Association Between Osteoarthritis Burden and Intervertebral Disc Degeneration in Patients Undergoing Lumbar Spine Surgery for Degenerative Lumbar Spondylolisthesis

Abstract

Study Design. A retrospective analysis of prospectively collected data Objective. To assess the association between intervertebral disc degeneration and hip and knee osteoarthritis (OA) in patients with degenerative lumbar spondylolisthesis (DLS). Background. The co-occurrence of hip OA and degenerative spinal pathologies was first described as the “Hip-Spine-Syndrome” and has also been observed in knee OA. It remains unclear if both pathologies share an underlying connection beyond demographic factors. Methods. Intervertebral disc degeneration was classified by the Pfirrmann Classification and intervertebral vacuum phenomenon (IVP). IVP was classified into mild (1 point), moderate (2 points), and severe (3 points) at each level and combined into a lumbar vacuum score (0 - 15 points). Similarly, a lumbar Pfirrmann Grade was calculated (5 - 25 points). Patients with previous hip or knee replacement surgery were classified as having an OA burden. We used multivariable regression to assess the association between OA and disc degeneration, adjusted for age, body mass index (BMI), and sex. Results. A total of 246 patients (58.9% female) were included in the final analysis. Of these, 22.3% had OA burden. The multivariable linear regression showed an independent association between OA burden and lumbar vacuum (β = 2.1, P<0.001) and Pfirrmann Grade (β = 2.6, P<0.001). Representing a 2.1 points higher lumbar vacuum and 2.6 points higher lumbar Pfirrmann Grade after accounting for demographic differences. Conclusion. Our study showed that OA burden was independently associated with the severity of the intervertebral disc degeneration of the lumbar spine. These findings give further weight to a shared pathology of OA of large joints and degenerative processes of the lumbar spine.