Is radiographic lumbar spondylolisthesis associated with occupational exposures? Findings from a nested case control study within the Wakayama spine study

Reference Data for Diagnosis of Spondylolisthesis and Disc Space Narrowing Based on NHANES-II X-rays

Robust reference data, representing a large and diverse population, are needed to objectively classify measurements of spondylolisthesis and disc space narrowing as normal or abnormal. The reference data should be open access to drive standardization across technology developers. The large collection of radiographs from the 2nd National Health and Nutrition Examination Survey was used to establish reference data. A pipeline of neural networks and coded logic was used to place landmarks on the corners of all vertebrae, and these landmarks were used to calculate multiple disc space metrics. Descriptive statistics for nine SPO and disc metrics were tabulated and used to identify normal discs, and data for only the normal discs were used to arrive at reference data. A spondylolisthesis index was developed that accounts for important variables. These reference data facilitate simplified and standardized reporting of multiple intervertebral disc metrics.

Factors Predisposing to The Formation of Degenerative Spondylolisthesis-A Narrative Review

The relationship between various factors predisposing to the formation of spondylolisthesis, including degenerative spondylolisthesis, has been analyzed by many authors. However, not all observations are consistent. In this review, we identified factors whose impact on the prevalence of spondylolisthesis was most often mentioned in the literature. These included gender, age, bone mineral density, ethnic origin, and oophorectomy. The results were inclusive in terms of physical activity, pregnancy status, and use of hormone replacement therapy. Associations between diabetes and smoking were very poorly marked. The literature so far has identified a number of factors significantly affecting the incidence of degenerative spondylolisthesis. These include age, gender, body weight, ethnic origin, bone mineral density, and hormonal balance. Radiological parameters, which include iliac crest, pelvic tilt, pelvic incidence, sacral slope, and lumbar lordosis, may also be of great importance for assessing changes in the occurrence and progression. However, the authors do not agree on the real significance of individual factors. The aim of this review was to identify the factors predisposing to the formation of degenerative spondylolisthesis, the importance of which has been suggested in the current literature. The systematization of knowledge in this field can allow a more accurate adjustment of the treatment plan for each patient affected by this condition.

The association between whole body vibration exposure and spine degeneration on imaging: A systematic review

BACKGROUND

Low frequency vibrations from motorized vehicles and heavy equipment have been associated with musculoskeletal disorders. Spine degeneration on diagnostic imaging provides direct and objective measures of the possible effects of such exposures on the spine.

OBJECTIVE

The objective of this systematic review was to evaluate the association of exposure to whole-body vibration (WBV) with spine degeneration on imaging.

METHODS

We conducted electronic searches in MEDLINE, CINAHL, EMBASE, and Web of Science to July 2021. Two reviewers independently screened search results, assessed quality, and extracted data. Studies evaluating the exposure to WBV and lumbar spine degeneration on imaging were included.

RESULTS

Fifteen studies (16 manuscripts) were included. Seven studies including a meta-demonstrated moderate quality evidence of no association between WBV and disc degeneration. There was also moderate quality evidence of no association between WBV and disc height narrowing and osteophytes. Overall, there was low level evidence of no association between WBV and other degenerations findings.

CONCLUSIONS

There was moderate to low quality evidence suggesting no association between WBV exposures with spine degeneration on imaging. The results of this study currently do not support assertion that motorized vehicle and WBV exposure accelerates degeneration and causes structural damage to the spine.

Characteristics of lumbar disc degeneration and risk factors for collapsed lumbar disc in Korean farmers and fishers

Background

Few studies have investigated the risk factors for lumbar intervertebral disc degeneration among hard physical workers involved in heavy lifting. In this study, we aimed to identify the characteristics of lumbar intervertebral disc degeneration and evaluate the relationship between collapsed lumbar disc and potential risk factors in farmers and fishers.

Methods

This study included 203 farmers (103 men and 100 women) and 166 fishers (95 men and 71 women) aged 40–69 years who had undergone lumbar magnetic resonance imaging and were enrolled in the Korea Farmer's Knee Cohort and the Jeonnam Fishers' Cohort. We evaluated each of the 5 lumbar discs using the Pfirrmann grading system and classified collapsed lumbar intervertebral disc (cLD) as a case with ≥ 1 grade 5 at any disc level. We investigated potential risk factors, such as gender, age, body mass index (BMI), working hours per day, working months per year, and cumulative heavy lifting working time (CLWT). The odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated.

Results

The prevalence of cLD was 19.8% (23.7% among fishers, 21.2% among fishers with farming, and 17.2% among farmers). cLD correlated with factors such as age and occupation. Gender, CLWT and the working time matrix were not significantly associated with cLD. The OR of cLD adjusted by gender, age, BMI, and working time matrix was 1.26 (95% CI: 0.69–2.30) for ≥ 5,000 hours CLWT compared to that for < 2,000 hours CLWT. The OR of cLD adjusted by gender, age, BMI, CLWT, and working time matrix was 2.08 (95% CI: 1.06–4.06) for fishers compared to that for farmers.

