Table 1. Characteristics of included studies.

Study	Study design	Participants	Sporting activities	Type of spine injuries	Outcomes
Pirruccio et al. (2020) [59]	Cross-sectional retrospective epidemiological study	Pediatric patients aged below 18 years	Football, bicycling, snowboarding, horseback riding, swimming and diving, snow skiing, skating, soccer, cheerleading, hockey	Acute vertebral fractures	Lumbosacral fractures were the most prevalent injuries, while coccygeal fractures were the least. Acute vertebral fractures were more prevalent in adolescent patients between the ages of 13 and 15 years
Plais et al. (2019) [60]	Epidemiology, descriptive research	-	Soccer	Lumbar, thoracolumbar, and cervical spine injuries	Lumbar disc herniation is diagnosed using an MRI. Thoracic disk herniation is rare and only represents about 0.25% to 0.75% of all disc herniations. Young athletes are at a high risk of spondylolysis and spondylolisthesis. Spondylolysis and spondylolisthesis are diagnosed using radiographic assessment such as MRI, CT scans, and X-rays
McNally et al. (2005) [48]	Descriptive research	-	Rowing	Annular tears, disc, and facet degeneration. Spondylolysis	Low-back pain problems are common in rowers. Rowers who habitually row on one side are at high risk of back pain problems related to asymmetric development. Spondylolysis is more common in rowers compared to other sporting activities. Imaging techniques used in diagnosing spondylolysis are MRI, CT scans, and SPECT. CT scans provide the best depiction of the bone anatomy of the par. MRI is essential in differentiating normal, acute, or chronic fractures
Tator et al. (2004) [61]	Retrospective study	Canadian athletes aged between 11 and 50 years	Ice hockey	Spinal injuries in general	Spine injuries were more common in young athletes aged between 16 and 20 years (49.0%). The main cause of spinal injuries was pushing/checking from behind, accounting for about 36.6%. Of the 256 cases reported, 83.5% involved cervical vertebrae, 5.1% thoracic vertebrae, 5.9% thoracolumbar, and 5.5% lumbosacral
Schmitt et al. (2001) [62]	Clinical and radiological study	21 male athletes with a mean age of 20 years	Javelin	Lumbar spine injuries	The most common lumbar spine injuries in javelin throwers are spondylolysis and spondylolisthesis. Nine athletes with spondylolisthesis and two with spondylolysis were associated with lumbar pains. Radiographs were essential in the demonstration of spondylolisthesis in athletes
Dunn (2010) [63]	Clinical study	27 male patients with a mean age of 25.3 years	Rugby	Cervical spine injuries	Most cervical spine injuries occur during a scrum (accounting for 37%). The player position highly associated with cervical spine injuries is scrumhalf, accounting for about 22% of the injuries. The injury distribution was as follows; 37% for unifacet dislocation, 22% for bifacet dislocation, 11% for dens type II fracture, and 5% for SCIWORA (spinal cord injury without radiological abnormality)
Baranto et al. (2009) [64]	Follow-up study	71 male athletes with a mean age of 26 years and 21 non-athletes	Weightlifting, wrestling, ice hockey, and orienteering	Thoracolumbar spine injuries	High spine abnormalities are observed in wrestlers and weightlifters because of heavy loading. Disc degeneration spine abnormalities are highly observed in ice hockey players. MRI was essential in the diagnosis of spine injuries as well as for showing the changes in spine abnormalities
Hubbard et al. (2011) [65]	Retrospective study	8634 patients with a mean age of 33.3 years	Snowboarding and skiing	General spinal injuries	Skiers had higher rates of cervical spine fracture or dislocation (3%), followed by thoracic and lumbar spine injuries (2.7% and 2.5%, respectively). Snowboarders were at higher risk of lumbar or thoracic spine injuries than cervical spine injuries
Schmitt et al. (2004) [66]	Radiological study	159 German male athletes with a mean age of 45.8 years	Field and track sports	Lumbar spine injuries	Osteophytes in the lumbar spine were more prevalent in shot put or discus throwers compared to the other disciplines
Nyska et al. (2000) [67]	Clinical Study	4 young athletes	Swimming	Spondylolysis	Routine X-ray examinations are essential for the diagnosis of spondylolysis and spondylolisthesis. The most common symptom exhibited by the patients was pain in the lower back area. The pain was exacerbated by hypertension, side flexion to the injured side, and extreme flexion
Yokoe et al. (2020) [68]	Retrospective comparative study	267 young athletes aged between 7 and 18 years with lower back pain	Soccer and baseball	Spondylolysis	MRI scans were essential in diagnosing spondylolysis as the cause of lower back pain in the patients. MRI scans showed that 56 lesions were observed in 33 soccer players while 60 lesions were observed in baseball players. 55.4% of soccer players and 60% of baseball players showed high signal-intensity lesions
Browne (2006) [69]	Retrospective descriptive case series study	Children under the age of 15 years	Rugby	Cervical spine injury	Most cervical spine injuries occurred in boys over 11 years of age (accounting for 97% of the injuries). The results showed no association between player position and cervical spine injuries
Shelly et al. (2006) [47]	Retrospective study	12 Irish athletes with a mean age of 21.6 years	Rugby	Cervical spine injury and thoracic spine injury	Hyperflexion was the most common injury mechanism as it occurred in nine patients, while for three patients, hyperextension was the mechanism of the injury. Most of the injured players were playing as fullbacks, hookers, or wings
Kim et al. (2016) [70]	Retrospective study	275 children with a mean age of 12 + 4.5 years	Wide range of sports	Spinal injuries in general	Hockey accounted for most of the sport-related spine injuries. MRI images are used to reveal contusions or hematomas of the spinal cord. The age group most associated with spine injuries among sport-related causes is between 14 and 18 years
Ellis et al. (2019) [71]	Retrospective cohort study	266 patients with suspected sport-related concussions aged between 6 and 19 years	Hockey, football, soccer, and basketball	Cervical spine injury	CT scans and MRI diagnosing imaging modalities were used to check for abnormalities in the cervical spine among athletes. Hockey accounted for the highest cervical spine dysfunction for patients with SCR (accounting for 50% of the injuries)