Fatty Infiltrate of the Lumbar Multifidus Muscles Predicts Return to Play in Young Athletes with Extension-Based Low Back Pain

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© 2019 Wolters Kluwer Health, Inc. Unauthorized reproduction of this 8 article is prohibited. Objective:To evaluate the predictive value of fatty infiltrate of the lumbar multifidus muscles (LMM) for return to play in young athletes with extension-based low back pain (EB LBP).Design:Retrospective cohort study.Setting:Hospital-based sports medicine practice.Patients:Sixty-two athletes, 61.3% female, and 38.7% male, mean age 14.8 years, with a primary complaint of EB LBP who underwent magnetic resonance imaging (MRI); 46.8% had a pars interarticularis stress reaction or fracture and 53.2% were MRI negative.Interventions:A musculoskeletal fellowship-trained radiologist reviewed MRI for all subjects and graded the degree of fatty infiltrate of the LMM, using the Goutallier classification system (GCS), at the L4/L5 and L5/S1 levels.Main Outcome Measure:Days to return to play after first MD visit were correlated with the amount of fatty infiltrate in the LMM measured on MRI for each subject.Results:When the level of fatty infiltrate increased to a 2 or 3 on the GCS (greater than fatty streaks in the muscle), the predicted probability of return to sport decreased significantly.Conclusion:Our study demonstrated that athletes with EB LBP and fatty infiltrate in the LMM had lower odds of return to sport compared with athletes with normal muscle.Level of Evidence:II B.Clinical Relevance:This study provides sports medicine clinicians with a prognostic tool to help manage young athletes with EB LBP. Clinicians can make decisions regarding rehabilitation and return to play based on MRI findings.

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Clinical Journal of Sport Medicine

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