title: Radiographic analysis of newly developed degenerative spondylolisthesis in a mean twelve-year prospective study.
abstract: METHODS
  Prospective study of community-based female volunteers.
  
  
  OBJECTIVE
  To investigate the incidence of newly developed degenerative spondylolisthesis (DS) among those without baseline deformity, and to clarify radiographic characteristics and predictors of DS.
  
  
  BACKGROUND
  There has been limited number of prospective studies of DS. Our on-going cohort study of healthy volunteers enabled long-term observation of highly susceptible perimenopause female subjects.
  
  
  METHODS
  A final total of 142 female subjects without spondylolisthesis at baseline radiographs were included and followed up for more than 8 years. Standardized serial entire spine radiographs were used to measure spinopelvic alignment, including pelvic incidence (PI), vertebral inclination angle, disc height, vertebral size, and facet orientation.
  
  
  RESULTS
  The incidence of newly developed DS was 12.7%. Comparison between DS and non-DS subjects demonstrated that DS subjects had significantly greater baseline lumbar lordosis, PI, vertebral inclination angle, and smaller vertebral size. Exaggerated lumbopelvic alignment was more prominent in L3-DS than in L4-DS, and L4-DS was associated with the decrease in L4/5 disc height. Multivariate analysis revealed that PI, L4 vertebral inclination, adjusted vertebral size, and facet sagittalization were independent predictors of the development of DS.
  
  
  CONCLUSIONS
  This was the first study to confirm the relationship of PI and the development of DS in a long-term prospective observation. Proposed pathogenetic differences might explain the fact that L4-DS is far more prevalent than L3-DS. The development of DS could be predicted by baseline lumbopelvic morphology among the highly susceptible perimenopause women.
authors.affiliation: Department of Orthopaedic Surgery, Asahikawa Medical College, 2-1E Midorigaoka, Asahikawa, Hokkaido, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Aono
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Shizuo
authors.initials: S
authors.lastname: Jimbo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Atsuta
authors.forename: Takeo
authors.initials: T
authors.lastname: Matsuno
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D008137:Longitudinal Studies; D008141:Lordosis / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000209:etiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D012737:Sex Factors; D013168:Spondylolisthesis / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D013997:Time Factors; D021801:Zygapophyseal Joint / Q000473:pathology / Q000503:physiopathology