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Park, Hwang, Kim, Oh, Chang, Kim, Park, Lim, and Riew: Concurrent Degenerative Cervical and Lumbar Spondylolisthesis
Original Article

Journal of Korean Spine Surg 2018;25(4):154-159.

Published online: 31 December 2018

DOI: https://doi.org/10.4184/jkss.2018.25.4.154

Concurrent Degenerative Cervical and Lumbar Spondylolisthesis

Moon Soo Park, M.D., Ji-Hyo Hwang, M.D., Tae-Hwan Kim, M.D.∗, Jae Keun Oh, M.D., Ho Guen Chang, M.D.†, Hyung Joon Kim, M.D., Kun-Tae Park, M.D., Jin Kyu Lim, M.D.‡, K. Daniel Riew, M.D.§

Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea

∗Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea

†Department of Neurosurgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea

‡Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Medical College of Hallym University, Seoul, Republic of Korea

§Department of Orthopedic Surgery, Columbia University Medical Center / NY-Presbyterian Hospital, The Spine Hospital at NY-Presbyterian/Allen Hospital, New York, NY, USA

Corresponding author: Moon Soo Park, M.D. ORCID ID: Moon Soo Park: https://orcid.org/0000-0003-2833-9148 Department of Orthopaedic Surgery Hallym University Sacred Heart Hospital Medical College of Hallym University 22 Gwanpyeong-ro 170 beon-gi, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, Republic of Korea TEL: +82-31-380-6000, FAX: +82-31-380-6008 E-mail: amhangpark@gmail.com

Received 14 October 201819 October 2018       Accepted 19 November 2018

Copyright © 2018 Korean Society of Spine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Retrospective radiographic study.

Objective

To evaluate the characteristics of concurrent degenerative cervical and lumbar spondylolisthesis.

Summary of Literature Review

Concurrent degenerative cervical and lumbar spondylotic diseases have been reported. Given that severe spondylosis can result in spondylolisthesis, one might expect that concurrent spondylolisthesis of the cervical and lumbar spines might also be prevalent. However, the incidence of spondylolistheses in the lumbar and cervical spines might differ due to anatomical differences between the 2 areas. Nonetheless, there is minimal information in the literature concerning the incidence of concurrent cervical and lumbar spondylolisthesis.

Material and Methods

We evaluated standing cervical and lumbar lateral radiographs of 2510 patients with spondylosis. Concurrence, age group, gender, and direction of spondylolisthesis were evaluated. Lumbar spondylolisthesis was defined as at least Meyerding grade I and degenerative cervical spondylolisthesis was defined as over 2 mm of displacement on standing lateral radiographs.

Results

Lumbar spondylolisthesis was found in 125 patients (5.0%) and cervical spondylolisthesis was found in 193 patients (7.7%). Seventeen patients had both degenerative cervical and lumbar spondylolistheses (0.7%). Lumbar spondylolisthesis is a risk factor for co-existing cervical spondylolisthesis. Lumbar spondylolisthesis was more common in females than males, independent of advancing age. In contrast, degenerative cervical spondylolisthesis was more common in older patients, independent of gender. Anterolisthesis was more common in the lumbar spine. Retrolisthesis was more common in the cervical spine.

Conclusions

There was a higher prevalence of degenerative cervical spondylolisthesis in patients with degenerative lumbar spondylolisthesis.

Keywords: Cervical vertebrae, Lumbar vertebrae, Concurrent degenerative spondylolisthesis

REFERENCES

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Fig. 1.
Meyerding grading method showing grade II spondylolisthesis of L4.
jkss-25-154f1.tif
Table 1.
Concurrent degenerative lumbar and cervical spondylolisthesis
  Cervical spondylolisthesis No cervical spondylolisthesis Total
Lumbar spondylolisthesis 17(0.7%) 108(4.3%) 125(5.0%)
No lumbar spondylolisthesis 176(7.0%) 2,209(88.0%) 2,385(95.0%)
Total 193(7.7%) 2,317(92.3%) 2,510(100%)
Table 2.
Degenerative spondylolisthesis according to gender
  Lumbar spondylolisthesis Cervical spondylolisthesis Subgroup population
Female 90(6.5%) 108(7.8%) 1,393(100.0%)
Male 35(3.1%) 85(7.6%) 1,117(100.0%)
Total 125(5.0%) 193(7.7%) 2,510(100.0%)
Table 3.
Degenerative spondylolisthesis according to age
  Lumbar spondylolisthesis Cervical spondylolisthesis Subgroup population
50s 45(3.9%) 57(4.9%) 1,156(100.0%)
60s 42(6.2%) 37(5.5%) 674(100.0%)
70s 25(4.9%) 64(12.5%) 510(100.0%)
80s 12(7.7%) 30(19.4%) 155(100.0%)
90s 1(6.7%) 5(33.3%) 15(100.0%)
Total 125(5.0%) 193(7.7%) 2,510(100.0%)
Table 4.
The direction of degenerative spondylolisthesis according to cervical and lumbar spine
  No cervical spondylolisthesis Cervical anterolisthesis Cervical retrolisthesi s Total
No lumbar spondylolisthesis 2,209(88.0%) 37(1.5%) 139(5.5%) 2,385(95.0%)
Lumbar anterolisthesis 79(3.1%) 5(0.2%) 1(0.0%) 85(3.4%)
Lumbar retrolisthesis 29(1.2%) 6(0.2%) 5(0.2%) 40(1.6%)
Total 2,317(92.3%) 48(1.9%) 145(5.8%) 2,510(100%)
Table 5.
Degenerative spondylolisthesis according to disc levels
  Lumbar spondylolisthesis Cervical spondylolisthesis
L1/2 3(2.2%)  
L2/3 22(15.8%)  
L3/4 32(23.0%)  
L4/5 70(50.4%)  
L5/S1 12(8.6%)  
C2/3   21(8.7%)
C3/4   81(33.5%)
C4/5   87(36.0%)
C5/6   48(19.8%)
C6/7   4(1.7%)
C7/T1   1(0.4%)
Total 139(100.0%) 242(100.0%)

When there is spondylolisthesis in the multiple disc levels, the disc level with most slippage was chosen for spondylolisthesis.

Table 6.
The correlation of the presence of degenerative spondylolisthe-sis between the disc levels of C3/4, C4/5, and L3/4, L4/5.
  C3/4 C4/5
L3/4 0.903 0.233
L4/5 0.836 0.509
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