The prevalence of isthmic and degenerative lumbar spondylolisthesis: an analysis of 1376 patients.

Mina Botros; Amy Phan; Serena Liu; Andrew Liu; Sherif Sherif; Peter Joo; Varun Puvanesarajah; Mark Ehioghae; Jonathan P Japa; Kevin Yoon; Lancelot Benn; Addisu Mesfin

doi:10.1016/j.jocn.2026.112255

PubMed · 42623789

The prevalence of isthmic and degenerative lumbar spondylolisthesis: an analysis of 1376 patients.

Mina Botros·Amy Phan·Serena Liu·Andrew Liu·Sherif Sherif·Peter Joo·Varun Puvanesarajah·Mark Ehioghae·Jonathan P Japa·Kevin Yoon·Lancelot Benn·Addisu Mesfin

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Abstract

INTRODUCTION: Typically, spondylolisthesis is an asymptomatic spinal condition that is often captured accidently in radiographic studies. The limited studies reviewing incidence primarily used lateral radiographs, which lack the granularity of advanced imaging. In response, computed tomography (CT) has been recommended to enhance the accuracy of spondylolisthesis diagnosis (degenerative versus isthmic). In the present study, we sought to determine the prevalence of isthmic and degenerative spondylolisthesis using CT imaging. METHODS: We conducted a retrospective study of 1,680 patients who underwent abdominal/pelvic CT scans at a single level-1 trauma center from January 1, 2017, to January 31, 2017. RESULTS: A total of 1,680 CT scans were screened, of which 1,376 patient scans met the inclusion criteria of having undergone complete imaging (axial and sagittal images). The average age of the study population was 57.1 (standard deviation, 18.7) years; 51.1% were female, and 83.2% were Caucasian. The prevalence of isthmic spondylolisthesis was 5.4% (n = 71): 3.6% of cases were at the L5-S1 level, 2.1% were at the L4-L5 level, and 0.6% were at the L3-L4 level. The female-to-male ratio was 0.73:1. The prevalence of degenerative spondylolisthesis was higher at 21.5% (n = 285), and the level most commonly affected was L4-L5 (11.8%), followed by L5-S1 (9.7%) and L3-L4 (4.6%). The female-to-male ratio was 1.3:1. There was a higher prevalence of degenerative spondylolisthesis in women at L4-L5 (51.2% vs. 35.6%; P < 0.001). CONCLUSION: We found that degenerative spondylolisthesis was more prevalent, occurring primarily in older women, between the L4-L5 vertebrae. On the other hand, isthmic spondylolisthesis more commonly occurred within male patients between the L5-S1 vertebrae. Our study is one of the first to recognize a high rate of degenerative spondylolisthesis within the L5-S1 region, highlighting the utility of CT scan to visualize spinal translation. LEVEL OF EVIDENCE: IV.

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Humans Female Spondylolisthesis Male Middle Aged Prevalence Retrospective Studies Lumbar Vertebrae Aged Tomography, X-Ray Computed Adult Aged, 80 and over Degenerative spondylolisthesis Isthmic spondylolisthesis Lumbar spine Prevalence spine disease Spine Journal Article

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Mina Botros, Amy Phan, Serena Liu, Andrew Liu, Sherif Sherif, Peter Joo, Varun Puvanesarajah, Mark Ehioghae, Jonathan P Japa, Kevin Yoon, Lancelot Benn, Addisu Mesfin. 2026-08-20. The prevalence of isthmic and degenerative lumbar spondylolisthesis: an analysis of 1376 patients.. https://doi.org/10.1016/j.jocn.2026.112255

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Journal Article resource Adult subject Aged subject Aged, 80 and over subject Degenerative spondylolisthesis subject Female subject Humans subject Isthmic spondylolisthesis subject Journal Article subject Lumbar Vertebrae subject Lumbar spine subject Male subject Middle Aged subject

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