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Orthop J Sports Med. 2019 Jan 23;7(1):2325967118820046. doi: 10.1177/2325967118820046. eCollection 2019 Jan.

Lumbar Spine Injuries in National Collegiate Athletic Association Athletes: A 6-Season Epidemiological Study.

Author information

Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA.
John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.
Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA.
Arizona State University, Tempe, Arizona, USA.



Lumbar spine injuries in National Collegiate Athletic Association (NCAA) athletes have not been well studied.


To describe the epidemiology of lumbar spine injuries in NCAA athletes during the 2009/2010 through 2014/2015 academic years utilizing the NCAA Injury Surveillance Program (ISP).

Study Design:

Descriptive epidemiology study.


A voluntary convenience sample of NCAA varsity teams from 25 sports was examined. Mechanism of injury, injury recurrence, and time lost from sport were recorded. Injury rates were calculated as the number of injuries divided by the total number of athlete-exposures (AEs). AEs were defined as any student participation in 1 NCAA-sanctioned practice or competition. Injury rate ratios and injury proportion ratios were calculated to compare the rates within and between sports by event type, season, patient sex, mechanism, injury recurrence, and time lost from sport. Comparisons between sexes were made utilizing data that had both male and female samples.


An estimated 37,435 lumbar spine injuries were identified. The overall rate of injuries was 6.01 per 1000 AEs. The rate of injuries was 4.94 per 1000 AEs in men compared with 3.94 per 1000 AEs in women for sex-comparable sports. Men were 1.25 times more likely than women to suffer a lumbar spine injury. Men's football (24.62 injuries/1000 AEs) and women's gymnastics (11.46 injuries/1000 AEs) had the highest rates of lumbar spine injuries. Athletes were 1.83 and 3.71 times more likely to sustain a lumbar spine injury during the preseason than the regular season or postseason, respectively. Noncontact was the most common mechanism of injury (38%). Injury recurrence was most common in men's outdoor track (58%). Most injuries resulted in less than 24 hours of time loss from event participation (61%).


The rate of lumbar spine injuries was high in NCAA athletes, and injuries commonly recurred (20%). In general, men were more likely to sustain a lumbar spine injury compared with women. Higher injury rates occurred during competition and via a noncontact mechanism of injury. In addition to prevention programs, reconditioning programs should be considered to prevent these injuries.


NCAA; back; collegiate sports; epidemiology; injury; low back

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: D.E.H. is a consultant for Arthrex, has received educational support from Arthrex and Smith & Nephew, has grants/grants pending from Arthrex, and has received hospitality payments from Smith & Nephew and Stryker. A.C. is a consultant for Arthrex, Zimmer Biomet, Trice Medical, and Cayenne Medical and has received educational support from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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