Lumbar olisthesis and lower back symptoms in elderly white women. The Study of Osteoporotic Fractures.

Study Design. A Cross-sectional study, Objectives. To determine the prevalence of lumbar olisthesis among white women aged 65 years and older and its relation to low back pain and back function. Background. Degenerative changes in the lumbar spine of elderly individuais may affect spinal stability, causing olisthesis (subluxation) of the lumbar spine. Neither the prevalence of this condition in the United States nor its relation to back symptoms has been studied previously. Methods Lateral radiographs of the lumbar spine for 788 women aged 66 years and older who were enrolled in the Study oi Osteoporotic Fractures were digitized. Olisthesis lantero- and retro-) was assessed at L3-L4, L4-L5, and L5-S1. Back pain and function also were assessed. Results. When olisthesis was defined as subluxation of 3 mm or more at any of the three levels studied, the overall prevalence of anterolisthesis was 29% and that of retroiisthesis was 14%, in 90% of women with anterolisthesis and 88% of women with retrolisthesis, subluxation occurred at a singie vertebral level. The prevalence of anterolisthesis and retroiisthesis did not vary by smoking status, presence of diabetes, or history of oophorectomy. Anterolisthesis was not associated with the presence of back symptoms. Only retrolisthesis at L3-L4 was associated with a statistically significantly increased likelihood of lower pack pain, greater severity of back pain, and impairment of back function. Conclusions. Anterollsthesis of 3 mm or more in the lower lumbar spine is relatively common among elderly women but is not correlated with back problems, Retrolisthesis at L3-L4 is associated with increased back pain and impaired back function.