Overuse injuries in female athletes.

The last three decades have witnessed a tremendous increase in female sports participation at all levels. However, increased sports participation of female athletes has also increased the incidence of sport-related injuries, which can be either acute trauma or overuse injuries. Overuse injuries may be defined as an imbalance caused by overly intensive training and inadequate recovery, which subsequently leads to a breakdown in tissue reparative mechanisms. This article will review the most frequent overuse injuries in female athletes in the context of anatomical, physiological, and psychological differences between genders.

Effect of postoperative lumbar sagittal alignment on the development of adjacent instability.

OBJECTIVE: This study investigated the effect of postoperative lumbar sagittal alignment on the development of adjacent segment instability. METHODS: The patients were retrospectively divided into two groups (hypolordotic and hyperlordotic) using the lumbar lordosis on lateral lumbosacral view. Diagnosis of adjacent segment instability depended on the dynamic lateral views of the lumbosacral spine. RESULTS: Thirteen (21.7%) cases developed adjacent segment instability during the 6-year follow-up. The two groups had no significant difference in rates of developing adjacent segment instability. CONCLUSION: Restoring the lordosis of the lumbar curve during one motion segment fusion does not prevent the development of adjacent instability.

Percutaneous transpedicular discectomy and drainage in pyogenic spondylodiscitis.

The natural history of uncomplicated hematogenous pyogenic spondylodiscitis is self-limiting healing. However, a variable degree of bone destruction frequently occurs, predisposing the spine to painful kyphosis. Delayed treatment may result in serious neurologic complications. Early debridement of these infections by percutaneous transpedicular discectomy can accelerate the natural process of healing and prevent progression to bone destruction and epidural abscess. The purpose of this manuscript is to present our technique of percutaneous transpedicular discectomy (PTD), to revisit this minimally invasive surgical technique with stricter patient selection, and to exclude cases of extensive vertebral body destruction with kyphosis and neurocompression by epidural abscess, infected disc herniation, and foraminal stenosis. In a previously published report of 28 unselected patients with primary hematogenous pyogenic spondylodiscitis, the immediate relief of pain after PTD was 75%, and in the long-term follow-up, the success rate was 68%. Applying stricter patient selection criteria in a second series of six patients (five with primary hematogenous spondylodiscitis and one with secondary postlaminectomy-discectomy spondylodiscitis), all patients with primary hematogenous spondylodiskitis (5/5) experienced immediate relief of pain that remained sustained at 12-18 months follow-up. This procedure was not very effective, however, in the patient who suffered from postlaminectomy infection. This lack of response was attributed to postlaminectomy-discitis instability. The immediate success rate after surgery for unselected patients in this combined series of 34 patients was 76%. This technique can be impressively effective and the results sustained when applied in the early stages of uncomplicated spondylodiscitis and contraindicated in the presence of instability, kyphosis from bone destruction, and neurological deficit. The special point of this procedure is a minimally invasive technique with high diagnostic and therapeutic effectiveness.

Abordaje anterior transperitoneal para lesiones de columna lumbo-sacra / Anterior transperitoneal access for lesions of the lunbo-sacral spine

Se relata un caso de dolor lumbar con irradiacion tipo radicular bilateral por Espondilolisis bilateral con Espondilolistesis L5-S1, sin mejoria con el tratamiento conservador, por lo que se decidio el abordaje posterior con decomprension radicular e instrumentacion metalica con marco de Hartshill mas artrodesis Lumbo-Sacra y en una segunda etapa el Abordaje anterior transperitoneal con el objetivo de hacerle discectomia y fusion con injerto oseo L5-S1.

Spondylolysis in fast bowlers: principles of prevention and a survey of awareness among cricket coaches.

Back injury in general, and spondylolysis in particular, represents a serious threat to the fast bowler. Hereditary factors, poor technique, overuse, and poor preparation for fast bowling may combine to produce the 'at risk' bowler. Three first-class county coaches were interviewed to establish a level of awareness of the lesion, with an emphasis on preparation of fast bowlers and the roles of technique alteration and bowling prescription in reducing the risk of back injury.

Back injuries in dancers.

Back injuries may occur at any age or level of skill and are slightly more prevalent in male dancers. The risk factors that may be involved in a given injury include training errors, musculotendinous imbalance, anatomic malalignment of the lower extremity, shoe wear, and floor surface. Assessment of these risk factors provides guides for management and prevention.

Gymnastic injuries.

The gymnast often places unphysiologic extreme stresses upon her body during the maneuvers characteristic of that sport. These may result in stress fractures to the skeleton, the lumbar spine being at greatest risk. Minor malalignments of the extremities can encourage injury. The extremes of joint position can produce significant symptoms with chrondromalacia.