Spondylolysis, spondylolisthesis, and degenerative changes of facet joint- low progression but high psychological burden: result of assessing lumbar imaging in a one-year follow up

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Alireza Omranzade , Jalal Kargar Shuraki , Hamid Moradi , Sirous Azizi , Masoud Mahdavi Rashed , Mohammad Reza Azimi Aval


Background and aim: Spondylolysis and spondylolisthesis are believed to be related to low back pain (LBP) and causes several sufferings for the patients. The condition may be more severe in some occupations. The aim of our study was to investigate the change of spondylolysis/spondylolisthesis and facet joint osteoarthritis in military and non-military cases. As a secondary aim we assessed the psychological burden of these disorders.

Method: Two similar groups including 85 military and 85 non-military spondylolysis/spondylolisthesis cases were enrolled. All the patients underwent imaging and Dayan grading for spondylolysis/spondylolisthesis and Goda score for facet joint degenerative changes were assessed. The patients were followed for a duration of one year. and the changes were assessed and compared between the two study groups. Moreover, to assess the psychological effect and the posed disability, beck anxiety index (BAI) and Oswestry Disability Index (ODI) questionnaires were used.

Results: Totally 82 cases in the military group and 84 cases in non-military group were assessed at the end of follow up. Only Dayan score in military group showed significant increase at the end of follow up (p=0.008). Regression analysis showed no relationship between being military and Goda (p=0.180) or Dayan scores (p=0.184). Furthermore, although there were no significant changes in ODI score at end of follow up in both military (p=0.136) and non-military groups (p=0.612), BAI significantly increased at the end of follow up in both military (p<0.001) and non-military groups (p<0.001).

Conclusion: The role of military occupation in spondylolysis/spondylolisthesis or facet joint osteoarthritis changes is still under question. However, it seems that the condition poses anxiety on patients.

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