Abstract
Introduction
Despite the high number of surgeries performed for spondylolisthesis, the basic epidemiology of lumbar spondylolisthesis in the general population is not well known. The aim of this study was to clarify the association of lumbar spondylolisthesis with symptomatic lumbar spinal stenosis (LSS) in a population-based cohort study with participants representing the general Japanese population.
Patients and Methods
This cross-sectional study included 938 participants (308 men, 630 women; mean age, 67.3 years; range, 40–93 years). Lumbar radiographs were obtained for all the participants, with lumbar spondylolisthesis classified as a slip of more than 5% on the lateral view. The diagnosis for symptomatic LSS required the presence of both leg symptoms and radiographic lumbar spinal stenosis on magnetic resonance imaging. The presence of symptomatic LSS was compared between participants with and those without lumbar spondylolisthesis using statistical analysis. Furthermore, we clarified the association between the amount of slippage and the presence of neurogenic claudication.
Results
The prevalence of spondylolisthesis at any level was 15.8% overall, 13.0% in men and 17.1% in women, with no significant difference between genders. The prevalence of symptomatic LSS was 9.0% overall, 9.4% in men, and 8.7% in women. Logistic regression analysis after adjustment for age, gender, and BMI showed that there existed a significant association of spondylolisthesis with symptomatic LSS overall. (OR: 2.07, 95% CI: 1.20–3.44). While, among participants with L4 anterior spondylolisthesis, the mean percentage slip in those with neurogenic claudication was 14 ± 1.2% and those without was 14 ± 0.5%, with no significant difference.
Conclusion
This population-based cohort study revealed that there was a significant association of spondylolisthesis with neurogenic claudication, although the amount of slippage was not related to the presence of neurogenic claudication.