Evaluating the characteristics of spondylolisthesis in low back pain by radiography


Journal of Surgery and Medicine, vol.5, no.5, pp.486-490, 2021 (Peer-Reviewed Journal)


Abstract Background/Aim: In physical therapy and rehabilitation practices, it is important to diagnose radiographic spondylolisthesis for correct choice of exercise in patients with low back pain. There are different results about the rates and the characteristics of spondylolisthesis. The aims of this study were to compare the radiographical findings, and evaluate the frequency and the radiographic characteristics of spondylolisthesis according to gender. Methods: Nine hundred and four patients with low back pain, who were over 18 years of age with records of age, gender, and lumbar spine radiographs (both anterior and lateral) were included in this retrospective cross sectional study. Three hundred and forty-eight patients (245 females, 103 males) who met our criteria were included in the study and reviewed for age, gender, and anterior/lateral-lumbar spine radiographies. Spine radiographies were assessed for the presence of spondylosis, scoliosis, fracture, flattening of the lordosis, hyperlordosis, sacralization, lumbarization and spondylolisthesis. The spondylolisthesis measurements were made according to the Meyerding Grading Scale. The levels and the pattern of anterior or posterior listhesis, and co-existing radiological findings such as osteophyte, sclerosis, intervertebral disk space narrowing and scoliosis, were noted. Results: The rate of hyperlordosis (P=0.003) and spondylolisthesis (P=0.012) were significantly higher in females compared to males. The rate of spondylolisthesis among all patients was 11.4% (female/male ratio:2.95/1). All male patients and 91.5% of female patients with spondylolisthesis had it at the L5-S1 level only. Among all, 90.6% of spondylolisthesis patients had anterolisthesis and 79.1% had grade 1 spondylolisthesis according to Meyerding. The most common radiological findings were sclerosis (95%), osteophytes (62.5%), intervertebral disk narrowing (62.5%), scoliosis (37.5%) in spondylolisthesis patients. Conclusion: The results of our study showed that hyperlordosis and spondylolisthesis were more common in females. The characteristics of spondylolisthesis include occurring mostly at one level only, being Meyerding grade 1 and showing anterolisthesis pattern. The most frequent coexisting radiological findings were sclerosis, osteophytes, and intervertebral disk narrowing. These result support the idea that the pathogenesis of spondylolisthesis is associated with spondylosis. The rate of spondylolisthesis was higher compared to many previous studies. Before deciding on an exercise, it is important to see the direct radiography of the patient with low back pain