Magnetic resonance imaging findings of the lumbar spine in elite horseback riders: correlations with back pain, body mass index, trunk/leg-length coefficient, and riding discipline.
BACKGROUND
Most orthopaedic problems experienced by competitive horseback riders are related to pain in the lower back, hip joint, and hamstring muscles. Riders-especially, show jumpers-are frequently hampered in their performance because of lumbar pain. To date, there has been no research into lumbar disk degeneration in elite competitive riders.


OBJECTIVE
Competitive horseback riding accelerates lumbar disk degeneration.


METHODS
Cross-sectional study; Level of evidence, 3.


METHODS
Fifty-eight elite riders (18 men, 40 women; mean age, 32.4 years) and a control group of 30 nonriding volunteers (17 men, 13 women; mean age, 28.7 years) were evaluated for lumbar disk degeneration, cross-sectional area of paraspinal muscles, spondylolysis, and spondylolisthesis, using magnetic resonance imaging (MRI). The prevalence of disk degeneration between the 2 groups was compared, and the relationship was investigated between low back pain (LBP), riding discipline, body mass index (BMI), trunk/leg-length coefficient, and MRI results.


RESULTS
Eighty-eight percent of elite riders (n = 51) had a history of LBP, versus 33% of the controls (P < .05). There was no statistical difference for the prevalence of LBP among the different riding disciplines. However, there was a high rate of pathologic T2 signal intensity of the lumbar intervertebral disk among riders-specifically, dressage riders-yet no significant increase when compared with controls. History of LBP symptoms, riding discipline, BMI, and trunk/leg-length ratio had no significant effect on the development of lumbar disk degeneration. Occult fractures of the pars interarticularis and manifest spondylolysis were not seen for any rider. Two controls had spondylolisthesis Meyerding grade 1 not associated with back pain.


CONCLUSIONS
Although riders have a high prevalence of LBP, there is no conclusive MRI evidence to suggest that the cause lies in undue disk degeneration, spondylolysis, spondylolisthesis, or pathologic changes of the paraspinal muscles of the lumbar spine.
Kraft
Clayton N
CN
Department of Orthopaedic Surgery, Helios Klinikum Krefeld, Academic Teaching Hospital University of Düsseldorf, Krefeld, Germany. clayton.kraft@helios-kliniken.de
Pennekamp
Peter H
PH
Becker
Ute
U
Young
Mei
M
Diedrich
Oliver
O
Lüring
Christian
C
von Falkenhausen
Makus
M
D000293:Adolescent; D000328:Adult; D000818:Animals; D001265:Athletic Injuries / Q000209:etiology* / Q000473:pathology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006736:Horses; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000209:etiology* / Q000473:pathology; D017116:Low Back Pain / Q000209:etiology* / Q000473:pathology; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D055815:Young Adult