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Spondylolisthesis may be more prevalent among elderly men than previously reported
Denard PJ. Spine. 2010; 35(10):1072-1078.
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Results of a prospective, cohort study have shown that spondylolisthesis may be more common among older men than once thought.
Estimates put the prevalence of spondylolisthesis among women aged 65 years and older at 29%; no study has estimated the prevalence of the disease in similarly aged men.
For their study, Patrick J. Denard, MD, and his colleagues in the Osteoporotic Fractures in Men (MrOS) Study Group, sought to determine the prevalence of spondylolisthesis in men as well as to identify the risk factors for the condition. The investigators used the lateral lumbar spine radiographs obtained at baseline and at a follow-up visit for the MrOS study, which examined a cohort of community-dwelling men aged 65 years and older. The average time between radiographs was 4.6 years, the authors wrote in their abstract. The study group had a mean age of 74 years.
The investigators randomly sampled 300 men at baseline for this study, 295 of which had a usable baseline radiograph. In total, 190 men had a follow-up radiograph. Denard and colleagues defined spondylolisthesis as a forward slip greater than or equal to 5%. A 5% increase in slip severity on the follow-up radiograph was labeled as progression.
The investigators found that 31% percent of participants had lumbar spondylolisthesis. The condition was seen at the L3/L4, L4/L5 and L5S1 levels. Only one vertebral level was involved in 96% of patients, according to the abstract. In these participants, slip degree ranged from 5% to 28%. The investigators classified nearly all listhesis as Meyerding grade 1.
Twelve percent of men progressed during follow-up, and 12% of patients who did not have spondylolisthesis at baseline had a new onset of the condition.
Height, body mass index, smoking history, diabetes and heart disease did not affect the prevalence of the condition.
“However, men with spondylolisthesis more often reported higher levels of physical activity or walking daily for exercise than men without spondylolisthesis,” the authors wrote.