Prevalence, radiological and clinical presentation of lumbar spondylolisthesis among patients with lower back pain at Mulago National Referral Hospital

Abstract

Introduction: Lumbar spondylolisthesis is a major cause of morbidity worldwide. In 2018, 39 million people were found to have LS worldwide. In Uganda, a study done in Mulago hospital in 2005 revealed that 4.9% of all lower back pain cases were associated with degenerative LS. This makes LS an area of concern. However, there’s limited data about the current prevalence, radiological and clinical presentation of LS among patients with lower back pain in Mulago Hospital given that no studies have been done in this setting before, hence this study. General objective: To determine the prevalence, radiological and clinical presentation of lumbar spondylolisthesis among patients at Mulago National Referral Hospital. Methods: This was descriptive cross-sectional study done among 606 patients with lower back pain at Mulago orthopedic in and out patients’ departments in period between October 2020 to March 2021 Results: A total of 606 patients with lower back pain were recruited into the study. 63 of 606 patients had Lumbar Spondylolisthesis which gave a prevalence of 10.4% (95% CI; 8.2 to 13.1). majority were females 37 (58.7%) .The most common pattern was Meyerding grade II spondylolisthesis, 44 (69.8%) The least common grades were Meyerding grade IV and V with no patients. The entire 63 (100%) patients had radiculopathy. Paresthesia was reported in 51 (81%) of the patients, the most common clinical sign was a step off sign in 55 (87.3%) of the 63 patients, 29 (46.0%) had low midline sill signs and interspinous gap change signs. most of the patients 51 (80.9%) had extreme leg pain and only 4 (6.4%) had no bothersome. Conclusion Prevalence of Lumbar spondylolisthesis among patients with lower back pain seen at Mulago National Referral Hospital was high (10.4%). The most common radiological patterns was grade (II) and least common were grades IV and V. Most of patients with LS presented with radiculopathy, paresthesia and step off signs.