Skip to main content
Top
Published in: Journal of Orthopaedic Science 6/2015

01-11-2015 | Original Article

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

Authors: Yoshio Enyo, Noriko Yoshimura, Hiroshi Yamada, Hiroshi Hashizume, Munehito Yoshida

Published in: Journal of Orthopaedic Science | Issue 6/2015

Login to get access

Abstract

Background

The 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.

Methods

This 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 ≥3 mm) at baseline and the incidence of DS at 15-year follow-up were recorded. Risk factors at baseline for progression of L4 slip (≥3 mm) over the 15-year period were determined by multiple logistic regression analysis.

Results

The 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 (≥3 mm), regardless of baseline condition, was observed in 23 participants after 15 years. 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.

Conclusions

We 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.
Literature
1.
go back to reference Junghanns H. Spondylisthesen ohne Spalt in Zwischengelenkstueck. Arch Orthop Unfall Chir. 1930;29:118–27.CrossRef Junghanns H. Spondylisthesen ohne Spalt in Zwischengelenkstueck. Arch Orthop Unfall Chir. 1930;29:118–27.CrossRef
2.
go back to reference MacNab I. Spondylolisthesis with an intact neural arch: the so-called pseudo-spondylolisthesis. J Bone Joint Surg Br. 1950;32(3):325–33.PubMed MacNab I. Spondylolisthesis with an intact neural arch: the so-called pseudo-spondylolisthesis. J Bone Joint Surg Br. 1950;32(3):325–33.PubMed
3.
go back to reference Newman PH, Stone KH. The etiology of spondylolisthesis. J Bone Joint Surg Br. 1963;45(1):39–59. Newman PH, Stone KH. The etiology of spondylolisthesis. J Bone Joint Surg Br. 1963;45(1):39–59.
4.
go back to reference Fischgrund JS, Mackay M, Herkowitz HN, Brower R, Montgomery DM, Kurz LT. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine. 1997;22(24):2807–12.CrossRefPubMed Fischgrund JS, Mackay M, Herkowitz HN, Brower R, Montgomery DM, Kurz LT. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine. 1997;22(24):2807–12.CrossRefPubMed
5.
go back to reference Weinstein JN, Lurie JD, Tosteson TD, Hanscom B, Tosteson ANA, Blood EA, Birkmeyer NJO, Hilibrand AS, Herkowitz HN, Cammisa FP, Albert TJ, Emery SE, Lenke LG, Abdu WA, Longley M, Errico TJ, Hu SS. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 2007;356(22):2257–70.PubMedCentralCrossRefPubMed Weinstein JN, Lurie JD, Tosteson TD, Hanscom B, Tosteson ANA, Blood EA, Birkmeyer NJO, Hilibrand AS, Herkowitz HN, Cammisa FP, Albert TJ, Emery SE, Lenke LG, Abdu WA, Longley M, Errico TJ, Hu SS. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 2007;356(22):2257–70.PubMedCentralCrossRefPubMed
6.
go back to reference Aono K, Kobayashi T, Jimbo S, Atsuta Y, Matsuno T. Radiographic analysis of newly developed degenerative spondylolisthesis in a mean 12-year prospective study. Spine. 2010;35(8):887–91.CrossRefPubMed Aono K, Kobayashi T, Jimbo S, Atsuta Y, Matsuno T. Radiographic analysis of newly developed degenerative spondylolisthesis in a mean 12-year prospective study. Spine. 2010;35(8):887–91.CrossRefPubMed
7.
go back to reference Jacobsen S, Sonne-Holm S, Rovsing H, Monard H, Gebuhr P. Degenerative lumbar spondylolisthesis. An epidemiological perspective. The Copenhagen osteoarthritis study. Spine. 2007;32(1):120–5.CrossRefPubMed Jacobsen S, Sonne-Holm S, Rovsing H, Monard H, Gebuhr P. Degenerative lumbar spondylolisthesis. An epidemiological perspective. The Copenhagen osteoarthritis study. Spine. 2007;32(1):120–5.CrossRefPubMed
8.
go back to reference Kauppila LI, Eustace S, Kiel DP, Felton DT, Wright AM. Degenerative displacement of lumbar vertebrae. A 25-year follow-up study in Framingham. Spine. 1998;23(17):1868–73.CrossRefPubMed Kauppila LI, Eustace S, Kiel DP, Felton DT, Wright AM. Degenerative displacement of lumbar vertebrae. A 25-year follow-up study in Framingham. Spine. 1998;23(17):1868–73.CrossRefPubMed
9.
go back to reference Vogt MT, Rubin D, Valentin RS, Palermo L, Donaldson WF III, Nevitt M, Cauley JA. Lumbar olisthesis and lower back symptoms in elderly white women. The Study of Osteoporotic Fractures. Spine. 1998;23(23):2640–7.CrossRefPubMed Vogt MT, Rubin D, Valentin RS, Palermo L, Donaldson WF III, Nevitt M, Cauley JA. Lumbar olisthesis and lower back symptoms in elderly white women. The Study of Osteoporotic Fractures. Spine. 1998;23(23):2640–7.CrossRefPubMed
