Elite rock-climbers exhibit early signs of degenerative spinal changes; enhanced analysis using quantitative MRI

Abstract Background Climbing has emerged as an increasingly popular competitive sport, leading to more demanding training regimens that often begin at a younger age. Competitive climbing training contains elements that, based on evidence from other sports, could predispose athletes to early degenerative changes in the spine. The one previous report that exists on this subject could not demonstrate any significant difference between elite climbers and controls. The present study employs objective quantitative measurements with the aim to detect early spinal changes in climbing athletes. Methods Fifteen climbers consisting of the Swedish national team and a group training for selection to the national team age mean (Standard Deviation, SD): 23.1(3.2) years; 7 men were included. A control group, matched in age and sex 24.3(1.5) years; 7 men, were recruited. Participants were scanned with a 1.5 T MRI system using standard spine protocols, including sagittal T1- and T2-weighted imaging covering Th1 to S1. Data-driven analysis of the T2-weighted images was performed to extract signal mean from midsagittal disc slices, both for the whole inner region and for subregions in the anterior to posterior direction. Results Significant differences in disc signal intensity between climbers and controls were observed both globally and across specific subregions. The difference was most prominent at the thoracolumbar junction ( p <0.05 in T10-L4 and p <0.01 T12-L2) with lower signal levels in the climbing group. In the subregion analysis, the central region, representing the nucleus pulposus, showed the greatest difference between groups. Conclusions The present method identified early signs of disc degeneration in the thoracolumbar spine of elite level climbers compared to controls. The signal reduction, representing disc dehydration, was identified in multiple discs and was more pronounced in the thoracolumbar junction and in the central parts of the discs. As disc dehydration is a recognized risk factor for annular fissures and other degenerative changes, these findings may reflect early stress-related degeneration associated with high training loads in climbing athletes.