#10 - TITLE: Prevalence of lumbar spondylolysis/spondylolisthesis and association with low back
pain
AUTHORS: David H. Kim**, Leonid Kalichman*, Ali Guermazi*, Ling Li**, Valerie Berkin*, and David
Hunter**
* Boston University School of Medicine
** New England Baptist Hospital, Boston, MA
INTRODUCTION: Spondylolysis and spondylolisthesis are prevalent in the general population; however
the relationship between these conditions and LBP is controversial.
OBJECTIVE: 1) to determine prevalence rates of spondylolysis, isthmic and degenerative
spondylolisthesis in an unselected adult community-based population; 2) to evaluate the association of
spondylolysis, isthmic and degenerative spondylolisthesis with low back pain (LBP).
METHODS: This study was an ancillary project to the Framingham Heart Study. A sample of 3529
participants of the Framingham Heart Study aged 40-80 years underwent multi-detector CT imaging to
assess aortic calcification. 188 individuals were consecutively enrolled in this study to assess
radiographic features potentially associated with LBP. The occurrence of LBP in the preceding 12 months
was evaluated using a self-report questionnaire. The presence of spondylolysis and spondylolisthesis
was characterized by CT imaging. We used multiple logistic regression models to examine the
association between spondylolysis, spondylolisthesis and LBP, while adjusting for gender, age and BMI.
RESULTS: Twenty-one study subjects demonstrated spondylolysis on CT imaging. The male-to-female
ratio was approximately 3:1. 21% of subjects with bilateral spondylolytic defects demonstrated no
measurable spondylolisthesis. The male-to-female ratio of degenerative spondylolisthesis was 1:3, and
the prevalence of degenerative spondylolisthesis increased from the fifth through eight decades of life.
38 subjects (20.4%) reported significant LBP. No significant association was identified between
spondylolysis, isthmic spondylolisthesis, or degenerative spondylolisthesis, and the occurrence of LBP.
CONCLUSION: Based on CT imaging of an unselected community-based population, the prevalence of
lumbar spondylolysis is 11.5%, nearly twice the prevalence of previous plain radiograph-based studies.
This study did not reveal a significant association between the observation of spondylolysis on CT and
the occurrence of LBP, suggesting that the condition does not appear to represent a major cause of LBP
in the general population.
SPONSOR: This work was supported by the National Heart, Lung and Blood Institute's Framingham
Heart Study contract (No. N01-HC-25195) for the recruitment, enrollment, and examination of the
Offspring and Third Generation Cohort and the imaging by computed tomography scan. L.K. is supported
by an Arthritis Foundation Postdoctoral Grant.
DISCLOSURE STATEMENT: Nothing to disclose. None of the authors have any conflict of interest
regarding the contents of this article.
ACKNOWLEDGMENT: None
CORRESPONDENCE CONTACT INFORMATION:
Name: David Kim
E-mail: dhkim@caregroup.harvard.edu
Phone: 617 754 5595
Institution: NEBH
PARTICIPATION: Check your preference (double click the box):
D:\116101898.doc
Prepared by the New England Baptist Hospital, Division of Research
Poster
Presentation
2/12/2016
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