Systematic review of observational studies reveals no association between low back pain and lumbar spondylolysis with or without isthmic spondylolisthesis

Research output: Contribution to journalArticle

Nicholas S. Andrade, Carol M. Ashton, Nelda Wray, Curtis Brown, Viktor Bartanusz

Purpose: The hypothesis that spondylolysis (SL) and/or isthmic spondylolisthesis (IS) cause low back pain (LBP) is widely accepted representing surgical indication in symptomatic cases. If SL/IS cause LBP, individuals with these conditions should be more prone to LBP than those without SL/IS. Therefore, the goal of the study was to assess whether the published primary data demonstrate an association between SL/IS and LBP in the general adult population. Methods: Systematic review of published observational studies to identify any association between SL/IS and LBP in adults. The methodological quality of the cohort and case–control studies was evaluated using the Newcastle-Ottawa scale. Results: Fifteen studies met inclusion criteria (one cohort, seven case–control, seven cross-sectional). Neither the cohort study nor the two highest-quality case–control studies detected an association between SL/IS and LBP; the same is true for the remaining studies. Conclusions: There is no strong or consistent association between SL/IS and LBP in epidemiological studies of the general adult population that would support a hypothesis of causation. It is possible that SL/IS coexist with LBP, and observed effects of surgery and other treatment modalities are primarily due to benign natural history and nonspecific treatment effects. We conclude that traditional surgical practice for the adult general population, in which SL/IS is assumed to be the cause of non-radicular LBP whenever the two coexist, should be reconsidered in light of epidemiological data accumulated in recent decades.

Original languageEnglish (US)
Pages (from-to)1289-1295
Number of pages7
JournalEuropean Spine Journal
Volume24
Issue number6
DOIs
StatePublished - Apr 2 2015

PMID: 25833204

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Systematic review of observational studies reveals no association between low back pain and lumbar spondylolysis with or without isthmic spondylolisthesis. / Andrade, Nicholas S.; Ashton, Carol M.; Wray, Nelda; Brown, Curtis; Bartanusz, Viktor.

In: European Spine Journal, Vol. 24, No. 6, 02.04.2015, p. 1289-1295.

Research output: Contribution to journalArticle

Harvard

Andrade, NS, Ashton, CM, Wray, N, Brown, C & Bartanusz, V 2015, 'Systematic review of observational studies reveals no association between low back pain and lumbar spondylolysis with or without isthmic spondylolisthesis' European Spine Journal, vol. 24, no. 6, pp. 1289-1295. https://doi.org/10.1007/s00586-015-3910-5

APA

Andrade, N. S., Ashton, C. M., Wray, N., Brown, C., & Bartanusz, V. (2015). Systematic review of observational studies reveals no association between low back pain and lumbar spondylolysis with or without isthmic spondylolisthesis. European Spine Journal, 24(6), 1289-1295. https://doi.org/10.1007/s00586-015-3910-5

Vancouver

Andrade NS, Ashton CM, Wray N, Brown C, Bartanusz V. Systematic review of observational studies reveals no association between low back pain and lumbar spondylolysis with or without isthmic spondylolisthesis. European Spine Journal. 2015 Apr 2;24(6):1289-1295. https://doi.org/10.1007/s00586-015-3910-5

Author

Andrade, Nicholas S. ; Ashton, Carol M. ; Wray, Nelda ; Brown, Curtis ; Bartanusz, Viktor. / Systematic review of observational studies reveals no association between low back pain and lumbar spondylolysis with or without isthmic spondylolisthesis. In: European Spine Journal. 2015 ; Vol. 24, No. 6. pp. 1289-1295.

BibTeX

@article{37ec2cd0e8114837919b97e11172f2b9,
title = "Systematic review of observational studies reveals no association between low back pain and lumbar spondylolysis with or without isthmic spondylolisthesis",
abstract = "Purpose: The hypothesis that spondylolysis (SL) and/or isthmic spondylolisthesis (IS) cause low back pain (LBP) is widely accepted representing surgical indication in symptomatic cases. If SL/IS cause LBP, individuals with these conditions should be more prone to LBP than those without SL/IS. Therefore, the goal of the study was to assess whether the published primary data demonstrate an association between SL/IS and LBP in the general adult population. Methods: Systematic review of published observational studies to identify any association between SL/IS and LBP in adults. The methodological quality of the cohort and case–control studies was evaluated using the Newcastle-Ottawa scale. Results: Fifteen studies met inclusion criteria (one cohort, seven case–control, seven cross-sectional). Neither the cohort study nor the two highest-quality case–control studies detected an association between SL/IS and LBP; the same is true for the remaining studies. Conclusions: There is no strong or consistent association between SL/IS and LBP in epidemiological studies of the general adult population that would support a hypothesis of causation. It is possible that SL/IS coexist with LBP, and observed effects of surgery and other treatment modalities are primarily due to benign natural history and nonspecific treatment effects. We conclude that traditional surgical practice for the adult general population, in which SL/IS is assumed to be the cause of non-radicular LBP whenever the two coexist, should be reconsidered in light of epidemiological data accumulated in recent decades.",
keywords = "Adults, Association, Causality, Isthmic spondylolisthesis, Low back pain, Lumbar fusion, Observational studies, Review, Spondylolysis",
author = "Andrade, {Nicholas S.} and Ashton, {Carol M.} and Nelda Wray and Curtis Brown and Viktor Bartanusz",
year = "2015",
month = "4",
day = "2",
doi = "10.1007/s00586-015-3910-5",
language = "English (US)",
volume = "24",
pages = "1289--1295",
journal = "European Spine Journal",
issn = "0940-6719",
publisher = "Springer Verlag",
number = "6",

