI][PubMed]
  • 44. Gurd DP. Back pain in the young athlete. Sports Med Arthrosc. 2011; 19(1): 7-16[DOI][PubMed]
  • 45. Radcliff KE, Kalantar SB, Reitman CA. Surgical management of spondylolysis and spondylolisthesis in athletes: indications and return to play. Curr Sports Med Rep. 2009; 8(1): 35-40[DOI][PubMed]
  • 46. El Rassi G, Takemitsu M, Woratanarat P, Shah SA. Lumbar spondylolysis in pediatric and adolescent soccer players. Am J Sports Med. 2005; 33(11): 1688-93[DOI][PubMed]
  • 47. d'Hemecourt PA, Zurakowski D, Kriemler S, Micheli LJ. Spondylolysis: returning the athlete to sports participation with brace treatment. Orthopedics. 2002; 25(6): 653-7[PubMed]
  • 48. Boston Overlap Brace . 2013;
  • 49. Pavlovcic V. Surgical treatment of spondylolysis and spondylolisthesis with a hook screw. Int Orthop. 1994; 18(1): 6-9[PubMed]
  • 50. Drazin D, Shirzadi A, Jeswani S, Ching H, Rosner J, Rasouli A, et al. Direct surgical repair of spondylolysis in athletes: indications, techniques, and outcomes. Neurosurg Focus. 2011; 31(5)[DOI][PubMed]
  • 51. Hardcastle PH. Repair of spondylolysis in young fast bowlers. J Bone Joint Surg Br. 1993; 75(3): 398-402[PubMed]
  • 52. Debnath UK, Freeman BJ, Gregory P, de la Harpe D, Kerslake RW, Webb JK. Clinical outcome and return to sport after the surgical treatment of spondylolysis in young athletes. J Bone Joint Surg Br. 2003; 85(2): 244-9[PubMed]
  • 53. Eck JC, Riley LH, 3rd. Return to play after lumbar spine conditions and surgeries. Clin Sports Med. 2004; 23(3): 367-79[DOI][PubMed]
  • 54. Rubery PT, Bradford DS. Athletic activity after spine surgery in children and adolescents: results of a survey. Spine (Phila Pa 1976). 2002; 27(4): 423-7[PubMed]
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments