Skip to main content

Advertisement

Log in

Degenerative spondylolisthesis: a prospective cross-sectional cohort study on the role of weakened anterior abdominal musculature on causation

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

Degenerative spondylolisthesis (DS) is a degenerative condition of the spine which, unlike others, is more common in a female population. Previous studies have highlighted possible causative factors such as facet tropism and pregnancy as reasons for this. This study sets out to assess the possible link between abdominal musculature and DS.

Method

A prospective cross-sectional cohort study in a single surgeon practice assessed all patients aged over 50 years attending for degenerative lumbar spinal complaints. Patient demographics, as well as the number of pregnancies, children, abdominal surgical procedures, were recorded.

Results

We found 205 patients that met our inclusion criteria (98 Males/107 Females). Women with multiple pregnancies (p = 0.036) and abdominal surgeries (p = 0.021) were more likely to develop DS. Males with ventral hernias were more likely to have developed DS (p = 0.004).

Conclusion

This study highlights the important role that the abdominal musculature plays in stabilization of the spine and highlights its potential role as a factor in the development of DS.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Sanderson PL, Fraser RD (1996) The influence of pregnancy on the development of degenerative spondylolisthesis. J Bone Jt Surg Br 78(6):951–954

    Article  CAS  Google Scholar 

  2. Imada K, Matsui H, Tsuji H (1995) Oophorectomy predisposes to degenerative spondylolisthesis. J Bone Jt Surg Br 77(1):126–130

    Article  CAS  Google Scholar 

  3. Cholewicki J, Lee A, Popovich LW et al (2017) Degenerative spondylolisthesis is related to multiparity and hysterectomy in older women. Spine 42(21):1643–1647

    Article  Google Scholar 

  4. Grobler LJ, Robertson PA, Novotny JE, Pope MH (1993) Etiology of spondylolisthesis. Assessment of the role played by lumbar facet joint morphology. Spine 18(1):80–91

    Article  CAS  Google Scholar 

  5. Ferreo E, Ould-Slimane M, Gille O et al (2015) Sagittal spinopelvic alignment in 654 degenerative spondylolisthesis. Eur Spine J 24:1219–1227

    Article  Google Scholar 

  6. Berlemann U, Jeszenszky DJ, Buhler DW, Harms J (1999) The role of lumbar lordosis, vertebral end-plate inclination, disc height, facet orientation in degenerative spondylolisthesis. J Spinal Disord 12(1):68–73

    Article  CAS  Google Scholar 

  7. Tomoaki T, Tomoyuki O, Koya K et al (2009) Facet joint orientation difference between cephalad and caudad portions: a possible cause of degenerative spondylolisthesis. Spine 34(21):2259–2262

    Article  Google Scholar 

  8. Enyo Y, Yoshimura N, Yamada H et al (2015) Radiographic natural course of lumbar degenerative spondylolisthesis and its risk factors related to the progression and onset in a 15-year community-based cohort study: the Miyama study. J Orthop Sci 20(6):978–984

    Article  Google Scholar 

  9. Smorgick Y, Mirovsky Y, Rischgrund JS et al (2014) Radiographic predisposing factors for degenerative spondylolisthesis. Orthopaedics 37(3):e260-4

    Article  Google Scholar 

  10. Love TW, Fagan AB, Fraser RD (1999) Degenerative spondylolisthesis. Developmental or acquired? J Bone Jt Surg Br 81-B:670–674

    Article  Google Scholar 

  11. Farfan HF, Cossette JW, Robertson GH, Wells RV, Kraus H (1970) The effects of torsion on the lumbar intervertebral joints: the role of torsion in the production of disc degeneration. J Bone Jt Surg Am 52(3):468–497

    Article  CAS  Google Scholar 

  12. Macintosh JE, Pearcy MJ, Bogduk N (1993) The axial torque of the lumbar back muscles: torsion strength of the back muscles. Aust N Z J Surg 63(3):205–212

    Article  CAS  Google Scholar 

  13. Meyerding H (1932) Spondylolisthesis: surgical treatment and results. Surg Gynecol Obstet 54:371–377

    Google Scholar 

  14. Jacobsen S, Sonne-Holm S, Rovsing H (2007) Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis study. Spine 32(1):120–125

