Association of Lumbar Spondylolisthesis With Low Back Pain and Symptomatic Lumbar Spinal Stenosis in a Population-based Cohort: The Wakayama Spine Study

Spine (Phila Pa 1976). 2017 Jun 1;42(11):E666-E671. doi: 10.1097/BRS.0000000000001960.


Study design: Cross-sectional study.

Objective: To determine the association between lumbar spondylolisthesis and low back pain and symptomatic lumbar spinal stenosis (LSS) in a population-based cohort.

Summary of background data: The basic epidemiology of lumbar spondylolisthesis is not well known. There is little information regarding the association between lumbar spondylolisthesis and clinical symptoms such as low back pain and LSS symptoms.

Methods: This cross-sectional study included data from 938 participants (308 males, 630 females; mean age, 67.3 years; range, 40-93 years). Lumbar spondylolisthesis was defined as a slip of ≥5%. Diagnostic criteria for symptomatic LSS required the presence of both leg symptoms and radiographic LSS findings on magnetic resonance imaging. The prevalence of low back pain and symptomatic LSS was compared between those with or without spondylolisthesis. Furthermore, we determined the association between the amount of slippage and presence of symptomatic LSS.

Results: The prevalence of spondylolisthesis at any level was 15.8% in the total sample, 13.0% in males, and 17.1% in females; the prevalence was not significantly different between males and females (P = 0.09). In both, males and females, symptomatic LSS was related to spondylolisthesis [odds ratio (OR): 2.07; 95% CI: 1.20-3.44]; however, no such association was found for spondylolisthesis and presence of low back pain. The amount of slippage was not related to the presence of symptomatic LSS (P = 0.93).

Conclusion: This population-based cohort study revealed that lumbar spondylolisthesis had a closer association with leg symptoms than with low back pain. There was a significant difference in the presence of symptomatic LSS between participants with and without spondylolisthesis. However, the amount of slippage was not related to the presence of symptomatic LSS.

Level of evidence: 3.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Low Back Pain / diagnostic imaging
  • Low Back Pain / epidemiology*
  • Lumbar Vertebrae / diagnostic imaging*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Prevalence
  • Spinal Stenosis / diagnostic imaging
  • Spinal Stenosis / epidemiology*
  • Spondylolisthesis / diagnostic imaging
  • Spondylolisthesis / epidemiology*