Back pain, neurogenic symptoms, and physical function in relation to spondylolisthesis among elderly men.
BACKGROUND
Degenerative spondylolisthesis is a presumed cause of back pain. Previous studies of spondylolisthesis and back pain included only women or combined results for men and women. Comparisons of the frequency of back pain, neurogenic symptoms, and functional limitations specifically among elderly men with and without spondylolisthesis are needed.


OBJECTIVE
To determine associations of prevalent spondylolisthesis with back pain symptoms, neurogenic symptoms, and functional limitations among elderly men.


METHODS
Cross-sectional epidemiologic study conducted within the Osteoporotic Fractures in Men (MrOS) cohort. The MrOS cohort is composed of 5,995 community-dwelling men aged 65 years or older who were recruited at six US academic medical centers. Extensive self-reported data and lumbar spine radiographs were obtained for all MrOS participants at baseline.


METHODS
For this study, 300 men were selected at random specifically for the evaluation of spondylolisthesis on the baseline spine radiographs.


METHODS
Standardized questionnaires were used to assess self-reported back pain, leg pain (radiculopathy), lower extremity numbness (paresthesias), and lower extremity weakness occurring in the past 12 months and to ascertain current difficulty with activities of daily living.


METHODS
In the present study, radiographic spondylolisthesis was classified as forward slip of ≥5%. Prevalence of back pain, neurogenic symptoms, and difficulty with activities of daily living was compared between men with and without spondylolisthesis using chi-square or Fisher exact tests.


RESULTS
Spondylolisthesis was present among 92 (31%) men. Among men with and without spondylolisthesis, back pain (63% vs. 67%, p=.46) and moderate/severe back pain (41% vs. 38%, p=.76) were reported with similar frequency. Men with spondylolisthesis more often reported radiculopathy (33% vs. 22%, p=.06), paresthesias (18% vs. 11%, p=.10), and weakness (18% vs. 9%, p=.02) in the lower extremities, as well as difficulty walking two to three blocks (21% vs. 11%, p=.03), doing their own shopping (8% vs. 2%, p=.04), and getting in/out of a car (14% vs. 6%, p=.03), compared with men without spondylolisthesis.


CONCLUSIONS
Among elderly men, spondylolisthesis was associated with neurogenic symptoms and lower extremity functional limitations; however, spondylolisthesis was not associated with a higher likelihood of back pain in this population.
Denard
Patrick J
PJ
Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098, USA.
Holton
Kathleen F
KF
Miller
Jessica
J
Fink
Howard A
HA
Kado
Deborah M
DM
Marshall
Lynn M
LM
Yoo
Jung U
JU
D000203:Activities of Daily Living; D000368:Aged; D001416:Back Pain / Q000453:epidemiology* / Q000209:etiology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006801:Humans; D008297:Male; D013168:Spondylolisthesis / Q000150:complications*; D011795:Surveys and Questionnaires; D001750:Urinary Bladder, Neurogenic / Q000453:epidemiology* / Q000209:etiology*