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Spine Injuries: Conservative Managment, Operative Management and Return to Sport

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Masterful Care of the Aging Athlete

Abstract

Back pain affects 85% of the population during their lifetime. Spinal injuries often prohibit people from both vocation and recreation. In treating the masters athlete, it is important for the physician and trainer to have an understanding of evidence-based treatment modalities to provide the best care to the athlete, and return them to sport in a safe and efficient manner. In this chapter, we will discuss the biology behind various spine maladies and the evidence-based treatment that can be useful in treating them.

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References

  1. Leboeuf-Yde C, Lauritsen JM. The prevalence of low back pain in the literature. A structured review of 26 Nordic studies from 1954 to 1993. Spine. 1995;20:2112–8.

    Article  CAS  PubMed  Google Scholar 

  2. WHO. The burden of musculoskeletal conditions at the start of the new millennium. In: World Health Organization technical report series. 2003.

    Google Scholar 

  3. Heneweer H, Staes F, Aufdemkampe G, et al. Physical activity and low back pain: a systematic review of recent literature. Eur Spine J. 2011;20:826–45.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Heneweer H, Vanhees L, Picavet HS. Physical activity and low back pain: a U-shaped relation? Pain. 2009;143:21–5.

    Article  PubMed  Google Scholar 

  5. Malmivaara A, Häkkinen U, Aro T, Heinrichs M-L, Koskenniemi L, Kuosma E, Lappi S, Paloheimo R, Servo C, Vaaranen V, Hernberg S. The treatment of acute low back pain—bed rest, exercises, or ordinary activity. N Engl J Med. 1995;332(6):351–5.

    Article  CAS  PubMed  Google Scholar 

  6. Rozenberg S, Delval C, Rezvani Y. Bed rest or normal activity for patients with acute low back pain: a randomized controlled trial. Spine. 2002;27:1487–93.

    Article  PubMed  Google Scholar 

  7. Wiesel SW, Cuckler JM, Deluca F, Jones F, Zeide MS, Rothman RH. Acute low back pain: an objective analysis of conservative therapy. Spine. 1980;5:324–30.

    Article  CAS  PubMed  Google Scholar 

  8. Berry H, Bloom B, Hamilton EBD, Swinson DR. Naproxen sodium, diflunisal, and placebo in the treatment of chronic back pain. Ann Rheum Dis. 1982;41:129–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Babej-Dolle R, Freytag S, Eckmeyer J, Zerle G, Schinzel S, Schmeider G, Stankov G. Parenteral dipyrone versus diclofenac and placebo in patients with acute lumbago or sciatic pain: randomized observer-blind multicenter study. Int J Clin Pharmacol Ther. 1994;32:204–9.

    PubMed  CAS  Google Scholar 

  10. Weinstein JN, Tosteson TD, Lurie JD, Tosteson A, Blood E, Herkowitz H, Cammisa F, Albert T, Boden SD, Hilibrand A, Goldberg H, Berven S, An H. Surgical versus non-operative treatment for lumbar spinal stenosis four year results of the Spine Patient Outcomes Research Trial (SPORT). Spine. 2010;35:1329–38.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Boos N, Weissbach S, Rohrbach H, Weiler C, Spratt KF, Nerlich AG. Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science. Spine. 2002;27(23):2631–44.

    Article  PubMed  Google Scholar 

  12. Weiler C, Schietzsch M, Kirchner T, Nerlich AG, Boos N, Wuertz K. Age-related changes in human cervical, thoracal and lumbar intervertebral disc exhibit a strong intra-individual correlation. Eur Spine J. 2012;21(Suppl 6):S810–8.

    Article  PubMed  Google Scholar 

  13. Matsumoto M, Fujimura Y, Suzuki N, et al. MRI of cervical intervertebral discs in asymptomatic subjects. J Bone Joint Surg Br. 1998;80(1):19–24.

    Article  CAS  PubMed  Google Scholar 

  14. Lees F, Turner JW. Natural history and prognosis of cervical spondylosis. Br Med J. 1963;2:1607–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Naylor JR, Mulley GP. Surgical collars: a survey of their prescription and use. Br J Rheumatol. 1991;30:282–4.

    Article  CAS  PubMed  Google Scholar 

  16. Swezey RL, Swezey AM, Warner K. Efficacy of home cervical traction therapy. Am J Phys Med Rehabil. 1999;78:30–2.

    Article  CAS  PubMed  Google Scholar 

  17. Ghasemi M, Masaeli A, Rezvani M, Shaygannejad V, Golabchi K, Norouzi R. Oral prednisolone in the treatment of cervical radiculopathy: a randomized placebo controlled trial. J Res Med Sci. 2013;18(Suppl 1):S43–6.

    PubMed  PubMed Central  Google Scholar 

  18. Stav A, Ovadia L, Sternberg A, et al. Cervical epidural steroid injection for cervicobrachialgia. Acta Anaesthesiol Scand. 1993;37:562–6.

    Article  CAS  PubMed  Google Scholar 

  19. Barlocher CB, Barth A, Krauss JK, Binggeli R, Seiler RW. Comparative evaluation of microdiscectomy only, autograft fusion, polymethylmethacrylate interposition, and threaded titanium cage fusion for treatment of single-level cervical disc disease: a prospective randomized study in 125 patients. Neurosurg Focus. 2002;12(1):E4.

    Article  PubMed  Google Scholar 

  20. Jawahar A, Cavanaugh DA, Kerr EJ 3rd, Birdsong EM, Nunley PD. Total disc arthroplasty does not affect the incidence of adjacent segment degeneration in cervical spine: results of 93 patients in three prospective randomized clinical trials. Spine J. 2010;10(12):1043–8.

