Prevalence Of Degenerative Spondylolisthesis Research Articles

Transitional vertebrae and numerical variants of the spine : prevalence and relationship to low back pain or degenerative spondylolisthesis.

Although lumbosacral transitional vertebrae (LSTV) are well-documented, few large-scale studies have investigated thoracolumbar transitional vertebrae (TLTV) and spinal numerical variants. This study sought to establish the prevalence of numerical variants and to evaluate their relationship with clinical problems. A total of 1,179 patients who had undergone thoracic, abdominal, and pelvic CT scanning were divided into groups according to the number of thoracic and lumbar vertebrae, and the presence or absence of TLTV or LSTV. The prevalence of spinal anomalies was noted. The relationship of spinal anomalies to clinical symptoms (low back pain, Japanese Orthopaedic Association score, Roland-Morris Disability Questionnaire) and degenerative spondylolisthesis (DS) was also investigated. Normal vertebral morphology (12 thoracic and five lumbar vertebrae without TLTV and LSTV) was present in 531 male (76.7%) and 369 female patients (75.8%). Thoracolumbar transitional vertebrae were present in 15.8% of males and 16.0% of females. LSTV were present in 7.1% of males and 9.0% of females. The prevalence of the anomaly of 16 presacral mobile vertebrae (total number of thoracolumbar vertebrae and TLTV) without LSTV was 1.0% in males and 4.1% in females, and that of the anomaly of 18 vertebrae without LSTV was 5.3% in males and 1.2% in females. The prevalence of DS was significantly higher in females with a total of 16 vertebrae than in those with normal morphology. There was no significant correlation between a spinal anomaly and clinical symptoms. Overall, 24% of subjects had anomalies in the thoracolumbar region: the type of anomaly differed between males and females, which could have significant implications for spinal surgery. A decreased number of vertebrae was associated with DS: numerical variants may potentially be a clinical problem. Cite this article: Bone Joint J2021;103-B(7):1301-1308.

Degenerative Spondylolisthesis Is Related to Multiparity and Hysterectomies in Older Women.

A case-control study. To determine whether parity and abdominal surgeries are associated with degenerative spondylolisthesis (DS). DS is considered to be a major cause of low back pain (LBP) in the older population, with greater prevalence of DS among women. Because LBP and impaired abdominal muscle function are common during pregnancy and post-partum, parity-related abdominal muscle deficiency, resulting in poor spinal mechanics, could be a factor in the development of DS in women. Indeed a relationship between the number of pregnancies and DS was reported in one study. A total of 322 women between the ages of 40 and 80 (149 with DS and 173 controls) filled out a questionnaire providing information about their demographics, the number of full-term pregnancies, the number and types of abdominal surgeries (including cesarean section and hysterectomies), and age at menopause among other items. A binary logistic regression was used as a multivariate model to identify the variables associated with DS. Along with age and body mass index as covariates, the number of full-term pregnancies and the hysterectomy were significant predictors of DS. Other abdominal surgeries, cesarean section, or the number of years postmenopause were not significant predictors of DS in this regression model after adjusting for all other significant variables. Each full-term pregnancy seems to be associated with the 22% increase in odds of developing DS. Hysterectomy nearly doubles the odds of DS as compared to women who did not have hysterectomy. 4.

South Korean degenerative spondylolisthesis patients had surgical treatment at earlier age than Japanese, American, and European patients: a published literature observation.

The epidemiology of lumbar degenerative spondylolisthesis (DS) has been controversial. We recently performed a systemic review with the aim to have a better understanding of DS’s prevalence in general population. The results showed the prevalence of DS is very gender specific and age specific (1). Both women and men have few DS before 50 years old, after 50 years old both women and men start to develop DS, with women having a faster developing rate than men. For elderly Chinese (mean age, 72.5 years), DS prevalence is around 25.0% for women and 19.1% for men, and the prevalence women:men ratio is 1.3:1. Elderly Caucasian American may have a higher DS prevalence, being approximately 60–70% higher than elderly Chinese; however the prevalence women:men ratio was similar to elderly Chinese population (1).

Radiographic natural course of lumbar degenerative spondylolisthesis and its risk factors related to the progression and onset in a 15-year community-based cohort study: the Miyama study

BackgroundThe natural history and risk factors for lumbar degenerative spondylolisthesis (DS) remain unclear. Because it is important for physicians to take these factors into account to ensure accurate decisions regarding surgical methods, this study aimed to elucidate the natural course and risk factors for the progression of DS. MethodsThis is a prospective observation and case control study of 15-year follow-up in a rural mountainous cohort in Wakayama, Japan. In 1990 and 2005, a total of 200 participants (baseline age, range 40–75) were subjected to anteroposterior and lateral radiographs of the lumbar spine, which were acquired with patients in a standing position. The prevalence of DS (slip ≥3mm) at baseline and the incidence of DS at 15-year follow-up were recorded. Risk factors at baseline for progression of L4 slip (≥3mm) over the 15-year period were determined by multiple logistic regression analysis. ResultsThe overall prevalence of DS in 1990 was 10% (20/200), and by spinal level was as follows: one case at L3, 14 cases at L4, and five at L5. In 2005, the overall prevalence of DS had risen to 22.5% (45/200). Thus the incidence of de novo DS during the 15-year period was estimated at 14% (25/180). Progression of the L4 slip (≥3mm), regardless of baseline condition, was observed in 23 participants after 15years. In multiple regression analysis, significant risk factors for L4 slip progression were identified as age less than 60 years, female sex, lumbar axis sacral distance, facet sagittalization, and existence of slip at baseline. ConclusionsWe successfully elucidated the risk factors for the progression of DS in a general population. Moreover, the results of this study identified preventive factors as well as risk factors for slip progression. This study provides useful information for physicians treating DS.

