Imada K, Matsui H, Tsuji H
Department of Orthopaedic Surgery, Toyama Medical University, Japan.
J Bone Joint Surg Br. 1995 Jan;77(1):126-30.
We performed a case-control study on the influence of oophorectomy on the development of degenerative spondylolisthesis, including a clinical review and determination of serum oestradiol levels. We also compared the radiological appearance of the lumbar spine at L4/5 in patients with and without spondylolisthesis and with and without oophorectomy. Oophorectomy was a risk factor for degenerative spondylolisthesis with an odds ratio of 7.5 (95% confidence interval, 1.6 to 46). The incidence of degenerative spondylolisthesis in 69 oophorectomised patients was about three times higher than in 69 non-oophorectomised matched control subjects. There was also a difference in spinal variation between oophorectomised and non-oophorectomised patients with spondylolisthesis. A high incidence of sagittal-plane orientation of the L4/5 facet and an increase in pedicle-facet angle were seen in both groups and are typical radiological features of this disease. An increase in lumbosacral angle and in disc-space narrowing was seen only in the non-oophorectomised patients with this condition. Our results suggest that the abrupt decrease in oestradiol level caused by oophorectomy may be a predisposing factor in degenerative spondylolisthesis at L4/5.
我们进行了一项关于卵巢切除术对退行性腰椎滑脱症发展影响的病例对照研究，包括临床评估和血清雌二醇水平测定。我们还比较了有或无腰椎滑脱症以及有或无卵巢切除术患者L4/5节段腰椎的影像学表现。卵巢切除术是退行性腰椎滑脱症的一个危险因素，比值比为7.5（95%置信区间为1.6至46）。69例接受卵巢切除术的患者中退行性腰椎滑脱症的发病率约为69例未接受卵巢切除术的匹配对照受试者的三倍。在患有腰椎滑脱症的接受卵巢切除术和未接受卵巢切除术的患者之间，脊柱变异也存在差异。两组均可见L4/5小关节矢状面方向的高发生率和椎弓根-小关节角度增加，这是该疾病典型的影像学特征。仅在患有这种疾病的未接受卵巢切除术的患者中观察到腰骶角增加和椎间盘间隙变窄。我们的结果表明，卵巢切除术导致的雌二醇水平突然下降可能是L4/5节段退行性腰椎滑脱症的一个诱发因素。
