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First published on July 20, 2004, doi:10.1177/0363546504264930
This version was published on September 1, 2004
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The American Journal of Sports Medicine 32:1434-1439 (2004)
© 2004 American Orthopaedic Society for Sports Medicine

Hyperconcavity of the Lumbar Vertebral Endplates in the Elite Football Lineman

Claude T. Moorman, III, MD*, David C. Johnson, MD{dagger}, Helene Pavlov, MD{dagger}, Ronnie Barnes, MS, ATC{dagger}, Russell F. Warren, MD{dagger}, Kevin P. Speer, MD* and Joseph H. Guettler, MD*,{ddagger}

From * Duke Sports Medicine, Duke University Medical Center, Durham, North Carolina, and the {dagger} Departments of Radiology and Orthopaedic Surgery, Hospital for Special Surgery, New York, New York

{ddagger} Address correspondence to Joseph H. Guettler, MD, Performance Orthopedics, 24255 13 Mile Road, Suite 100, Bingham Farms, MI 48025 (e-mail: jguettlermd{at}wideopenwest.com).

Background: Hyperconcavity of the vertebral endplates is a previously unreported radiologic phenomenon.

Purpose: To analyze hyperconcavity of the vertebral endplates with expansion of the disk space in pre–National Football League lineman and to determine its clinical significance.

Study Design: Descriptive anatomical study.

Methods: Over a 2-year period (1992–1993), 266 elite football linemen were evaluated at the National Football League scouting combine held in Indianapolis, Indiana. Evaluation focused on the lumbosacral spine and included history, physical examination, and lateral radiographs. Measurements were taken of all the vertebral endplate defects of involved vertebrae and compared with an age-matched control group of 110 patients.

Results: The analyzed data revealed the following: (1) hyperconcavity of the vertebral endplates appeared as a distinct entity in a high percentage of pre–National Football League lineman (33%) compared with age-matched controls (8%), (2) there was a trend toward a lower incidence of lumbosacral spine symptoms in those players who displayed hyperconcavity of the vertebral endplates (16%) versus those who did not (25%), and (3) when hyperconcavity of the vertebral endplates was present, all 5 lumbosacral disk spaces were commonly affected.

Conclusions: Hyperconcavity of the vertebral endplates and hypertrophy of the disk space are likely adaptive changes occurring over time in response to the repetitive high loading and axial stress experienced in football line play.

Key Words: spine • hyperconcavity • lumbar • adaptive • football






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