Yuyu Ishimoto1, Noriko Yoshimura, Shigeyuki Muraki, Hiroshi Yamada, Keiji Nagata, Hiroshi Hashizume, Noboru Takiguchi, Akihito Minamide, Hiroyuki Oka, Sakae Tanaka, Hiroshi Kawaguchi, Kozo Nakamura, Toru Akune, Munehito Yoshida. 1. *Wakayama Medical University, Wakayama, Japan †Department of Joint Disease Research, 22nd Century Medical and Research Center, University of Tokyo, Tokyo, Japan ‡Department of Clinical Motor System Medicine, 22nd Century Medical and Research Center, University of Tokyo, Tokyo, Japan §Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, University of Tokyo, Tokyo, Japan ¶Department of Orthopedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan ||JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan **National Rehabilitation Center for Persons with Disabilities, Saitama, Japan.
Abstract
STUDY DESIGN: Cross-sectional study. OBJECTIVE: To determine the association between lumbar spondylolisthesis and low back pain and symptomatic lumbar spinal stenosis (LSS) in a population-based cohort. SUMMARY OF BACKGROUND DATA: The basic epidemiology of lumbar spondylolisthesis is not well known. There is little information regarding the association between lumbar spondylolisthesis and clinical symptoms such as low back pain and LSS symptoms. METHODS: This cross-sectional study included data from 938 participants (308 males, 630 females; mean age, 67.3 years; range, 40-93 years). Lumbar spondylolisthesis was defined as a slip of ≥5%. Diagnostic criteria for symptomatic LSS required the presence of both leg symptoms and radiographic LSS findings on magnetic resonance imaging. The prevalence of low back pain and symptomatic LSS was compared between those with or without spondylolisthesis. Furthermore, we determined the association between the amount of slippage and presence of symptomatic LSS. RESULTS: The prevalence of spondylolisthesis at any level was 15.8% in the total sample, 13.0% in males, and 17.1% in females; the prevalence was not significantly different between males and females (P = 0.09). In both, males and females, symptomatic LSS was related to spondylolisthesis [odds ratio (OR): 2.07; 95% CI: 1.20-3.44]; however, no such association was found for spondylolisthesis and presence of low back pain. The amount of slippage was not related to the presence of symptomatic LSS (P = 0.93). CONCLUSION: This population-based cohort study revealed that lumbar spondylolisthesis had a closer association with leg symptoms than with low back pain. There was a significant difference in the presence of symptomatic LSS between participants with and without spondylolisthesis. However, the amount of slippage was not related to the presence of symptomatic LSS. LEVEL OF EVIDENCE: 3.
STUDY DESIGN: Cross-sectional study. OBJECTIVE: To determine the association between lumbar spondylolisthesis and low back pain and symptomatic lumbar spinal stenosis (LSS) in a population-based cohort. SUMMARY OF BACKGROUND DATA: The basic epidemiology of lumbar spondylolisthesis is not well known. There is little information regarding the association between lumbar spondylolisthesis and clinical symptoms such as low back pain and LSS symptoms. METHODS: This cross-sectional study included data from 938 participants (308 males, 630 females; mean age, 67.3 years; range, 40-93 years). Lumbar spondylolisthesis was defined as a slip of ≥5%. Diagnostic criteria for symptomatic LSS required the presence of both leg symptoms and radiographic LSS findings on magnetic resonance imaging. The prevalence of low back pain and symptomatic LSS was compared between those with or without spondylolisthesis. Furthermore, we determined the association between the amount of slippage and presence of symptomatic LSS. RESULTS: The prevalence of spondylolisthesis at any level was 15.8% in the total sample, 13.0% in males, and 17.1% in females; the prevalence was not significantly different between males and females (P = 0.09). In both, males and females, symptomatic LSS was related to spondylolisthesis [odds ratio (OR): 2.07; 95% CI: 1.20-3.44]; however, no such association was found for spondylolisthesis and presence of low back pain. The amount of slippage was not related to the presence of symptomatic LSS (P = 0.93). CONCLUSION: This population-based cohort study revealed that lumbar spondylolisthesis had a closer association with leg symptoms than with low back pain. There was a significant difference in the presence of symptomatic LSS between participants with and without spondylolisthesis. However, the amount of slippage was not related to the presence of symptomatic LSS. LEVEL OF EVIDENCE: 3.