Quality of life in osteoporotic patients with low-grade degenerative spondylolisthesis
1Department of Physical and Rehabilitation Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
2Department of Physical and Rehabilitation Medicine, Sama Medical Center, 200349 Craiova, Romania
3Department of Family Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
4Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
5Department of Hematology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
Submitted: 10 August 2021 Accepted: 24 September 2021
Online publish date: 22 March 2022
Degenerative spondylolisthesis (DS) and osteoporosis (Op) are two complex diseases affecting the spine in the general population over the age of 50 years and can cause an accumulating clinical-dysfunctional impact that ultimately impacts on quality of life. The aim of the present study is to investigate whether our rehabilitation program relieves pain and restores physical function and quality of life in 52 females with postmenopausal Op and DS with a degree of slip ranging from 5%–25%, Meyerding grade Ⅰ, during a six-month period. All patients were randomized (Study group—25 patients, Control group—27 patients) and completely assessed. Functional parameters were measured at admission to inpatient rehabilitation (T1), after 4 weeks (T2), and 6 months (T3) following the commencement of rehabilitation. We used student’s t-test to compare the study and control groups for each variable measured and each time, and ANOVA (Analysis of variance) to compare the three sets of result obtained for each measured variable over time. The values for VAS (Visual Analogue Scale), SRM (Roland-Morris Disability Questionnaire) and SF-MOS (Medical Outcomes Study Questionnaire Short Form 36 Health Survey) improved in a highly significant manner over the duration of the study, both for the study and control groups. The results confirmed the complexity in the level of functionality and the results had no statistical significance in the T2 and T3 assessment. The effectiveness of the rehabilitation program for the study group was supported by the development of the differences between VAS and SRM. We found that non-surgical care and rehabilitation program is one of the optimal choices for osteoporotic patients with minimal DS, especially after 60 years of age.
Degenerative spondylolisthesis; Postmenopausal osteoporosis; Rehabilitation program
Magdalena Rodica Traistaru,Diana Kamal,Constantin Kamal,Dragos Ovidiu Alexandru,Simona-Daniela Neamtu,Ana Maria Bumbea. Quality of life in osteoporotic patients with low-grade degenerative spondylolisthesis. Signa Vitae. 2022.doi:10.22514/sv.2022.022.
 Lawhorne 3rd TW, Girardi FP, Mina CA, Pappou I, Cammisa FP Jr. Treatment of degenerative spondylolisthesis: potential impact of dynamic stabilization based on imaging analysis. European Spine Journal. 2009; 18: 815–822.
 Denard PJ, Holton KF, Miller J, Fink HA, Kado DM, Marshall LM, et al. Back pain, neurogenic symptoms, and physical function in relation to spondylolisthesis among elderly men. The Spine Journal. 2010; 10: 865–873.
 Denard PJ, Holton KF, Miller J, Fink HA, Kado DM, Yoo JU, et al. Lumbar spondylolisthesis among elderly men: prevalence, correlates, and progression. Spine. 2010; 35: 1072–1078.
 Ferrari S, Vanti C, O’Reilly C. Clinical presentation and physiotherapy treatment of 4 patients with low back pain and isthmic spondylolisthesis. Journal of Chiropractic Medicine. 2012; 11: 94–103.
 Brooks BK, Southam SL, Mlady GW, Logan J, Rosett M. Lumbar spine spondylolysis in the adult population: using computed tomography to evaluate the possibility of adult onset lumbar spondylosis as a cause of back pain. Skeletal Radiology. 2010; 39: 669–673.
 Kalichman L, Kim DH, Li L, Guermazi A, Berkin V, Hunter DJ. Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine. 2009; 34: 199–205.
 Jacobsen S, Sonne-Holm S, Rovsing H, Monrad H, Gebuhr P. Degen-erative lumbar spondylolisthesis: an epidemiological perspective: the copenhagen osteoarthritis study. Spine. 2007; 32: 120–125.
 Wang YXJ, Káplár Z, Deng M, Leung JCS. Lumbar degenerative spondylolisthesis epidemiology: a systematic review with a focus on gender-specific and age-specific prevalence. Journal of Orthopaedic Translation. 2016; 11: 39-52.
 Cabraja M, Mohamed E, Koeppen D, Kroppenstedt S. The analysis of segmental mobility with different lumbar radiographs in symptomatic patients with a spondylolisthesis. European Spine Journal. 2012; 21: 256–261.
 Hu SS, Tribus CB, Diab M, Ghanayem AJ. Spondylolisthesis and spondylolysis. Instructional Course Lectures. 2008; 57: 431–445.
 Beutler WJ, Fredrickson BE, Murtland A, Sweeney CA, Grant WD, Baker D. The natural history of spondylolysis and spondylolisthesis: 45-year follow-up evaluation. Spine. 2003; 28: 1027–1035.
 Sakai T, Sairyo K, Takao S, Nishitani H, Yasui N. Incidence of lumbar spondylolysis in the general population in Japan based on multidetector computed tomography scans from two thousand subjects. Spine. 2009; 34: 2346–2350.
