Prevalence and clinical features of sports-related lumbosacral stress injuries in the young

Arch Orthop Trauma Surg. 2017 May;137(5):685-691. doi: 10.1007/s00402-017-2686-y. Epub 2017 Mar 27.


Background: Stress injuries (stress fractures and stress reactions) of the lumbosacral region are one of the causes of sports-related lower back pain in young individuals. These injuries can be detected by bone marrow edema lesion on MRI. However, little is known about the prevalence and clinical features of early stage lumbosacral stress injuries. This study aimed to evaluate the epidemiology of lumbosacral stress injuries.

Methods: A total of 312 patients (under 18 years of age) who complained of sports-related lower back pain that had lasted for ≥7 days underwent magnetic resonance imaging (MRI) scans. We reviewed patients' records retrospectively.

Results: MRI showed that 33.0% of the patients had lumbar stress injuries and 1.6% had sacral stress injuries. Lumbar stress injuries were more common in males than in females and were found in 30% of 13- to 18-year-old patients. About 50% of the patients that participated in soccer or track and field were diagnosed with lumbar stress injuries. No clinical patterns in the frequencies of sacral stress injuries were detected due to the low number of patients that suffered this type of injury. Plain radiography is rarely able to detect the early stage lesions associated with lumbosacral stress injuries, but such lesions can be detected in the caudal-ventral region of the pars interarticularis on sagittal computed tomography scans. Thirty-three percent of young patients that complained of sports-related lower back pain for ≥7 days had lumbar stress injuries, while 1.6% of them had sacral stress injuries. Clinicians should be aware of the existence of these injuries. MRI is useful for diagnosing lumbosacral stress injuries.

Keywords: Low back pain; Lumbar spine; Prevalence; Sacrum; Stress injury.

MeSH terms

  • Adolescent
  • Athletic Injuries* / diagnosis
  • Athletic Injuries* / epidemiology
  • Athletic Injuries* / physiopathology
  • Female
  • Humans
  • Japan / epidemiology
  • Low Back Pain* / diagnosis
  • Low Back Pain* / epidemiology
  • Low Back Pain* / etiology
  • Lumbar Vertebrae* / diagnostic imaging
  • Lumbar Vertebrae* / injuries
  • Magnetic Resonance Imaging / methods
  • Male
  • Prevalence
  • Radiography / methods
  • Retrospective Studies
  • Sacrum* / diagnostic imaging
  • Sacrum* / injuries
  • Tomography, X-Ray Computed / methods