Merbs C F
Department of Anthropology, Arizona State University, Tempe 85287-2402, USA.
Am J Phys Anthropol. 1996 Nov;101(3):357-67. doi: 10.1002/(SICI)1096-8644(199611)101:3<357::AID-AJPA5>3.0.CO;2-W.
Spondylolysis of the lower back, particularly that involving the isthmus between the superior and inferior articular processes (pars interarticularis), is generally attributed to stress fracturing caused by movement of the affected vertebra relative to the vertebra below. The finding of isthmic spondylolysis in the first vertebra of a fused sacrum is thus unusual and requires explanation. Although unrepresented in the clinical literature, sacral spondylolysis has been reported for archaeological specimens and appears to be especially prevalent in North American Inuit. A study of 373 Inuit sacra from Alaska and Canada produced 16 examples of spondylolysis (eight from each area). All but one of the affected individuals were male, and nearly all were young adults, many between 18 and 20 years of age. All cases of sacral spondylolysis observed in this study were judged to have resulted from stress fracturing that occurred while S1 was still unfused, and most appear to have been in the process of healing, following fusion of S1 with S2, when death occurred. The high frequency observed in these people is attributed to unusual stresses becoming concentrated in the lower back of adolescent males due to such activities as weight lifting, wrestling, kayak paddling, and harpooning, combined with, and perhaps even contributing to, delayed maturation (S1-S2 fusion) of the sacrum.
下背部椎弓峡部裂，尤其是累及上下关节突之间峡部（椎弓根峡部）的情况，通常归因于受影响椎体相对于下方椎体运动所导致的应力性骨折。因此，在融合骶骨的第一椎体中发现峡部裂是不寻常的，需要作出解释。尽管临床文献中没有相关记载，但已有针对考古标本的骶椎弓峡部裂报告，且在北美因纽特人中似乎尤为普遍。一项对来自阿拉斯加和加拿大的373块因纽特人骶骨的研究发现了16例椎弓峡部裂（每个地区各8例）。除1例受影响个体为女性外，其余均为男性，且几乎都是年轻人，许多年龄在18至20岁之间。本研究中观察到的所有骶椎弓峡部裂病例均被判定是在S1仍未融合时发生的应力性骨折所致，并且在S1与S2融合后，大多数病例在死亡时似乎正处于愈合过程中。这些人群中观察到的高发病率归因于诸如举重、摔跤、划皮划艇和捕鲸等活动，使异常应力集中在青春期男性的下背部，这可能与骶骨延迟成熟（S1 - S2融合）有关，甚至可能是其促成因素。
