Vogt Molly T, Rubin David A, Palermo Lisa, Christianson Lisa, Kang James D, Nevitt Michael C, Cauley Jane A
Department of Orthopaedic Surgery, University of Pittsburgh, PA 15213, USA.
Spine J. 2003 Jul-Aug;3(4):255-61. doi: 10.1016/s1529-9430(03)00024-x.
Degenerative changes in the lumbar spine may result in a loss of spinal stability and subluxation of one vertebra relative to another. Cadaveric studies and clinical case series have suggested that listhesis may be much more common in African Americans than in whites.
To determine the prevalence of lumbar spine listhesis (anterolisthesis and retrolisthesis) among African American women aged 65 years and older and the relationship of listhesis to low back pain, physical function and quality of life.
STUDY DESIGN/SETTING: Cross-sectional study.
A total of 481 African American women aged 65 years and older who were enrolled in the Study of Osteoporotic Fractures. These women were recruited from population-based listings in Baltimore, MD, Minneapolis, MN, Pittsburgh, PA, and Portland, OR.
Not applicable.
Lateral radiographs of the lumbar spine were digitized, and listhesis (anterolisthesis and retrolisthesis) was assessed at spinal levels L3-L4, L4-L5 and L5-S1. Usable data were obtained for 470 women. Listhesis was defined as present when the subluxation (antero or retro) was 3 mm or more.
The overall prevalence of anterolisthesis was 58.3% and varied by spinal level (13.2% at L3-L4, 36.5% at L4-L5 and 29.6% at L5-S1). The prevalence increased with age but was lower among oophorectomized women and those currently on estrogen replacement therapy. Anterolisthesis was not associated (p>.05) with disc height nor was it related to back function. Retrolisthesis occurred in 4% of women and was associated with decreased disc height and an increased prevalence of spinal problems and walking problems.
The prevalence of anterolisthesis among older African American women living in the community was two to three times greater than that found in white women of a similar age. This condition was not related to an increased frequency of back problems nor did it adversely affect general physical function. Retrolisthesis was relatively rare but was associated with decreased back function.
腰椎的退行性改变可能导致脊柱稳定性丧失以及一个椎体相对于另一个椎体的半脱位。尸体研究和临床病例系列表明，腰椎滑脱在非裔美国人中可能比在白人中更为常见。
确定65岁及以上非裔美国女性腰椎滑脱（前滑脱和后滑脱）的患病率，以及腰椎滑脱与腰痛、身体功能和生活质量的关系。
研究设计/地点：横断面研究。
共有481名65岁及以上的非裔美国女性参与了骨质疏松性骨折研究。这些女性是从马里兰州巴尔的摩、明尼苏达州明尼阿波利斯、宾夕法尼亚州匹兹堡和俄勒冈州波特兰的人群名单中招募的。
不适用。
腰椎侧位X线片数字化，在L3-L4、L4-L5和L5-S1椎体水平评估腰椎滑脱（前滑脱和后滑脱）。获得了470名女性的可用数据。当半脱位（前或后）为3毫米或更多时，定义为存在腰椎滑脱。
前滑脱的总体患病率为58.3%，并因椎体水平而异（L3-L4为13.2%，L4-L5为36.5%，L5-S1为29.6%）。患病率随年龄增加，但在接受卵巢切除术的女性和目前接受雌激素替代疗法的女性中较低。前滑脱与椎间盘高度无关（p>0.05），也与背部功能无关。4%的女性发生后滑脱，与椎间盘高度降低、脊柱问题和行走问题的患病率增加有关。
居住在社区中的老年非裔美国女性前滑脱的患病率比同龄白人女性高两到三倍。这种情况与背部问题频率增加无关，也未对总体身体功能产生不利影响。后滑脱相对少见，但与背部功能下降有关。
