Nagashima et al identified risk factors for lumbar disc degeneration in high school students playing American football. These can help to identify a patient who may be at increased risk for low back pain and who may benefit from follow-up. The authors are from multiple universities in Japan.

Patient selection: high school player of American football


Outcome: lumbar disc degeneration, as evidence by decrease in the signal intensity of the nucleus pulposus on MRI


Risk factors for lumbar disc degeneration:

(1) played lineman

(2) played >= 2 full seasons

(3) presence of Schmorl node (sharply marginated indentation of the vertebral endplate)

(4) disc hermiation


Risk factors for low back pain if the student continues to play football:

(1) radiological instability on imaging studies (> 5% of angulation on flexion at one intervertebral level in a lateral view)

(2) high body mass index (>= 25 kg per square meter)

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