Conclusions

Heavy lifting did not show a significant association with cLD in farmers and fishers. However, there is possibility that fishers are at a higher risk of lumbar disc collapse than farmers.

Prevalence of Lumbar Spondylolisthesis in Middle-Aged People in Beijing Community

OBJECTIVE

Lumbar spondylolisthesis (LS) is a common lumbar disease, and the prevalence of LS in different countries or regions was not consistent in the past. This study intends to make statistics on the prevalence of lumbar spondylolisthesis in middle-aged people in Beijing community.

METHODS

This is an epidemiological study. 4548 people in Beijing community aged 50 to 64 years were recruited from the local communities by advertisements placed in housing estates and community centres for people to take part in a prospective cohort study from August from September 2013 to March 2014. There is no intervention on the subjects. RadiAnt DICOM Viewer is adopted to read the lateral CT positioning images of all the studied objects, adjust the image as bone window, observe and evaluate the slide of L1 to L5 vertebra in the lateral CT positioning image.

RESULTS

Among the 4,548 subjects included in the study, 2,490 (54.75%) were male and 2,058 (45.25%) were female. A total of 785 subjects had lumbar spondylolisthesis, with a total incidence of 17.26%. There was no significant difference between prevalence of males and females in the subgroup 50-54 years old (13.55% males / 12.53% females) and 55-59 years old (14.77% males / 14.93% females). But the prevalence of LS in 60-64 years old females (28.57%) increased significantly, compared with 55-59 years old females (14.93%) and 60-64 years old males (18.76%). There were 847 levels that had slipped, L5S1 > L4/5 > L3/4 > L2/3 > L1/2. The retrolisthesis was the most, accounting for 61.51% (521/847), and the anterolisthesis was 38.49% (326/847), including anterolisthesis gradeI for 95.71% (312/326), anterolisthesis gradeII for 4.29% (14/326). Neither of anterolisthesis and retrolisthesis presented more than grade III. Among all the subjects, 318 had anterolisthesis, with a total incidence of 6.99%, and 467 subjects only had retrolisthesis.

CONCLUSION

The total prevalence of LS in the middle-aged people in Beijing community was 17.26%, 15.98% in males and 18.80% in females, and women are more likely to suffer from LS after 60 years old.

Degenerative Spondylolisthesis: A Narrative Review

Degenerative spondylolisthesis (DS) is a condition leading to the slippage of one vertebral body over the one below due to degenerative changes resulting in spinal stenosis and producing neurogenic claudication, with or without low back pain. DS prevalence is age and gender specific. Other risk factors mainly include a history of occupational driving, intense manual activity and sedentary work. Diagnosis for patients with DS include detailed history, physical examination and imaging through standing lateral radiographs and MRI. Most patients with symptomatic DS and absence of neurologic deficits should perform better with conservative treatment, whereas, patients with neurological symptoms, are more prone to undergo progressive functional deterioration without surgery. There is a lack of agreement on the best surgical management in patients with DS and symptomatic stenosis. There is a contradictory data that does not permit for a recommendation for or against the addition of fusion to decompression. There is also controversy on which fusion technique is best. Spinal minimally invasive surgery is a promising approach for DS promoting early recovery and enhanced quality of life by reducing skin incision, muscular damage and perioperative pain with significant improvements in clinical results and high satisfaction rates.

Occupational influences on Spondylolysis and Spondylolisthesis in a cohort of 18-year-old male military conscripts

Background

The reported prevalence of spondylolysis (SL) in the adult population is 6–7%. Data concerning adolescent-onset spondylolisthesis (SLS) and the impact of certain activities on it is scarce. We examined the risk of clinical progression of SL and SLS as a function of primary severity and occupational strain among military recruits.

Methods

Based on the Israel defense Force (IDF) central human resources database, we identified 1521 18-year-old males inducted to the IDF with SL/SLS between the late nineteen nineties and early two-thousands. We followed changes in the SL/SLS status during the 3 years of obligatory military service. Disease severity was classified as Cat2: radiological findings of SL without clinical findings; Cat3: painful SL or asymptomatic grade 1 SLS; Cat4: grade 1 SLS with pain; Cat5: Grade 2 SLS. The soldiers were subdivided into the following occupational categories: administrative, combat, maintenance, and driving. The purpose was to compare the progression rates in different medical categories and job assignments.

Results

There were 162 recruits in Cat2, 961 in Cat3, and 398 recruits in Cat4. The overall progression rate to Cat5 (grade 2 SLS) was 1.02%. Significant progression rates were seen amongst administrative soldiers with a relatively higher risk of progression from Cat4 (painful-grade-1 SLS: 2.2%) vs. Cat3 (asymptomatic SLS: 0.5%, relative risk = 4.7, p < 0.02). Other occupational categories did not exhibit significant progression rates.

Conclusion

Progression of SL/SLS was highest in Cat4, i.e. for recruits already diagnosed with painful SLS (i.e. with a more severe baseline disorder). Progression did not correlate with military occupation. We recommend further follow-up studies that include, aside from progression rates, incidence rates of newly diagnosed grade 2 SL during military service.