    Article  Google Scholar 

  15. Hodges PW, Richardson CA (1996) Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine 21:2640–2650

    Article  CAS  Google Scholar 

  16. Stokes IAF, Gardner-Morse MG, Henry SM (2011) Abdominal muscle activation increases lumbar spinal stability. Analysis of contributions of different muscle groups. Clin Biomech 26(8):797–803

    Article  Google Scholar 

  17. Brown SHM, McGill SM (2008) How the inherent stiffness of the in vivo human trunk varies with changing magnitudes of muscular activation? Clin Biomech 23(1):15–22

    Article  Google Scholar 

  18. Lee JH, Hoshino Y, Nakamura K et al (1999) Trunk muscle weakness as a risk factor for low back pain. Spine 24(1):54–57

    Article  CAS  Google Scholar 

  19. Beimborn DS, Morrisey MC (1988) A review of the literature related to trunk muscle performance. Spine 13(6):655–660

    Article  CAS  Google Scholar 

  20. de Vries Reilingh TS, van Goor H, Charbon JA et al (2007) Repair of giant midline abdominal wall hernias: “components separation technique” versus prosthetic repair interim analysis of a randomized controlled trial. World J Surg 31(4):756–763

    Article  Google Scholar 

  21. Farfan HF (1980) The pathological anatomy of degenerative spondylolisthesis: a cadaver study. Spine 5:412–418

    Article  CAS  Google Scholar 

  22. Kelsy JL, Githens PB, White AA 3rd et al (1984) An epidemiological study of lifting and twisting on the job and risk for acute prolapsed lumbar intervertebral disc. J Orthop Res 2:61–66

    Article  Google Scholar 

  23. Veres SP, Robertson PA, Broom ND (2010) The influence of torsion on disc herniation when combined with flexion. Eur Spine J 19(9):1468–1478

    Article  Google Scholar 

  24. Drake JD, Aultman CD, McGill SM et al (2005) The influence of static axial torque in combined loading on intervertebral joint failure mechanics using a porcine model. Clin Biomech 20:1038–1045

    Article  Google Scholar 

  25. Adams MA, Hutton WC (1981) The relevance of torsion to the mechanical derangement of the lumbar spine. Spine 6:241–248

    Article  CAS  Google Scholar 

  26. Vleeming A, Schuenke MD, Danneels L, Willard FH (2014) The functional coupling of the deep abdominal and paraspinal muscles: the effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia. J Anat 225:447–462

    Article  CAS  Google Scholar 

  27. Zhu R, Niu WX, Zeng ZL et al (2017) The Effects of Muscle weakness on degenerative spondylolisthesis: a finite element study. Clin Biomech 41:34–38

    Article  Google Scholar 

  28. Nagaosa Y, Kikuchi S, Hasue M, Sato S (1998) Pathoanatomic mechanisms of degenerative spondylolisthesis. A radiographic study. Spine 23(13):1447–1451

    Article  CAS  Google Scholar 

  29. Kim HJ, Chun HJ, Lee HM et al (2013) The biomechanical influence of the facet joint orientation and the facet tropism in the lumbar spine. Spine J 13(10):1301–1308

    Article  Google Scholar 

  30. Dar G, Peled N (2014) The association between sacralization and spondylolisthesis. Anat Sci Int 89(3):156–160

    Article  Google Scholar 

  31. Kong CG, Park JS, Park JB (2008) Sacralization of L5 in radiological studies of degenerative spondylolisthesis at L4–L5. Asian Spine J 2(1):34–37

    Article  Google Scholar 

  32. Lc He, Wang YX, Gong JS et al (2014) Prevalence and risk factors of lumbar spondylolisthesis in elderly Chinese men and women. Eur Radiol 24(2):441–448

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francis Brooks.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PPTX 298 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fraser, R.D., Brooks, F. & Dalzell, K. Degenerative spondylolisthesis: a prospective cross-sectional cohort study on the role of weakened anterior abdominal musculature on causation. Eur Spine J 28, 1406–1412 (2019). https://doi.org/10.1007/s00586-018-5758-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-018-5758-y

Keywords

Navigation