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Degenerative Lumbar Spondylolisthesis: An Epidemiological Perspective: The Copenhagen Osteoarthritis Study

Jacobsen, Steffen, MD*; Sonne-Holm, Stig, MD, PhD*; Rovsing, Hans, MD, PhD; Monrad, Henrik, MD; Gebuhr, Peter, MD*

doi: 10.1097/01.brs.0000250979.12398.96
Epidemiology
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Study Design. A cross-sectional epidemiological survey of 4151 participants of the Copenhagen Osteoarthritis Study.

Objective. To identify prevalences and individual risk factors for degenerative lumbar spondylolisthesis.

Summary of Background Data. The Copenhagen Osteoarthritis Study has registered health parameters since 1976. In 1993, standardized, lateral radiographs of the lumbar spine were recorded. There were 1533 men and 2618 women.

Methods. Statistical correlations were made between degenerative spondylolisthesis, and physical, occupational, and general epidemiological data.

Results. A total of 254 cases of lumbar slip were found (males 2.7%, females 8.4%). In females, no significant relationship between age at menopause or childbirths and the presence of degenerative spondylolisthesis were found. In women, relationships between body mass index (BMI) in 1976 and L4 olisthesis (P = 0.001), and between BMI in 1993 and both L4 and L5 olisthesis were found (L4: P = 0.003; L5: P = 0.006). Lumbar lordosis was associated with degenerative spondylolisthesis in women. Occupational exposures to daily lifting or smoking were not associated with degenerative spondylolisthesis. Degenerative spondylolisthesis was associated with increased age in both sexes (L4: P < 0.001; L5: P < 0.001).

Conclusions. BMI longitudinally and at index evaluations, age, and angle of lordosis were significantly associated with degenerative spondylolisthesis in women. In men, no individual risk factors for degenerative spondylolisthesis were found, save increased age.

We reviewed 4151 randomly selected subjects to identify prevalences and individual risk factors for degenerative lumbar spondylolisthesis. Aging, angle of lumbar lordosis, and increased body mass index were significant risk factors for L4 slips in women. Only increased age constituted a risk factor for lumbar slips in men.

From the Departments of *Orthopaedic Surgery and †Radiology, Copenhagen University Hospital of Hvidovre, Copenhagen, Denmark.

Acknowledgment date: November 21, 2005. First revision date: February 14, 2006. Second revision date: March 11, 2006. Acceptance date: March 13, 2006.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Foundation funds were received in support of this work. Although one or more of the author(s) has/have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this manuscript, benefits will be directed solely to a research fund, foundation, educational institution, or other nonprofit organization which the author(s) has/have been associated.

Address correspondence and reprint requests to Steffen Jacobsen, MD, Skodsborg Strandvej 157 A, II, DK-2942 Skodsborg, Denmark; E-mail: sjac@dadlnet.dk

© 2007 Lippincott Williams & Wilkins, Inc.