 Wang P, Wang F, Gao YL, Li JQ, Zhang JT, Miao DC, et al. Lumbar spondylolisthesis is a risk factor for osteoporotic vertebral fractures: a case–control study. Journal of International Medical Research. 2018; 46: 3605–3612.
 Fechtenbaum J, Etcheto A, Kolta S, Feydy A, Roux C, Briot K. Sagittal balance of the spine in patients with osteoporotic vertebral fractures. Osteoporosis International. 2016; 27: 559–567.
 Ionovici N, Negru M, Grecu D, Vasilescu M, Mogoantă L, Bold A, et al. Hypothesis of microfractures by buckling theory of bone’s trabeculas from vertebral bodies affected by osteoporosis. Romanian Journal of Morphology and Embryology. 2009; 50: 79–84.
 Kamal KC, Alexandru DO, Rogoveanu OC, Pănuş C, Kamal D, Maria DT, et al. Immunohistochemical analysis of bone metabolism in osteonecrosis of the femoral head. Romanian Journal of Morphology and Embryology. 2018; 59: 819–824.
 Sinaki M. Musculoskeletal rehabilitation in patients with osteoporosis—Rehabilitation of Osteoporosis Program-Exercise (ROPE). Journal of Mineral Metabolism & Musculoskeletal Disorders. 2010; 17: 60–65.
 Garet M, Reiman MP, Mathers J, Sylvain J. Nonoperative treatment in lumbar spondylolysis and spondylolisthesis. Sports Health. 2013; 5: 225–232.
 Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. Spirit 2013 statement: defining standard protocol items for clinical trials. Annals of Internal Medicine. 2013; 158: 200–207.
 Wiltse LL, Newman PH, Macnab I. Classification of spondylolisis and spondylolisthesis. Clinical Orthopaedics and Related Research. 1976; 117: 23–29.
 Stratford PW, Binkley J, Solomon P, Finch E, Gill C, Moreland J. Defining the minimum level of detectable change for the Roland-Morris questionnaire. Physical Therapy. 1996; 76: 359–365.
 McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care. 1993; 31: 247–263.
 Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis International. 2013; 24: 23–57.
 United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Ageing 2019: Highlights (ST/ESA/SER.A/430). World population ageing 2019 highlights 2019. Available at: https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf (Accessed: 18 March 2020).
 Dai F, Liu Y, Zhang F, Sun D, Luo F, Zhang Z, et al. Surgical treatment of the osteoporotic spine with bone cement-injectable cannulated pedicle screw fixation: technical description and preliminary application in 43 patients. Clinics. 2015; 70: 114–119.
 Tomé-Bermejo F, Piñera AR, Alvarez-Galovich L. Osteoporosis and the management of spinal degenerative disease (I). Archives of Bone and Joint Surgery. 2017; 5: 272–282.
 Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G. A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthritis and Cartilage. 2005; 13: 769–781.
 Wang YX, Griffith JF, Zeng XJ, Deng M, Kwok AW, Leung JC, et al. Prevalence and sex difference of lumbar disc space narrowing in elderly Chinese men and women: osteoporotic fractures in men (Hong Kong) and osteoporotic fractures in women (Hong Kong) studies. Arthritis & Rheumatism. 2013; 65: 1004–1010.
 Andersen T, Christensen FB, Langdahl BL, Ernst C, Fruensgaard S, Østergaard J, et al. Degenerative spondylolisthesis is associated with low spinal bone density: a comparative study between spinal stenosis and degenerative spondylolisthesis. BioMed Research International. 2013; 2013: 123847.
 Cakir B, Ulmar B, Koepp H, Huch K, Puhl W, Richter M. Posterior dynamic stabilization as an alternative for dorso-ventral fusion in spinal stenosis with degenerative instability. Journal of Orthopedics and Trauma Surgery. 2003; 141: 418–424. (In German)
 Huang MH, Barrett-Connor E, Greendale GA, Kado DM. Hyperkyphotic posture and risk of future osteoporotic fractures: the rancho bernardo study. Journal of Bone and Mineral Research. 2006; 21: 419–423.
 Kado DM, Huang MH, Barrett-Connor E, Greendale GA. Kyphotic posture and poor physical functional ability in older community dwelling men and women: the rancho bernardo study. The Journals of Gerontology Series A. 2005; 60: 633–637.
 Keller TS, Harrison DE, Colloca CJ, Harrison DD, Janik TJ. Prediction of osteoporotic spinal deformity. Spine. 2003; 28: 455–462.
 Vibert BT, Sliva CD, Herkowitz HN. Treatment of instability and spondylolisthesis. Clinical Orthopaedics & Related Research. 2006; 443: 222–227.
 O’Sullivan PB. Lumbar segmental instability: clinical presentation and specific stabilizing exercise management. Manual Therapy. 2000; 5: 2–12.
