Medical Student University of Illinois College of Medicine at Chicago Chicago, Illinois, United States
Introduction: The fitness industry has grown substantially in the past two decades, resulting in higher participation in exercise and weightlifting activities according to CDC estimates. Certain heavy or high-intensity exercises may predispose to lumbar spine injuries that require subsequent surgical intervention. The purpose of this study is to evaluate the incidence and characteristics of such injuries over the past two decades.
Methods: The National Electronic Injury Surveillance System was queried from 2002 to 2021 for all fracture and dislocation injuries to the lower trunk associated with exercise or exercise equipment in the United States. Injuries were classified as either weight-bearing (WB) or non-weight-bearing (non-WB) based on the type of exercise equipment involved. Differences in incidence, patient demographics, and treatment disposition were assessed with Student’s t-tests and chi-squared tests.
Results: A total of 43,397 estimated patients with exercise-associated fracture or dislocation injury of the lumbar spine between 2002 and 2021 were identified. In 2021, there were an estimated 3,647 injuries, 99.27% of which were non-WB injuries, corresponding to an incidence of 10.91 cases per million per year. These rates represent a 70.63% increase for WB and 467.03% increase for non-WB injuries since 2002. Differences between the WB and non-WB groups in age (16 vs. 66, p< 0.001), percent female (63.76% vs. 61.18%, p=0.785), percent minority population (63.76% vs. 9.34%, p=0.067), and percent treated and subsequently admitted following presentation to the emergency department (63.76% vs. 63.38%, p=1) were compared.
Conclusion : The incidence of exercise-associated lumbar spine injuries have increased five-fold since 2002, overwhelmingly driven by non-WB exercises. Older white women participating in non-WB exercises represent the highest risk profile. Further research is warranted to aid neurosurgical spine practices to better manage and prevent this increasingly prevalent route of injury.
