An Adolescent Athlete with Low Back Pain Associated with Spina Bifida Occulta at the Thoracolumbar Junction : A Case Report

Introduction : Spina bifida occulta (SBO) is a common malformation of lamina of the spine, most commonly occurring in the sacrum or lower lumbar spine. Athletes with anatomical abnormalities such as SBO may be vulnerable to discoordination of muscles and/or skeletal structures. Case Report : We present a case of a 15-year-old male adolescent who presented with persistent low back pain (LBP) associated with SBO at T11-L1 that had been overlooked for several years. He participated in karate as a top-level competitor at the nationallevel, but the LBP interfered with his play. Dynamic X-ray films showed limited range of motion (ROM) in his lower lumbar spine (L3-S1). Instead, the thoracolumbar junction compensated for the lack of ROM in the lumbar spine, enabling trunk flexion and extension. To restore normal coordination, he was treated with a 2-week rehabilitation program including flexibility and core conditioning for the trunk to improve coordination of spinal movement. Two weeks later, his LBP resolved. Conclusion : These results suggest that evaluation of the coordination of the muscles and skeletal structures has an important role in the treatment of cases with an anatomical abnormality such as SBO.