    Article  PubMed  Google Scholar 

  21. Song KJ, Choi BW, Kim GH, Song JH. Usefulness of polyetheretherketone (PEEK) cage with plate augmentation for anterior arthrodesis in traumatic cervical spine injury. Spine J. 2010;10(1):50–7.

    Article  PubMed  Google Scholar 

  22. Watters WC 3rd, Levinthal R. Anterior cervical discectomy with and without fusion. Results, complications, and long-term follow-up. Spine (Phila Pa 1976). 1994;19(20):2343–7.

    Article  Google Scholar 

  23. Bohlman HH, Emery SE, Goodfellow DB, Jones PK. Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients. J Bone Joint Surg Am. 1993;75(9):1298–307.

    Article  CAS  PubMed  Google Scholar 

  24. Herkowitz HN, Kurz LT, Overholt DP. Surgical management of cervical soft disc herniation. A comparison between the anterior and posterior approach. Spine (Phila Pa 1976). 1990;15(10):1026–30.

    Article  CAS  Google Scholar 

  25. Coric D, Nunley PD, Guyer RD, et al. Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex|C artificial disc investigational device exemption study with a minimum 2-year follow-up. J Neurosurg Spine. 2011;15(4):348–58.

    Article  PubMed  Google Scholar 

  26. Hakelius A. Prognosis in sciatica. A clinical follow-up of surgical and non-surgical treatment. Acta Orthop Scand Suppl. 1970;129:1–76.

    Article  CAS  PubMed  Google Scholar 

  27. Githens PB, O’Conner T, Weil U, Calogero JA, Holford TR, White AA 3rd, Walter SD, Ostfeld AM, Southwick WO. Acute prolapsed lumbar intervertebral disc. An epidemiologic study with special reference to driving automobiles and cigarette smoking. Spine. 1984;9:608–13.

    Article  PubMed  Google Scholar 

  28. Hofstee DJ, Gijtenbeek JM, Hoogland PH, van Houwelingen HC, Kloet A, Lotters F, Tans JT. Westeinde sciatica trial: randomized controlled study of bed rest and physiotherapy for acute sciatica. J Neurosurg. 2002;96(1 Suppl):45–9.

    PubMed  Google Scholar 

  29. Vroomen PC, de Krom MC, Slofstra PD, Knottnerus JA. Conservative treatment of sciatica: a systematic review. J Spinal Disord. 2000;13:463–9.

    Article  CAS  PubMed  Google Scholar 

  30. Beresford HR. Dexamethasone is not superior to placebo for treating lumbosacral radicular pain. Neurology. 1986;36:1593–4.

    Article  PubMed  Google Scholar 

  31. Damunni G, Hoffer E, Baum Y, Krivoy N. Lamotrigine for intractable sciatica: correlation between dose, plasma concentration and analgesia. Eur J Pain. 2003;7:485–91.

    Article  CAS  PubMed  Google Scholar 

  32. Arden NK, Price C, Reading I, Stubbing J, Hazelgrove J, Dunne C, Michel M, Rogers P, Cooper C, WEST Study Group. A multicentre randomized controlled trial of epidural corticosteroid injections for sciatica: the WEST study. Rheumatology (Oxford). 2005;44:1399–406.

    Article  CAS  Google Scholar 

  33. Schaufele M, Hatch L. Interlaminar versus transforaminal epidural injections in the treatment of symptomatic lumbar intervertebral disc herniations. Arch Phys Med Rehabil. 2002;83:1661.

    Google Scholar 

  34. Dubourg G, Rozenberg S, Fautrel B, Valls-Bellec I, Bissery A, Lang T, Faillot T, Duplan B, Briancon D, Levy-Weil F, Morlock G, Crouzet J, Gatfosse M, Bonnet C, Houvenagel E, Hary S, Brocq O, Poiraudeau S, Beaudreuil J, de Sauverzac C, Durieux S, Levade MH, Esposito P, Maitrot D, Goupille P, Valat JP, Bourgeois P. A pilot study on the recovery from paresis after lumbar disc herniation. Spine. 2002;27:1426–31.

    Article  PubMed  Google Scholar 

  35. Bush K, Cowan N, Katz DE, Gishen P. The natural history of sciatica associated with disc pathology. A prospective study with clinical and independent radiologic follow-up. Spine. 1992;17:1205–12.

    Article  CAS  PubMed  Google Scholar 

  36. Balderston RA, Gilyard GG, Jones AA, Wiesel SW, Spengler DM, Bigos SJ, Rothman RH. The treatment of lumbar disc herniation: simple fragment excision versus disc space curettage. J Spinal Disord. 1991;4:22–5.

    PubMed  CAS  Google Scholar 

  37. Slover J, Abdu WA, Hanscom B, Lurie J, Weinstein JN. Can condition-specific health surveys be specific to spine disease? An analysis of the effect of comorbidities on baseline condition-specific and general health survey scores. Spine. 2006;31:125–71.

    Google Scholar 

  38. Hsu WK, Mccarthy KJ, Savage JW, et al. The Professional Athlete Spine Initiative: outcomes after lumbar disc herniation in 342 elite professional athletes. Spine J. 2011;11(3):180–6.

    Article  PubMed  Google Scholar 

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Correspondence to Joon Y. Lee MD .

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Nwasike, C., Hong, P., Lee, J.Y. (2018). Spine Injuries: Conservative Managment, Operative Management and Return to Sport. In: Wright, V., Middleton, K. (eds) Masterful Care of the Aging Athlete. Springer, Cham. https://doi.org/10.1007/978-3-319-16223-2_13

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  • DOI: https://doi.org/10.1007/978-3-319-16223-2_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-16222-5

  • Online ISBN: 978-3-319-16223-2

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