Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea.
Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Spine (Phila Pa 1976). 2019 Jan 1;44(1):E7-E12. doi: 10.1097/BRS.0000000000002764.
Retrospective observational and case-control study.
To determine the risk factors for progression of degenerative listhesis by comparing patients with and without progression at greater than 5-year follow-up.
The previous study with 2- to 7-year follow-up showed that degenerative spondylolisthesis of the cervical spine did not progress. Longer-term follow-up may reveal that these patients actually do progress over time.
We identified 218 patients with greater than 5-year follow-up without surgery. They were categorized as either having or not having cervical spondylolisthesis. We defined spondylolisthesis as the presence of greater than 2 mm of translation in standing neutral lateral radiographs of the cervical spine at the initial evaluation. The control group at baseline was those without spondylolisthesis. Progression of translation was defined as greater than 2 mm of additional translation on the final standing neutral radiograph.
The mean follow-up duration was 6.4 ± 1.0 years (range: 5-9.4 yr). Progression of translation was found in 20 patients (9.2%), including 4 patients in the spondylolisthesis group and 16 patients in the control group. Progression of translation was not related to the presence of spondylolisthesis or the severity of translation at the initial evaluation, but was more common in the elderly and in the patients with anterior translation than those with posterior translation at the initial evaluation. In addition, progression of spondylolisthesis was not correlated with any change of symptoms.
Progression of cervical spondylolisthesis is not related to the presence of spondylolisthesis at baseline.
回顾性观察性和病例对照研究。
通过比较大于 5 年随访时无进展和有进展的患者，确定退行性滑椎进展的危险因素。
之前的 2-7 年随访研究表明，颈椎退行性滑椎不会进展。更长时间的随访可能会发现这些患者实际上会随着时间的推移而进展。
我们确定了 218 例大于 5 年随访且未接受手术的患者。他们分为有进展和无进展两组。我们将滑椎定义为颈椎中立位侧位站立位初始评估时存在大于 2mm 的平移。基线时无滑椎的患者为对照组。进展定义为最终中立位站立位放射片中存在大于 2mm 的额外平移。
平均随访时间为 6.4±1.0 年（范围：5-9.4 年）。20 例患者（9.2%）出现平移进展，其中滑椎组 4 例，对照组 16 例。平移进展与滑椎的存在或初始评估时平移的严重程度无关，但在老年人和初始评估时存在前方平移的患者中更为常见，而在初始评估时存在后方平移的患者中则不常见。此外，滑椎的进展与任何症状变化均无相关性。
颈椎滑椎的进展与基线时滑椎的存在无关。
4 级。
