A Comparative Study of Spinal Deformity in High Impact Spinal Fractures in Young Athletes Versus that of Low Impact Spinal Fractures in the Elderly

Introduction: Stress fractures are increasingly common among young athletes, often due to high-intensity training and early exposure to spinal stress, making them prone to injury. Elderly individuals, who experience bone degeneration, also have high rates of spinal fractures. We hypothesized that elderly spines respond similarly to those of young athletes under significantly different forces.

Methods: This retrospective review spans 10 years and includes data from a single center. Pediatric patients under 18 were included if they had an exercise-related injury or motor vehicle collision and were diagnosed with spinal stress fractures, spondylosis, spondylolisthesis, spondylolysis, or vertebral fractures. Geriatric patients over 60 with spine injuries from ground-level falls were also included. All cases were graded using the thoracolumbar spine fracture classification. Statistical differences were assessed using Fisher’s test, Welch’s t-test, and Mann-Whitney U-test.

Results: The study analyzed 90 patients in total—47 pediatric and 43 geriatric. No significant difference was found between the thoracolumbar grading level and age (p = .2440). However, geriatric patients had a higher median injury severity than adolescents (p = 0.005). Among geriatric patients, 100% had thoracolumbar classification A (compression-type), while 92% of pediatric cases shared this. Within type A fractures, 51% of geriatric patients and 49% of pediatric patients had A1 (wedge compression) fractures. 30% of pediatric patients had A0 (spinous/transverse) fractures compared to only 7% of geriatric patients. A2 fractures (split/pincer) were present in 7% of geriatric patients and 0% of the pediatric population. A3 fractures (incomplete burst) were present in 23% of geriatric and 16% of pediatric cases. Finally, A4 fractures (complete burst) were present in 12% of geriatric patients and 5% of pediatric patients.

Conclusion : In conclusion, thoracolumbar grading levels (A, B, and C) are similar across age groups, but older patients show an overall higher severity of fractures. This information may inform treatment approaches for vertebral trauma across these demographics.