10.
go back to reference Matsunaga S, Sakou T, Morizono Y, Demirtas AM. Natural history of degenerative spondylolisthesis. Pathogenesis and natural course of the slippage. Spine. 1990;15(11):1204–10.CrossRefPubMed Matsunaga S, Sakou T, Morizono Y, Demirtas AM. Natural history of degenerative spondylolisthesis. Pathogenesis and natural course of the slippage. Spine. 1990;15(11):1204–10.CrossRefPubMed
11.
go back to reference Matsunaga S, Ijiri K, Hayashi K. Nonsurgically managed patients with degenerative spondylolisthesis. J Neurosurg. 2000;93(2 Suppl):194–8.PubMed Matsunaga S, Ijiri K, Hayashi K. Nonsurgically managed patients with degenerative spondylolisthesis. J Neurosurg. 2000;93(2 Suppl):194–8.PubMed
12.
go back to reference Denard PJ, Holton KF, Miller J, Fink HA, Kado DM, Yoo JU, Marshall LM. Lumbar spondylolisthesis among elderly men. Prevalence, correlates, and progression. Spine. 2010;35(10):1072–8.PubMedCentralPubMed Denard PJ, Holton KF, Miller J, Fink HA, Kado DM, Yoo JU, Marshall LM. Lumbar spondylolisthesis among elderly men. Prevalence, correlates, and progression. Spine. 2010;35(10):1072–8.PubMedCentralPubMed
13.
go back to reference Yoshimura N, Kinoshita H, Danjoh S, Yamada H, Tamaki T, Morioka S, Kasamatsu T, Hashimoto T, Inoue T. Prevalence of vertebral fractures in a rural Japanese population. J Epidemiol. 1995;5(4):171–5.CrossRef Yoshimura N, Kinoshita H, Danjoh S, Yamada H, Tamaki T, Morioka S, Kasamatsu T, Hashimoto T, Inoue T. Prevalence of vertebral fractures in a rural Japanese population. J Epidemiol. 1995;5(4):171–5.CrossRef
14.
go back to reference Yoshimura N, Kinoshita H, Danjoh S, Takijiri T, Morioka S, Kasamatsu T, Sakata K, Hashimoto T. Bone loss at the lumbar spine and the proximal femur in a rural Japanese community, 1990–2000: the Miyama study. Osteoporos Int. 2002;13(10):803–8.CrossRefPubMed Yoshimura N, Kinoshita H, Danjoh S, Takijiri T, Morioka S, Kasamatsu T, Sakata K, Hashimoto T. Bone loss at the lumbar spine and the proximal femur in a rural Japanese community, 1990–2000: the Miyama study. Osteoporos Int. 2002;13(10):803–8.CrossRefPubMed
15.
go back to reference Kasamatsu T, Morioka S, Hashimoto T, Kinoshita H, Yamada H, Tamaki T. Epidemiological study on bone mineral density of inhabitants in Miyama Village, Wakayama Prefecture (Part 1) background of study population and sampling method. J Bone Miner Metabol. 1991;9(1 Suppl):50–5.CrossRef Kasamatsu T, Morioka S, Hashimoto T, Kinoshita H, Yamada H, Tamaki T. Epidemiological study on bone mineral density of inhabitants in Miyama Village, Wakayama Prefecture (Part 1) background of study population and sampling method. J Bone Miner Metabol. 1991;9(1 Suppl):50–5.CrossRef
16.
go back to reference Ministry of Health and Welfare of Japan. Results of National nutrition survey 1988. Tokyo: Daiichi-shuppan; 1990. Ministry of Health and Welfare of Japan. Results of National nutrition survey 1988. Tokyo: Daiichi-shuppan; 1990.
17.
go back to reference Farfan HF. Mechanical disorders of the low back. Philadelphia: Lea and Febiger; 1973. p. 37–40. Farfan HF. Mechanical disorders of the low back. Philadelphia: Lea and Febiger; 1973. p. 37–40.
18.
go back to reference Kawakami M, Tamaki T, Ando M, Yamada H, Hashizume H, Yoshida M. Lumbar sagittal balance influences the clinical outcome after decompression and posterolateral spinal fusion for degenerative lumbar spondylolisthesis. Spine. 2002;27(1):59–64.CrossRefPubMed Kawakami M, Tamaki T, Ando M, Yamada H, Hashizume H, Yoshida M. Lumbar sagittal balance influences the clinical outcome after decompression and posterolateral spinal fusion for degenerative lumbar spondylolisthesis. Spine. 2002;27(1):59–64.CrossRefPubMed
19.
go back to reference Wiltse LL, Winter RB. Terminology and measurement of spondylolisthesis. J Bone Joint Surg Am. 1983;65(6):768–72.PubMed Wiltse LL, Winter RB. Terminology and measurement of spondylolisthesis. J Bone Joint Surg Am. 1983;65(6):768–72.PubMed
20.