Epidemiological, Clinical, and Radiological Profile of Patients with Degenerative Scoliosis: Experience of 20 Years at the National Institute of Rehabilitation

Introduction Adult scoliosis is a complex three-dimensional rotational deformity of the spine result in a progressive degeneration, with a Cobb angle greater than 10 degrees in the coronal plane, which alters the sagittal and axial planes, it occurs in a previously straight spine; most often in elderly. The adult degenerative or de novo scoliosis is believed to develop as the result of asymmetric degeneration of the discs, osteoporosis, and vertebral body compression fractures; this causes increased asymmetric loading and therefore a progression of degeneration and deformity. The main symptom is pain; and the surgical treatment is preferred for patients with neurological deficit, severe pain, or radiculopathy. Risk factors are female gender, age over 50 years, osteoporosis; and for curve progression may be a curve size over 30 degrees, an asymmetric disc above and below the apical vertebra, lateral subluxation of the apical vertebra over 6 mm, and L5 vertebra being located above rather than below the intercrestal line. The degenerative scoliosis prevalence varies from 2.5 to 15% in controlled populations. The increase in life expectancy in our population and the pursuit of improving the quality of life has turned degenerative scoliosis in a common problem of medical care. The main objective of this study is to examine the epidemiological, clinical, and radiographical features of patients with this disease who have been diagnosed and treated in an institution of concentration in the past 20 years. Patients and Methods We retrospectively analyzed electronic and radiographic records of patients between 40 to 80 years, diagnosed with adult degenerative scoliosis who have undergone surgery in our institute, during the period from January 1995 to December 2013. Results The prevalence was 0.087%, with a total of 61 individuals. We observed increased frequency of degenerative lumbar scoliosis in women (72.1%), at a rate of 2.6:1 and also an increase in the frequency in older adults (70.5%) (43/61). The prevalence of degenerative spondylolisthesis associated with lumbar scoliosis was 21%. In a gender analysis in women, increased prevalence was 3.52%; women have an increased frequency of spondylolisthesis compared with men. Women had 2.4 times the risk of degenerative lumbar scoliosis. Men had 1.9 times the risk of degenerative spondylolisthesis associated with lumbar scoliosis. The most affected level was L4–L5. Conclusion Although degenerative scoliosis is a common disease that affects the adult population, the prevalence in our institute is low compared with international literature and the age of our sample was higher than that the of the series presented, this is because patients come late to the care for not having medical service. The distribution of gender, the severity of the curvature, and the presence of spondylolisthesis and olisthesis was similar to the literature review.

Prevalence of Radiographic Findings in Individuals With Chronic Low Back Pain Screened for a Randomized Controlled Trial: Secondary Analysis and Clinical Implications

ObjectiveThe purpose of this study is to measure the prevalence of graded disc degeneration, spondylolisthesis, transitional segmentation, and the distribution of sacral slope in patients 21 to 65 years of age with chronic low back pain (CLBP). MethodsThis retrospective study analyzed 247 digital lumbar radiographic series obtained during a randomized controlled trial of chiropractic patients with CLBP. Chronic low back pain was defined as pain in the low back lasting 12 weeks or longer. Radiographic findings of disc degeneration, spondylolisthesis, and lumbosacral transitional segmentation were graded by 2 authors using established classification criteria. Sacral slope was measured with a digital tool contained within imaging software. ResultsLumbosacral transitional segments graded I to IV (Castellvi classification) were present in 14% of cases. Lumbar disc degeneration was most prevalent at L3-4 (49%), followed by L4-5 (42%), L2-3 (41%), L5-S1 (37%), and L1-2 (29%). Isthmic spondylolisthesis was present in 5% of cases, with L5 the most common location. Degenerative spondylolisthesis demonstrated a prevalence of 18%, most commonly occurring at L4. The prevalence of degenerative spondylolisthesis was 51% for women aged 50 to 59 years and 24% for men in the same age range. ConclusionsModerate-severe disc degeneration, multilevel disc narrowing, and degenerative spondylolisthesis were common in individuals with CLBP with age more than 40 years. Isthmic spondylolisthesis was not more prevalent than what has been reported in other populations. Transitional segmentation was identified in a minority of participants, with some of these exhibiting accessory joints or fusion. Mean sacral slope in individuals with CLBP was not substantially different from mean slopes reported in other populations.

Association of Estrogen Receptor Gene Polymorphism in Patients with Degenerative Lumbar Spondylolisthesise

The purpose of this study was to investigate the possible association of estrogen receptor alpha (ERα) gene polymorphisms in a cohort of degenerative spondylolisthesis (DS) patients. Accordingly, the authors examined the association between DS and ERα gene polymorphisms in 174 patients diagnosed with DS. The Pvu II and Xba I polymorphisms, bone mineral density at the lumbar spine and femoral neck, and biochemical markers were analyzed and compared in the 174 patients with DS and 214 patients with spinal stenosis (SS). A comparison of genotype frequencies in DS and SS patients revealed a significant difference for the Pvu II polymorphism only (p=0.0452). No significant difference was found between these two groups with respect to the Xba I polymorphism, BMD or biochemical markers. No significant association was found between the Pvu II polymorphism of ERα and BMD, vertebral slip or biochemical markers in patients with DS. These results suggest that the ERα gene polymorphism using Pvu II restriction enzyme influences the prevalence of DS.