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. 2022 Nov 15;10(11):23259671221119439.
doi: 10.1177/23259671221119439. eCollection 2022 Nov.

Effects of Competition Level on the Prevalence and Incidence of Lumbar Disk Degeneration in Japanese Collegiate Gymnasts

Koji Koyama  1 , Koichi Nakazato  2 , Yoshiaki Kubo  1 , Koji Gushiken  3 , Yoshiaki Hatakeda  3 , Kyoko Seo  3 , Takuya Nakase  3 , Kenji Hiranuma  4
Affiliations

Effects of Competition Level on the Prevalence and Incidence of Lumbar Disk Degeneration in Japanese Collegiate Gymnasts

Koji Koyama et al. Orthop J Sports Med. .

Abstract

Background: Lumbar disk degeneration (LDD) occurs frequently in athletes. Researchers have found that LDD occurs mainly in the lower disks (L4/L5 and L5/S1) in the general and athletic populations. However, a retrospective study showed a high prevalence of LDD in the upper lumbar disks (L1/L2), especially in elite gymnasts.

Purpose: To investigate the effect of competition level on the prevalence and incidence of LDD in the upper lumbar disks (L1/L2).

Study design: Cross-sectional study; Level of evidence, 3; and cohort study; Level of evidence, 2.

Methods: We conducted 2 studies to evaluate the effect of competition level on the prevalence and incidence of LDD in Japanese collegiate gymnasts. In study 1, a cross-sectional study of 298 collegiate gymnasts was conducted between 2011 and 2015. Competition levels were categorized as regional, national, and international, and T2-weighted magnetic resonance imaging (MRI) was used to evaluate LDD. Chi-square testing was applied to assess differences in the prevalence of LDD and spinal levels among the 3 competition levels. In study 2--a prospective cohort study--LDD progression and its related risk factors were investigated in 51 collegiate gymnasts. Baseline lumbar MRI scans and measurements of physical function (generalized joint laxity and finger-floor distance test) were performed in March 2014. Follow-up lumbar MRI scans were obtained 2 years later, in February 2016. Logistic regression analyses were performed to investigate the relationship between competition level and LDD progression.

Results: In study 1, the prevalence of at least 1 degenerated disk in the regional, national, and international groups was 44.2% (19/43), 44.7% (98/219), and 52.8% (19/36), respectively (P = .655). The prevalence of LDD at L1/L2 in the international group was significantly higher than that in the other 2 groups (P = .018). In study 2, the presence of LDD at L1/L2 was associated significantly with international-level competition (adjusted odds ratio, 47.8; 95% CI, 2.75-830.50).

Conclusion: In Japanese collegiate gymnasts, competing at the international level was found to be a risk factor for LDD at L1/L2.

Keywords: gymnastics; intervertebral disk degeneration; magnetic resonance imaging; risk factor.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: This work was supported by a Japan Society for the Promotion of Science KAKENHI grant (16K01741). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Flow diagram of studies 1 and 2.
Figure 2.
Figure 2.
Progression of LDD at L1/L2 on sagittal T2-weighted MRI scans in gymnasts competing at the international level. (A) At baseline. (B) Two-year follow-up MRI scan showing a reduction in signal intensity of the intervertebral disk at L1/L2 (black arrow). LDD, lumbar disk degeneration; MRI, magnetic resonance imaging.
See this image and copyright information in PMC

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