 Hicks GE, Gaines JM, Shardell M, Simonsick EM. Associations of back and leg pain with health status and functional capacity of older adults: findings from the retirement community back pain study. Arthritis & Rheumatism. 2008; 59: 1306–1313.
 Koreckij TD, Fischgrund JS. Degenerative spondylolisthesis. Journal of Spinal Disorders & Techniques. 2015; 28: 236–241.
 Ewais IG, Abo-Elkhir MM, Elshafei MA. Evaluation of surgical management of spondylolithesis in osteoporotic patients. Al-Azhar International Medical Journal. 2020; 1: 132–136.
 Nava-Bringas TI, Ramírez-Mora I, Coronado-Zarco R, Macías-Hernández SI, Cruz-Medina E, Arellano-Hernández A, et al. Association of strength, muscle balance, and atrophy with pain and function in patients with degenerative spondylolisthesis. Journal of Back and Musculoskeletal Rehabilitation. 2014; 27: 371–376.
 Epstein NE, Hollingsworth RD. Nursing review of diagnosis and treatment of lumbar degenerative spondylolisthesis. Surgical Neurology International. 2017; 8: 246.
 Camacho PM, Petak SM, Binkley N, Clarke BL, Harris ST, Hurley DL, et al. American association of clinical endocrinologists and American college of endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis—2016. Endocrine Practice. 2016; 22: 1–42.
 Link TM. Osteoporosis imaging: state of the art and advanced imaging. Radiology. 2012; 263: 3–17.
 He LC, Wang YX, Gong JS, Griffith JF, Zeng XJ, Kwok AW, et al. Prevalence and risk factors of lumbar spondylolisthesis in elderly Chinese men and women. European Radiology. 2014; 24: 441–448.
 Livshits G, Ermakov S, Popham M, MacGregor AJ, Sambrook PN, Spector TD, et al. Evidence that bone mineral density plays a role in degenerative disc disease: the UK twin spine study. Annals of the Rheumatic Diseases. 2010; 69: 2102–2106.
 Gezer NS, Balcı A, Kalemci O, Köremezli N, Başara Akın I, Ur K. Vertebral body bone mineral density in patients with lumbar spondylolysis: a quantitative CT study. Diagnostic and Interventional Radiology. 2017; 23: 385–389.
 Perikal PJ, Srikantha U, Joshi KC, J AJ, Khanapure K, Varma RG, et al. Minimally invasive augmented fixation for anatomical reduction of grade 2 and grade 3 listhesis in patients with osteoporosis. Asian Spine Journal. 2018; 12: 887–892.
 O’Sullivan PB, Phyty GD, Twomey LT, Allison GT. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997; 22: 2959–2967.
 Louw A, Diener I, Landers MR, Puentedura EJ. Preoperative pain neuroscience education for lumbar radiculopathy. Spine. 2014; 39: 1449–1457.
 Boyd ED, Mundluru SN, Feldman DS. Outcome of conservative management in the treatment of symptomatic spondylolysis and grade I spondylolisthesis. Bulletin of the NYU Hospital for Joint Diseases. 2019; 77: 172–182.
 Devine JG, Schenk-Kisser JM, Skelly AC. Risk factors for degenerative spondylolisthesis: a systematic review. Evidence-Based Spine-Care Journal. 2012; 3: 25–34.
 Dixit R. Low Back Pain. In Drs. Gary S. Firestein, Ralph C. Budd, Sherine E. Gabriel, Iain B. McInnes, James R. O’Dell (eds.) Kelley and Firestein’S Textbook of Rheumatology (pp. 696–716). 10th edn. Elsevier: Philadelphia. 2017.
 Fedorchuk C, Lightstone DF, McRae C, Kaczor D. Correction of grade 2 spondylolisthesis following a non-surgical structural spinal rehabilitation protocol using lumbar traction: a case study and selective review of literature. Journal of Radiology Case Reports. 2017; 11: 13–26.
 Bonetti F, Curti S, Mattioli S, Mugnai R, Vanti C, Violante FS, et al. Effectiveness of a ‘global postural reeducation’ program for persistent low back pain: a non-randomized controlled trial. BMC Musculoskeletal Disorders. 2010; 11: 285.
 Cyriac M, Kyhos J, Iweala U, Lee D, Mantell M, Yu W, et al. Anterior lumbar interbody fusion with cement augmentation without posterior fixation to treat isthmic spondylolisthesis in an osteopenic patient—a surgical technique. International Journal of Spine Surgery. 2018; 12: 322–327.
 Zhang S, Ye C, Lai Q, Yu X, Liu X, Nie T, et al. Double-level lumbar spondylolysis and spondylolisthesis: a retrospective study. Journal of Orthopaedic Surgery and Research. 2018; 13: 55.
 Matz PG, Meagher RJ, Lamer T, Tontz WL Jr, Annaswamy TM, Cassidy RC, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. The Spine Journal. 2016; 16: 439–448.
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