Abstract

To try to establish whether mechanical stress and muscular activity in earlier life influence the incidence and severity of spinal osteoporosis in old age lateral x-ray films of the lumbar vertebrae were obtained from three matched groups, each of 100 women 50 to 90 years old. Group A was of rural Bantu accustomed to carrying heavy loads on their heads. Group B was of urban Bantu, mainly in domestic service. Group C was of women of European origin.Severe osteoporosis occurred in three cases from group A, two from group B, and 14 from group C. Lesser degrees of osteoporosis could not be assessed precisely enough for inclusion in these figures. Evenly biconcave vertebral bodies, strongly suggestive of osteomalacia, were seen in 10 from group A, five from group B, and one from group C. In many Bantu subjects the fifth lumbar vertebra appeared flattened though of good radiodensity and with no marked changes in the other vertebrae. Twenty-eight of these were from group A, 16 from group B, and none from group C.About a third of each group showed severe degenerative changes in the spine; another third showed milder changes. More cases of spondylolisthesis occurred in the Bantu groups than in the white group. Severe calcification in the abdominal aorta was noted in 24 women in group C. Mild signs occurred in 35 further women from group C, in six from group B, and in only one from group A.

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