Meyerding, JAMA 1938 - Spondylolisthesis as an Etiologic Factor in Backache

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Spondylolisthesis as an Etiologic Factor in Backache

Meyerding·JAMA·1938·40 citations·Retrospective cohort

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Meyerding examined how common spondylolisthesis is as a cause of backache, who it affects, and how the degree of slip can be graded. Retrospective series of 583 consecutive spondylolisthesis cases at the Mayo Clinic, reviewing symptoms, demographics, level and radiographic slip grade.

Key Findings

Slip graded by translation of the slipped vertebra's posteroinferior corner across the lower endplate on lateral radiograph:
- Grade 1: less than 25%
- Grade 2: 25 to 50%
- Grade 3: 50 to 75%
- Grade 4: greater than 75%
Backache was the chief complaint in more than 80% of patients, with mean symptom duration of 7.5 years before diagnosis. More than 10% were asymptomatic and found incidentally.
L5-S1 was involved in 82% and L4-L5 or L5-S1 in over 93%. Grade 1 made up 45.2% of graded patients and Grades 3 and 4 together 10.6%.
About 70% were male manual laborers, contradicting the view that spondylolisthesis was mainly a female, pregnancy-related condition. Trauma history did not correlate with slip grade.
Significance: Established spondylolisthesis as a cause of backache and introduced the Meyerding classification, the standard radiographic grading of slip severity.

Board PearlMeyerding grade is the percentage of slip across the inferior vertebral endplate on lateral radiograph: under 25% is Grade 1, 25 to 50% Grade 2, 50 to 75% Grade 3, over 75% Grade 4.

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Spondylolisthesis as an Etiologic Factor in Backache

Meyerding·JAMA·1938·40 citations·Retrospective cohort

|

Meyerding examined how common spondylolisthesis is as a cause of backache, who it affects, and how the degree of slip can be graded. Retrospective series of 583 consecutive spondylolisthesis cases at the Mayo Clinic, reviewing symptoms, demographics, level and radiographic slip grade.

Key Findings

Slip graded by translation of the slipped vertebra's posteroinferior corner across the lower endplate on lateral radiograph:
- Grade 1: less than 25%
- Grade 2: 25 to 50%
- Grade 3: 50 to 75%
- Grade 4: greater than 75%
Backache was the chief complaint in more than 80% of patients, with mean symptom duration of 7.5 years before diagnosis. More than 10% were asymptomatic and found incidentally.
L5-S1 was involved in 82% and L4-L5 or L5-S1 in over 93%. Grade 1 made up 45.2% of graded patients and Grades 3 and 4 together 10.6%.
About 70% were male manual laborers, contradicting the view that spondylolisthesis was mainly a female, pregnancy-related condition. Trauma history did not correlate with slip grade.
Significance: Established spondylolisthesis as a cause of backache and introduced the Meyerding classification, the standard radiographic grading of slip severity.

Board PearlMeyerding grade is the percentage of slip across the inferior vertebral endplate on lateral radiograph: under 25% is Grade 1, 25 to 50% Grade 2, 50 to 75% Grade 3, over 75% Grade 4.

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