title: Degenerative Spondylolisthesis Is Related to Multiparity and Hysterectomies in Older Women.
abstract: METHODS
  A case-control study.
  
  
  OBJECTIVE
  To determine whether parity and abdominal surgeries are associated with degenerative spondylolisthesis (DS).
  
  
  BACKGROUND
  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
  A total of 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 and hysterectomies), and age at menopause among other items. A binary logistic regression was used as a multivariate model to identify the variables associated with DS.
  
  
  RESULTS
  Along with age and body mass index as covariates, the number of full-term pregnancies and the hysterectomy were significant predictors of DS. Other abdominal surgeries, cesarean section, or the number of years postmenopause 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.
  
  
  METHODS
  4.
authors.affiliation: MSU Center for Orthopedic Research, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.|Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.
authors.forename: Jacek
authors.initials: J
authors.lastname: Cholewicki
authors.affiliation: MSU Center for Orthopedic Research, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.|Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.
authors.forename: Angela S
authors.initials: AS
authors.lastname: Lee
authors.affiliation: MSU Center for Orthopedic Research, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.|Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.
authors.forename: John M
authors.initials: JM
authors.lastname: Popovich
authors.affiliation: MSU Center for Orthopedic Research, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.|Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.
authors.forename: Lawrence W
authors.initials: LW
authors.lastname: Mysliwiec
authors.affiliation: MSU Center for Orthopedic Research, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.|Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Winkelpleck
authors.affiliation: MSU Center for Orthopedic Research, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.|Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.
authors.forename: John N
authors.initials: JN
authors.lastname: Flood
authors.affiliation: MSU Center for Orthopedic Research, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.|Department of Statistics and Probability, College of Natural Sciences, Michigan State University, East Lansing, MI.
authors.forename: Pramod K
authors.initials: PK
authors.lastname: Pathak
authors.affiliation: MSU Center for Orthopedic Research, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.|Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.
authors.forename: Kiilani H
authors.initials: KH
authors.lastname: Kaaikala
authors.affiliation: MSU Center for Orthopedic Research, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.|Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.
authors.forename: N Peter
authors.initials: NP
authors.lastname: Reeves
authors.affiliation: Department for Spinal Surgery, Schön Klinik, Hamburg, Germany.|Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Ralph
authors.initials: R
authors.lastname: Kothe
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects / Q000639:trends; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000639:trends; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D008875:Middle Aged; D010298:Parity / Q000502:physiology; D011247:Pregnancy; D015995:Prevalence; D013168:Spondylolisthesis / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D011795:Surveys and Questionnaires