Introduction to Spondylolisthesis

Incidence of Spondylolisthesis

Spondylolysis is present in approximately 4-6% of asymptomatic school children. It is rarely seen before the age of 4 and the incidence goes up with age. It is estimated that 5-10% of people who come to a physician for lower back pain have either spondylolysis or spondylolisthesis. By the age of 18, the incidence of spondylolysis is approximately 7% with prevalence appearing in individuals who practice sports that require repetitive hyperextension or flexion and extension the spine. Spondylolysis is twice as common in male children as female children but females are more likely to exhibit progressive slippage of the vertebra. It is estimated that up to 50% of cases of spondylolysis progress and develop into spondylolisthesis.

Approximately 4% of adults have isthmic spondylolisthesis. Approximately 87% of cases occur at the level of L5-S1 while close to 10% occur at L4-L5 and up to 3% occur at the level of L3-L4.

The incidence of degenerative spondylolisthesis increases with age. The slip associated with degenerative spondylolisthesis occurs most commonly at the level of L4-L5 and is found more frequently in females (9.1%) than males (5.8%). African-American women are affected 3 times more commonly than Caucasian women. Degenerative spondylolisthesis is the most common form of spondylolisthesis in adults.