We are hearing more and more about the importance of preventing concussions in youth sports — which is great — but, as an orthopedic surgeon specializing in spine and neck health, it is my mission to also educate parents about two lesser-known sport-related injuries that can occur as a result of overuse or repeated trauma to the back.
The first injury is known as spondylolysis, which essentially is a stress fracture in the lower part of the back (the lumbar spine). The second type of injury is known as spondylolisthesis, which happens when a vertebral disc becomes unstable and slips out of its normal position over or under another disc.
Football players, gymnasts, and soccer players are especially at risk of spondylolysis and spondylolisthesis, but any activity that involves repetitive hyperextension or twisting of the spine can lead to these injuries.
Getting the right care
Although the prevalence of simple back pain in children is very low, if your son or daughter is complaining of back pain and/or leg pain for longer than a few weeks, it might be time to see a spine specialist for further evaluation. If your child’s back pain is accompanied by neurological symptoms such as numbness or tingling, it is imperative to investigate these symptoms as thoroughly as possible to determine and treat the cause.
In my office, we conduct a full neurological exam, including MRI or CT scanning of the lower back, to diagnose suspected spinal injuries in pediatric patients. If spondylolysis or spondylolisthesis is diagnosed, the first line of treatment is always conservative, non-surgical management. Treatment most often includes a period of rest coupled with a back brace, which is typically worn for three months while the injury heals.
If the back pain is resolved after rest and treatment with the brace, most patients are able to resume normal activities after the three months, although participation in sports may be limited at first to avoid reinjuring the back. Physical therapy and sports conditioning may also be recommended after such an injury.
The young spine and scoliosis
Another spinal condition commonly seen in children is scoliosis, which is an abnormal sideways curvature of the spine. Under New Jersey law, all schools are required to screen students age 10 through 18 for scoliosis every other year. Screening is done by the school nurse, and students who have signs of curvature are referred to their family’s health care provider for additional follow-up.
Treatment of scoliosis depends on many factors, including the patient’s age and size of the curve detected, which is the most important factor. A curve of less than 30 degrees usually requires observation with X-rays at least once a year. A curve between 30 and 50 degrees usually requires a brace, while curves that exceed 50 degrees are most often treated surgically.
If your child participates in sports, the most important take-away for parents is to take your child’s complaints of back pain very seriously and make sure your child is evaluated by a dedicated spine specialist to ensure the best outcome possible.
At CentraState, we have a team approach to the evaluation and treatment of spinal injuries and diseases in young patients. Our expert team includes pediatricians, brace specialists, physical therapists, and spine surgeons, all working together to guide pediatric patients and their parents through every step of the diagnostic and treatment process. Additionally, at the Spine Institute of Central Jersey at CentraState, pediatric patients will receive customized and tailored physical therapy treatment plans for both non-surgical and surgical conditions to help young patients return to normal activities quickly. For more information on all of the services offered at The Spine Institute of Central Jersey, call (732) 637-6316.
Grigory Goldberg, MD is a fellowship-trained orthopedic surgeon specializing in spine surgery, including minimally invasive spine surgery. He treats all aspects of spine problems in patients of all ages, including degenerative diseases of the neck and back, sciatica pain, arm pain, scoliosis, tumors, and more. Dr. Goldberg may be reached by calling 866-CENTRA7.
