Spine www.spinejournal.com 1881 DIAGNOSTICS SPINE Volume 39, Number 22, pp 1881-1886 ©2014, Lippincott Williams & Wilkins Early Intervertebral Disc Degeneration Changes in Asymptomatic Weightlifters Assessed by T1 ρ-Magnetic Resonance Imaging Gianluca Vadalà, MD, PhD,* Fabrizio Russo, MD,* Sofia Battisti, MD,† Luigi Stellato, MD,† Francesca Martina, MD,† Riccardo Del Vescovo, MD,† Antonino Giacalone, MD,* Arijitt Borthakur, PhD,‡ Bruno Beomonte Zobel, MD,† and Vincenzo Denaro, MD* DOI: 10.1097/BRS.0000000000000554 Study Design. Case-control study. Objective. To evaluate early intervertebral disc degeneration quantified by T1 ρ- and T2-weighted magnetic resonance imaging (MRI) in asymptomatic weightlifters compared with a healthy control group matched for sex and age. Summary of Background Data. Athletes consistently recruit or transfer high levels of repetitive forces through the spine, and MRI has documented a higher rate of intervertebral disc degeneration in athletes compared with matched controls. This study aims to analyze the potential role of T1 ρ-MRI in the assessment of early degenerative changes occurring in intervertebral discs of young asymptomatic weightlifters compared with healthy controls. Methods. Twenty-six asymptomatic young male weightlifters versus a sedentary control group matched for age and sex, both having no lower back pain nor any spinal symptoms, underwent MRI (1.5 T). Degenerative grade was assessed using T2-weighted images, according to the Pfirrmann scale. T1 ρ mapping and values in the nucleus pulposus (n = 130) were obtained. Differences in T1 ρ value between among the groups and linear regression analyses with degenerative grade were determined. Results. Pfirrmann degenerative grade did not show significant differences among groups. Instead, T1 ρ values were significantly lower in the lumbar spine of weightlifters compared with controls ( P < 0.05). T1 ρ values decreased linearly with degenerative grade. From the *Orthopaedic and Trauma Surgery Unit and †Radiology Unit, Campus Bio-Medico University of Rome, Rome, Italy; and ‡Department of Radiology, CMROI, University of Pennsylvania School of Medicine, Philadelphia, PA. Acknowledgment date: August 12, 2013. First revision date: November 18, 2013. Second revision date: February 19, 2014. Third revision date: April 17, 2014. Acceptance date: May 14, 2014. The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No relevant financial activities outside the submitted work. Address correspondence and reprint requests to Gianluca Vadalà, MD, PhD, Orthopedic and Trauma Surgery Unit, Campus Bio-Medico University of Rome, Rome, Italy, Via Alvaro del Portillo 200, 00128 Rome, Italy; E-mail: g.vadala@gmail.com L ow back pain in young athletes is one of the most com- mon findings, with an incidence that ranges, according to the literature, from 1% to 30% influenced by sport type, sex, training intensity, and frequency. Almost 85% of people never achieve a specific diagnosis associated with their symptoms, making the treatment very challenging. 1,2 More- over, after the first episode, low back pain shows a tendency to become recurrent. 3,4 Sport activities can play a duplex and opposite role in intervertebral disc (IVD) disease, indeed some sports help to prevent physiological degenerative changes, on the contrary some particular types of excessive movement con- tribute to the intervertebral disc degeneration (IDD) leading to disc protrusion, prolapse, herniation, or spondylolisthesis. 5 Athletes consistently recruit or transfer high levels of repet- itive force through the spine, and magnetic resonance imaging (MRI) has documented higher rates of IDD in athletes com- pared with matched controls. 6 In particular, the positive and negative effects of physical activity are mainly centered on the lumbar region of the spine. 7 Previous studies have demonstrated that among athletes, weightlifters have a higher lifetime risk of specific spinal pathologies, obviously correlated with loading. Indeed, radio- logical changes are more common in weightlifters (84%) than in other athletes such as runners, jumpers, and throwers (72%). 8 Appropriate imaging techniques could be useful to deter- mine early IDD stages in athletes and further help defining physiopathological changes that occur in the disc, in particular Conclusion. T1 ρ values were significantly lower in athletes compared with a sedentary matched control group showing differences in intervertebral disc degeneration onset among individuals with lifestyle and environmental factors leading to back pain. T1 ρ can be potentially used as a valid clinical tool to identify early changes in intervertebral disc on the verge of new emerging intervertebral discs regenerative strategies and treatments. Key words: T1 ρ, spine, MRI, weightlifter, athletes. Level of Evidence: 4 Spine 2014;39:1881–1886 Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.