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Decision Making and Classification

The primary decision that a sports physician must make when confronted with a thoracolumbar condition is whether the athlete has a significant mechanical and/or neurological instability requiring urgent or emergent stabilization.

The spinal problem can be categorized initially as a high-energy injury, a low-energy injury, or even a no-injury situation. In turn, high-energy injuries to […]

Diagnostic Imaging

For the majority of athletes presenting with thoracolumbar pain, the initial investigation is still the plain-film anteroposterior (AP) and lateral radiographs. The AP view will depict the sagittal alignment as well as congenital anomalies at the thoracolumbar and lumbosacral junctions.

The architecture of the bodies, spinous processes, transverse processes, lamina, and pedicles also are depicted […]

Clinical Evaluation-Physical Examination

The examination of the injured athlete’s spine initially may be limited to a cursory four-limb sensory and voluntary motor assessment along with palpation of the entire spine for point tenderness during the log-roll onto a spine board for transport off the playing field.

The primary concern of the sports physician with a severely traumatized athlete […]

Clinical Evaluation-History

The sports physician may be required to assess for a spinal problem in situations varying from an unconscious athlete in a difficult environmental presentation, such as on a steep ski slope or in a crumpled racecar, to a preparticipation examination in a sports medicine clinic.

The history may be the most important aspect of a […]

Anatomy and Biomechanics

A good background in the anatomy and clinical biomechanics of the thoracolumbar spine will provide the basis for understanding the mechanisms of injury and the principles of management. The majority of thoracolumbar spine injuries arising from low-velocity sports usually are less catastrophic than some of the athletic injuries involving the more vulnerable cervical spine.

The […]