Degenerative Spondylolisthesis Is Related to Multiparity and Hysterectomies in Older Women

Abstract

Study Design A case-control study Objective To determine whether parity and abdominal surgeries are associated with degenerative spondylolisthesis (DS). Summary of Background Data DS is considered to be a major cause of low back pain (LBP) in the older population, with greater prevalence of DS among women. Because LBP and impaired abdominal muscle function are common during pregnancy and post-partum, parity-related abdominal muscle deficiency, resulting in poor spinal mechanics, could be a factor in the development of DS in women. Indeed a relationship between the number of pregnancies and DS was reported in one study. Methods 322 women between the ages of 40 and 80 (149 with DS and 173 controls) filled out a questionnaire providing information about their demographics, the number of full-term pregnancies, the number and types of abdominal surgeries (including cesarean section (CS) and hysterectomies), and age at menopause among other items. A binary logistic regression was used as a multi-variate model to identify the variables associated with DS. Results Along with age and body-mass-index as co-variates, the number of full-term pregnancies and the hysterectomy were significant predictors of DS. Other abdominal surgeries, CS or the number of years post-menopause were not significant predictors of DS in this regression model after adjusting for all other significant variables. Conclusions Each full-term pregnancy seems to be associated with the 22% increase in odds of developing DS. Hysterectomy nearly doubles the odds of DS as compared to women who did not have hysterectomy.

Surgical Outcome of Decompression and Fixation of Degenerative Lumbosacral Spondylolisthesis Surgery in Pakistani Population

“…Radiologically, spondylolisthesis can be described according to its degree of severity, with one commonly used description being grade-I least advanced, and grade-V being most advanced. Surgical indications include progressive slip, significant lumbosacral kyphotic deformity, neurologic deficit, intractable back pain, and refractory radicular pain [10,11].…”

Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle?

“…In the post-menopausal state, the presenting symptom is usually pain ( Wang, 2016 ). The IVD degeneration types include adult-onset lumbar scoliosis ( Aebi, 2005 ; Rumancik et al, 2005 ; Urrutia et al, 2011a ; Urrutia et al, 2011b ) or spondylolisthesis ( Jacobsen et al, 2007 ; Cholewicki et al, 2017 ). The causes for the development of such conditions in post-menopausal women is mainly unknown, but some associations with parity have been made ( Cevik et al, 2020 ), and risk factors for pregnancy-related pelvic girdle pain investigated ( Wuytack et al, 2020 ), as well as a focus on pregnancy-associated changes in motor control of the spine ( Desgagnes et al, 2022 ).…”

Factors Predisposing to The Formation of Degenerative Spondylolisthesis—A Narrative Review

“…It has been demonstrated repeatedly that with an increase in body mass index (BMI), the axial load on the discs and facet joints, as well as compressive force acting on the vertebrae, increases. Chronic exposure to this type of stressor may contribute to increased intersegmental mobility, anterior displacement of the trunk, and an enhanced risk of degenerative spondylolisthesis [ 6 , 7 , 24 , 26 , 31 , 57 , 75 ]. In the aforementioned work, Jacobsen et al drew attention to another feature that may affect the prevalence of degenerative spondylolisthesis: the weight of patients.…”