Departments of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
Spine (Phila Pa 1976). 2009 Oct 1;34(21):2346-50. doi: 10.1097/BRS.0b013e3181b4abbe.
Epidemiological analysis using CTs.
To investigate the true incidence of lumbar spondylolysis in the general population in Japan.
Although there have been several reports on the incidence of lumbar spondylolysis, they had some weakness. One of them concerns the subjects investigated, because the incidence of lumbar spondylolysis varies considerably, and some patients are asymptomatic. In addition, most of the past studies used plain radiograph films or skeletal investigation. Therefore, the past reported incidence may not correspond to that of the general population.
We reviewed the computed tomography (CT) scans of 2000 subjects (age: 20-92 years) who had undergone abdominal and pelvic CT on a single multidetector CT scanner for reasons unrelated to low back pain. We reviewed them for spondylolysis, spondylolytic spondylolisthesis, and spina bifida occulta (SBO) in the lumbosacral region. The grade (I-IV) of spondylolisthesis was measured using midsagittal reconstructions.
Lumbar spondylolysis was found in 117 subjects (5.9%). Their male-female ratio was 2:1. Multiple-level spondylolysis was found in 5 subjects (0.3%). Among these 117 subjects, there were 124 vertebrae with spondylolysis. Of them, 112 (90.3%) corresponded to L5, and 26 (21.0%) had unilateral spondylolysis.SBO was found in 154 subjects. Of them, 25 had spondylolysis (16.2%), whereas, in 1846 subjects without SBO, 92 had spondylolysis (5.0%). The incidence of spondylolysis among the patients with SBO was significantly higher than that in subjects without SBO (Odd ratio was 3.7-fold).Of 124 vertebrae with spondylolysis, 75 (60.5%) showed low-grade (Meyerding grade I or II) spondylolisthesis, and no subject presented high-grade spondylolisthesis. Spondylolisthesis was found in 74.5% of the subjects with bilateral spondylolysis, and in 7.7% of those with unilateral spondylolysis.
The incidence of lumbar spondylolysis in the Japanese general population was 5.9% (males: 7.9%, females: 3.9%).
使用 CT 进行的流行病学分析。
调查日本普通人群中真性腰椎峡部裂的真实发病率。
尽管已有几项关于腰椎峡部裂发病率的报告，但这些报告存在一些局限性。其中之一涉及到研究对象，因为腰椎峡部裂的发病率差异很大，有些患者无症状。此外，过去的大多数研究都使用了普通 X 线片或骨骼研究。因此，过去报告的发病率可能与普通人群的发病率不相符。
我们回顾了 2000 名在单台多排 CT 扫描仪上因与腰痛无关的原因接受腹部和骨盆 CT 检查的患者的 CT 扫描图像。我们对腰骶部的峡部裂、峡部裂性脊椎滑脱和隐性脊柱裂（SBO）进行了检查。使用矢状重建测量脊椎滑脱的等级（I-IV 级）。
在 117 名患者（5.9%）中发现了腰椎峡部裂。他们的男女比例为 2:1。5 名患者（0.3%）存在多节段峡部裂。在这 117 名患者中，有 124 个椎体存在峡部裂。其中 112 个（90.3%）对应 L5，26 个（21.0%）为单侧峡部裂。在 154 名患者中发现了 SBO。其中 25 名（16.2%）存在峡部裂，而在 1846 名没有 SBO 的患者中，有 92 名（5.0%）存在峡部裂。患有 SBO 的患者的峡部裂发病率明显高于没有 SBO 的患者（比值比为 3.7 倍）。在 124 个存在峡部裂的椎体中，75 个（60.5%）为低度（Meyerding 分级 I 或 II）脊椎滑脱，没有患者出现高度脊椎滑脱。双侧峡部裂患者的脊椎滑脱发生率为 74.5%，单侧峡部裂患者的脊椎滑脱发生率为 7.7%。
日本普通人群中腰椎峡部裂的发病率为 5.9%（男性：7.9%，女性：3.9%）。
