• Jacek Cholewicki, Angela S Lee, John M Popovich, Lawrence W Mysliwiec, Michael D Winkelpleck, John N Flood, Pramod K Pathak, Kiilani H Kaaikala, ReevesN PeterNPMSU 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., and Ralph Kothe.
• MSU Center for Orthopedic Research, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.
• Spine. 2017 Nov 1; 42 (21): 1643-1647.

Study DesignA case-control study.ObjectiveTo determine whether parity and abdominal surgeries are associated with degenerative spondylolisthesis (DS).Summary Of Background DataDS 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.MethodsA 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.ResultsAlong 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.ConclusionEach 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.Level Of Evidence4.

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