PT  - JOURNAL ARTICLE
AU  - Yamashita, Kazuta
AU  - Sakai, Toshinori
AU  - Takata, Yoichiro
AU  - Tezuka, Fumitake
AU  - Manabe, Hiroaki
AU  - Morimoto, Masatoshi
AU  - Kinoshita, Yutaka
AU  - Yonezu, Hiroshi
AU  - Chikawa, Takashi
AU  - Mase, Yasuyoshi
AU  - Sairyo, Koichi
TI  - Low Back Pain in Adolescent Athletes: Comparison of Diagnoses Made by General Orthopedic Surgeons and Spine Surgeons
AID  - 10.14444/6024
DP  - 2019 Apr 01
TA  - International Journal of Spine Surgery
PG  - 6024
4099  - https://www.ijssurgery.com/content/early/2019/04/23/6024.short
4100  - https://www.ijssurgery.com/content/early/2019/04/23/6024.full
AB  - Background Nonspecific low back pain (NSLBP) is a term used to describe low back pain of unknown origin with no identifiable generators. Over a decade ago, it was reported to account for about 85% of all cases of low back pain, although there is some doubt about the frequency. The purpose of this study was to determine the frequency of NSLBP in adolescent athletes diagnosed by general orthopedic surgeons and by spine surgeons. Materials and Methods A total of 69 adolescent athletes consulted our sports spine clinic to seek a second opinion for low back pain. Data on age, sex, type of sport played, the previous diagnosis made by general orthopedic surgeons, and the final diagnosis made by spine surgeons were collected retrospectively from medical records.Results The frequency of NSLBP diagnosed by general orthopedic surgeons was 18.9% and decreased to 1.4% after careful imaging and functional nerve block examination by spine surgeons. The final diagnoses made by spine surgeons for those patients previously diagnosed as having NSLBP by general orthopedic surgeons were as follows: early-stage lumbar spondylolysis, discogenic low back pain, facet joint arthritis, lumbar disc herniation, and lumbar apophyseal ring fracture.Conclusions In adolescent athletes, the rate of NSLBP diagnosed by general orthopedic surgeons decreased markedly when the diagnosis was made by spine surgeons. A thorough medical interview, careful physical examination, appropriate diagnostic imaging, and selective nerve block examination can effectively identify the cause of low back pain.