go back to reference Nathan H, Islael J. Osteophytes of the vertebral column: an anatomical study of their development according to age, race, and sex with considerations as to their etiology and significance. J Bone Joint Surg Am. 1962;44(2):243–68. Nathan H, Islael J. Osteophytes of the vertebral column: an anatomical study of their development according to age, race, and sex with considerations as to their etiology and significance. J Bone Joint Surg Am. 1962;44(2):243–68.
21.
go back to reference Sato K, Wakamatsu E, Yoshizumi A, Watanabe N, Irei O. The configuration of the laminas and facet joints in degenerative spondylolisthesis A clinicoradiologic study. Spine. 1989;14(11):1265–71.CrossRefPubMed Sato K, Wakamatsu E, Yoshizumi A, Watanabe N, Irei O. The configuration of the laminas and facet joints in degenerative spondylolisthesis A clinicoradiologic study. Spine. 1989;14(11):1265–71.CrossRefPubMed
22.
go back to reference Genant HK, Wu CY, van Kuijk C, Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 1993;8(9):1137–48.CrossRefPubMed Genant HK, Wu CY, van Kuijk C, Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 1993;8(9):1137–48.CrossRefPubMed
23.
go back to reference Kalichman L, Kim DH, Li L, Guermazi A, Berkin V, Hunter DJ. Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine. 2009;34(2):199–205.PubMedCentralCrossRefPubMed Kalichman L, Kim DH, Li L, Guermazi A, Berkin V, Hunter DJ. Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine. 2009;34(2):199–205.PubMedCentralCrossRefPubMed
24.
go back to reference Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop. 1982;165:110–23.PubMed Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop. 1982;165:110–23.PubMed
25.
go back to reference Jackson RP, McManus AC. Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. Spine. 1994;19(14):1611–8.CrossRefPubMed Jackson RP, McManus AC. Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. Spine. 1994;19(14):1611–8.CrossRefPubMed
26.
go back to reference Barrey C, Jund J, Noseda O, Roussouly P. Sagittal balance of the pelvis–spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J. 2007;16(9):1459–67.PubMedCentralCrossRefPubMed Barrey C, Jund J, Noseda O, Roussouly P. Sagittal balance of the pelvis–spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J. 2007;16(9):1459–67.PubMedCentralCrossRefPubMed
27.
go back to reference Boden SD, Riew KD, Yamaguchi K, Branch TP, Schellinger D, Wiesel SW. Orientation of the lumbar facet joints. Association with degenerative disc disease. J Bone Joint Surg Am. 1996;78(3):403–11.PubMed Boden SD, Riew KD, Yamaguchi K, Branch TP, Schellinger D, Wiesel SW. Orientation of the lumbar facet joints. Association with degenerative disc disease. J Bone Joint Surg Am. 1996;78(3):403–11.PubMed
28.
go back to reference Toyone T, Ozawa T, Kamikawa K, Watanabe A, Matsuki K, Yamashita T, Wada Y. Facet joint orientation difference between cephalad and caudal portions: a possible cause of degenerative spondylolisthesis. Spine. 2009;34(21):2259–62.CrossRefPubMed Toyone T, Ozawa T, Kamikawa K, Watanabe A, Matsuki K, Yamashita T, Wada Y. Facet joint orientation difference between cephalad and caudal portions: a possible cause of degenerative spondylolisthesis. Spine. 2009;34(21):2259–62.CrossRefPubMed
29.
go back to reference Love TW, Fagan AB, Fraser RD. Degenerative spondylolisthesis. Developmental or acquired? J Bone Joint Surg Br. 1999;81(4):670–4.CrossRefPubMed Love TW, Fagan AB, Fraser RD. Degenerative spondylolisthesis. Developmental or acquired? J Bone Joint Surg Br. 1999;81(4):670–4.CrossRefPubMed
30.
go back to reference Berlemann U, Jeszenszky DJ, Buhler DW, Harms J. Facet joint remodeling in degenerative spondylolisthesis: an investigation of joint orientation and tropism. Eur Spine J. 1998;7(5):376–80.PubMedCentralCrossRefPubMed Berlemann U, Jeszenszky DJ, Buhler DW, Harms J. Facet joint remodeling in degenerative spondylolisthesis: an investigation of joint orientation and tropism. Eur Spine J. 1998;7(5):376–80.PubMedCentralCrossRefPubMed
Metadata
Title
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
Authors
Yoshio Enyo
Noriko Yoshimura
Hiroshi Yamada
Hiroshi Hashizume
Munehito Yoshida
Publication date
01-11-2015
Publisher
Springer Japan
Published in
Journal of Orthopaedic Science / Issue 6/2015
Print ISSN: 0949-2658
Electronic ISSN: 1436-2023
DOI
https://doi.org/10.1007/s00776-015-0759-8

Other articles of this Issue 6/2015

Journal of Orthopaedic Science 6/2015 Go to the issue