}

RIS

TY - JOUR

T1 - Systematic review of observational studies reveals no association between low back pain and lumbar spondylolysis with or without isthmic spondylolisthesis

AU - Andrade, Nicholas S.

AU - Ashton, Carol M.

AU - Wray, Nelda

AU - Brown, Curtis

AU - Bartanusz, Viktor

PY - 2015/4/2

Y1 - 2015/4/2

N2 - Purpose: The hypothesis that spondylolysis (SL) and/or isthmic spondylolisthesis (IS) cause low back pain (LBP) is widely accepted representing surgical indication in symptomatic cases. If SL/IS cause LBP, individuals with these conditions should be more prone to LBP than those without SL/IS. Therefore, the goal of the study was to assess whether the published primary data demonstrate an association between SL/IS and LBP in the general adult population. Methods: Systematic review of published observational studies to identify any association between SL/IS and LBP in adults. The methodological quality of the cohort and case–control studies was evaluated using the Newcastle-Ottawa scale. Results: Fifteen studies met inclusion criteria (one cohort, seven case–control, seven cross-sectional). Neither the cohort study nor the two highest-quality case–control studies detected an association between SL/IS and LBP; the same is true for the remaining studies. Conclusions: There is no strong or consistent association between SL/IS and LBP in epidemiological studies of the general adult population that would support a hypothesis of causation. It is possible that SL/IS coexist with LBP, and observed effects of surgery and other treatment modalities are primarily due to benign natural history and nonspecific treatment effects. We conclude that traditional surgical practice for the adult general population, in which SL/IS is assumed to be the cause of non-radicular LBP whenever the two coexist, should be reconsidered in light of epidemiological data accumulated in recent decades.

AB - Purpose: The hypothesis that spondylolysis (SL) and/or isthmic spondylolisthesis (IS) cause low back pain (LBP) is widely accepted representing surgical indication in symptomatic cases. If SL/IS cause LBP, individuals with these conditions should be more prone to LBP than those without SL/IS. Therefore, the goal of the study was to assess whether the published primary data demonstrate an association between SL/IS and LBP in the general adult population. Methods: Systematic review of published observational studies to identify any association between SL/IS and LBP in adults. The methodological quality of the cohort and case–control studies was evaluated using the Newcastle-Ottawa scale. Results: Fifteen studies met inclusion criteria (one cohort, seven case–control, seven cross-sectional). Neither the cohort study nor the two highest-quality case–control studies detected an association between SL/IS and LBP; the same is true for the remaining studies. Conclusions: There is no strong or consistent association between SL/IS and LBP in epidemiological studies of the general adult population that would support a hypothesis of causation. It is possible that SL/IS coexist with LBP, and observed effects of surgery and other treatment modalities are primarily due to benign natural history and nonspecific treatment effects. We conclude that traditional surgical practice for the adult general population, in which SL/IS is assumed to be the cause of non-radicular LBP whenever the two coexist, should be reconsidered in light of epidemiological data accumulated in recent decades.

KW - Adults

KW - Association

KW - Causality

KW - Isthmic spondylolisthesis

KW - Low back pain

KW - Lumbar fusion

KW - Observational studies

KW - Review

KW - Spondylolysis

UR - http://www.scopus.com/inward/record.url?scp=84930277471&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930277471&partnerID=8YFLogxK

U2 - 10.1007/s00586-015-3910-5

DO - 10.1007/s00586-015-3910-5

M3 - Article

VL - 24

SP - 1289

EP - 1295

JO - European Spine Journal

T2 - European Spine Journal

JF - European Spine Journal

SN - 0940-6719

IS - 6

ER -

ID: 13066607