Clin Orthop Surg.  2011 Mar;3(1):34-38. 10.4055/cios.2011.3.1.34.

Prevalence of Spondylolysis and Its Relationship with Low Back Pain in Selected Population

• Ko SB
• Lee SW

• KMID: 999458
• DOI: http://doi.org/10.4055/cios.2011.3.1.34

Abstract

BACKGROUND
To determine the prevalence of spondylolysis in a selected population and evaluate the association of spondylolysis with low back pain (LBP). Spondylolysis is widespread in the general population but the prevalence of spondylolysis and its relationship with LBP in the Korean population is controversial.
METHODS
A sample of 855 participants (age, 20 to 86 years) from our medical center who underwent multidetector computed tomography (CT) imaging to assess abdominal and urological lesions were enrolled in this study. The occurrence of LBP requiring medication in the preceding 12 months was evaluated using a self-report questionnaire (a modified Nordic Low Back Pain Questionnaire). The presence of spondylolysis was characterized by CT imaging. Multiple logistic regression models were used to examine the association between spondylolysis and LBP, while adjusting for gender and age.
RESULTS
Seventy-eight study subjects (9%) demonstrated spondylolysis on CT imaging. There was no significant difference between the age groups (p = 0.177). The p-value of gender was 0.033 but this was not significant due to the selected population bias. Three hundred eleven study subjects (36%) had back pain. There was a significant difference between gender (p = 0.001). No significant association was identified between spondylolysis and the occurrence of LBP.
CONCLUSIONS
The prevalence of LBP was 36.37% and the prevalence of lumbar spondylolysis in a selected population, who visited hospital for abdominal or urological lesions except LBP, was 9.12% based on CT imaging. Males demonstrated a similar presence of LBP to females but a significantly higher incidence of spondylolysis (p = 0.033). The prevalence of spondylolysis was not associated with the presence of LBP and age in adulthood.

Keyword

Lumbar spine; Spondylolysis; Prevalence; Selected population

MeSH Terms

Adult
Age Factors
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Humans
Korea/epidemiology
Logistic Models
Low Back Pain/*etiology
Male
Middle Aged
Prevalence
Self Report
Sex Factors
Spondylolysis/*complications/*epidemiology/radiography
Tomography, X-Ray Computed
Young Adult

Reference

1. Hu SS, Tribus CB, Diab M, Ghanayem AJ. Spondylolisthesis and spondylolysis. J Bone Joint Surg Am. 2008; 90(3):656–671. PMID: 18326106.

2. Sonne-Holm S, Jacobsen S, Rovsing HC, Monrad H, Gebuhr P. Lumbar spondylolysis: a life long dynamic condition? A cross sectional survey of 4.151 adults. Eur Spine J. 2007; 16(6):821–828. PMID: 17120072.

3. Teplick JG, Laffey PA, Berman A, Haskin ME. Diagnosis and evaluation of spondylolisthesis and/or spondylolysis on axial CT. AJNR Am J Neuroradiol. 1986; 7(3):479–491. PMID: 3085451.

4. Krupski W, Majcher P, Tatara MR. Computed tomorgaphy diagnostic of lumbar spondylolysis. Ortop Traumatol Rehabil. 2004; 6(5):652–657. PMID: 17618216.

5. Kuorinka I, Jonsson B, Kilbom A, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987; 18(3):233–237. PMID: 15676628.

6. Dovrat E, Katz-Leurer M. Cold exposure and low back pain in store workers in Israel. Am J Ind Med. 2007; 50(8):626–631. PMID: 17595006.

7. Ghaffari M, Alipour A, Jensen I, Farshad AA, Vingard E. Low back pain among Iranian industrial workers. Occup Med (Lond). 2006; 56(7):455–460. PMID: 16837536.

8. Fredrickson BE, Baker D, McHolick WJ, Yuan HA, Lubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am. 1984; 66(5):699–707. PMID: 6373773.

9. 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 (Phila Pa 1976). 2009; 34(2):199–205. PMID: 19139672.

10. Virta L, Ronnemaa T, Osterman K, Aalto T, Laakso M. Prevalence of isthmic lumbar spondylolisthesis in middle-aged subjects from eastern and western Finland. J Clin Epidemiol. 1992; 45(8):917–922. PMID: 1624974.

11. Sakai T, Sairyo K, Takao S, Nishitani H, Yasui N. Incidence of lumbar spondylolysis in the general population in Japan based on multidetector computed tomography scans from two thousand subjects. Spine (Phila Pa 1976). 2009; 34(21):2346–2350. PMID: 19934813.

12. Newman PH. Stenosis of the lumbar spine in spondylolisthesis. Clin Orthop Relat Res. 1976; (115):116–121. PMID: 1253474.

13. Beutler WJ, Fredrickson BE, Murtland A, Sweeney CA, Grant WD, Baker D. The natural history of spondylolysis and spondylolisthesis: 45-year follow-up evaluation. Spine (Phila Pa 1976). 2003; 28(10):1027–1035. PMID: 12768144.

14. Waldron HA. Variations in the prevalence of spondylolysis in early British populations. J R Soc Med. 1991; 84(9):547–549. PMID: 1941859.

15. Ivanic GM, Pink TP, Achatz W, Ward JC, Homann NC, May M. Direct stabilization of lumbar spondylolysis with a hook screw: mean 11-year follow-up period for 113 patients. Spine (Phila Pa 1976). 2003; 28(3):255–259. PMID: 12567027.

16. Miyauchi A, Baba I, Sumida T, Manabe H, Hayashi Y, Ochi M. Relationship between the histological findings of spondylolytic tissue, instability of the loose lamina, and low back pain. Spine (Phila Pa 1976). 2008; 33(6):687–693. PMID: 18344864.

17. Blanda J, Bethem D, Moats W, Lew M. Defects of pars interarticularis in athletes: a protocol for nonoperative treatment. J Spinal Disord. 1993; 6(5):406–411. PMID: 8274809.

18. Eisenstein S. Spondylolysis. A skeletal investigation of two population groups. J Bone Joint Surg Br. 1978; 60(4):488–494. PMID: 361744.