title: Degenerative spondylolisthesis is associated with low spinal bone density: a comparative study between spinal stenosis and degenerative spondylolisthesis.
abstract: Spinal stenosis and degenerative spondylolisthesis share many symptoms and the same treatment, but their causes remain unclear. Bone mineral density has been suggested to play a role. The aim of this study was to investigate differences in spinal bone density between spinal stenosis and degenerative spondylolisthesis patients. 81 patients older than 60 years, who underwent DXA-scanning of their lumbar spine one year after a lumbar spinal fusion procedure, were included. Radiographs were assessed for disc height, vertebral wedging, and osteophytosis. Pain was assessed using the Low Back Pain Rating Scale pain index. T-score of the lumbar spine was significantly lower among degenerative spondylolisthesis patients compared with spinal stenosis patients (-1.52 versus -0.52, P = 0.04). Thirty-nine percent of degenerative spondylolisthesis patients were classified as osteoporotic and further 30% osteopenic compared to only 9% of spinal stenosis patients being osteoporotic and 30% osteopenic (P = 0.01). Pain levels tended to increase with poorer bone status (P = 0.06). Patients treated surgically for symptomatic degenerative spondylolisthesis have much lower bone mass than patients of similar age treated surgically for spinal stenosis. Low BMD might play a role in the development of the degenerative spondylolisthesis, further studies are needed to clarify this.
authors.affiliation: Orthopaedic Department, Spine Section, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Andersen
authors.forename: Finn B
authors.initials: FB
authors.lastname: Christensen
authors.forename: Bente L
authors.initials: BL
authors.lastname: Langdahl
authors.forename: Carsten
authors.initials: C
authors.lastname: Ernst
authors.forename: Søren
authors.initials: S
authors.lastname: Fruensgaard
authors.forename: Jørgen
authors.initials: J
authors.lastname: Østergaard
authors.forename: Jens Langer
authors.initials: JL
authors.lastname: Andersen
authors.forename: Sten
authors.initials: S
authors.lastname: Rasmussen
authors.forename: Bent
authors.initials: B
authors.lastname: Niedermann
authors.forename: Kristian
authors.initials: K
authors.lastname: Høy
authors.forename: Peter
authors.initials: P
authors.lastname: Helmig
authors.forename: Randi
authors.initials: R
authors.lastname: Holm
authors.forename: Niels
authors.initials: N
authors.lastname: Egund
authors.forename: Cody
authors.initials: C
authors.lastname: Bünger
mesh_terms: D000368:Aged; D015519:Bone Density; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D011859:Radiography; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000473:pathology*; D016896:Treatment Outcome
references.citation: Neurosurgery. 2007 Nov;61(5):981-6; discussion 986
references.pmid: 18091275
references.citation: Spine (Phila Pa 1976). 2005 Jun 15;30(12):1441-5; discussion 1446-7
references.pmid: 15959375
references.citation: Spine (Phila Pa 1976). 1990 Nov;15(11):1204-10
references.pmid: 2267617
references.citation: Adv Ther. 2003 Mar-Apr;20(2):114-20
references.pmid: 12836811
references.citation: Prague Med Rep. 2009;110(4):343-9
references.pmid: 20059885
references.citation: Spine (Phila Pa 1976). 1995 Aug 1;20(15):1674-8
references.pmid: 7482016
references.citation: Clin Rehabil. 2002 Dec;16(8):867-70
references.pmid: 12506878
references.citation: Spine (Phila Pa 1976). 2009 Oct 1;34(21):2241-7
references.pmid: 19934802
references.citation: Spine (Phila Pa 1976). 1989 May;14(5):511-6
references.pmid: 2524890
references.citation: J Rheumatol. 1995 May;22(5):932-6
references.pmid: 8587085
references.citation: Ann Rheum Dis. 2010 Dec;69(12):2102-6
references.pmid: 20570838
references.citation: J Bone Joint Surg Am. 1983 Jul;65(6):768-72
references.pmid: 6863359
references.citation: Spine (Phila Pa 1976). 2009 Oct 1;34(21):2259-62
references.pmid: 19934805
references.citation: Pain. 1994 Jun;57(3):317-326
references.pmid: 7936710
references.citation: J Rheumatol. 2000 Mar;27(3):735-8
references.pmid: 10743818
references.citation: Spine (Phila Pa 1976). 2010 Feb 1;35(3):298-305
references.pmid: 20075768
references.citation: Osteoporos Int. 1996;6(1):43-9
references.pmid: 8845599
references.citation: Osteoporos Int. 1997;7(6):564-9
references.pmid: 9604053
references.citation: Spine (Phila Pa 1976). 2009 Oct 1;34(21):2248-53
references.pmid: 19934803
references.citation: Spine (Phila Pa 1976). 2010 Apr 15;35(8):887-91
references.pmid: 20354469
references.citation: Spine (Phila Pa 1976). 2010 May 1;35(10):1072-8
references.pmid: 20393398
references.citation: Osteoporos Int. 2007 Sep;18(9):1219-24
references.pmid: 17387420
references.citation: Osteoporos Int. 1993 Dec;3(6):300-7
references.pmid: 8292840
references.citation: Spine (Phila Pa 1976). 2005 Aug 1;30(15):1750-5
references.pmid: 16094277
references.citation: Osteoporos Int. 1994 Mar;4(2):67-71
references.pmid: 8003842
references.citation: JAMA. 2001 Feb 14;285(6):785-95
references.pmid: 11176917
references.citation: Spine (Phila Pa 1976). 1999 Dec 1;24(23):2536-41
references.pmid: 10626317
references.citation: Eur Spine J. 2003 Dec;12(6):596-601
references.pmid: 14564559
references.citation: J Bone Joint Surg Br. 1999 Jul;81(4):670-4
references.pmid: 10463743
references.citation: Eur Spine J. 2012 Nov;21(11):2181-7
references.pmid: 22639298
references.citation: Spine (Phila Pa 1976). 2009 Aug 1;34(17):E596-8
references.pmid: 19644318
references.citation: J Bone Joint Surg Am. 2006 Apr;88 Suppl 2:3-9
references.pmid: 16595435
references.citation: Spine (Phila Pa 1976). 1989 Apr;14(4):477-9
references.pmid: 2655115
references.citation: Spine (Phila Pa 1976). 2009 Jul 15;34(16):E552-7
references.pmid: 19770597