Belgin KARAN, Burhan Oral GÜDÜ
Journal of Turkish Spinal Surgery - 2026;37(2):71-75
Objective: To compare the prevalence of cranial lumbar disc degeneration (L1-L4) in patients with spondylolysis (SL) and isthmic spondylolisthesis (IS) with those having L5-S1 lumbar disc herniation (LDH) and asymptomatic individuals with normal lumbar vertebrae (NLV). Materials and Methods: This retrospective study included 133 individuals aged 25-50 years, divided into four groups: IS (n=28), SL (n=38), LDH (n=34), and NLV (n=33). Lumbar intervertebral discs were evaluated using the Pfirrmann classification on sagittal T2-weighted magnetic resonance imaging. Disc degeneration was defined as Pfirrmann grade >=3. Intergroup comparisons of degeneration prevalence were performed using the chi-square test. Results: Upper lumbar degeneration rates did not differ significantly among the SL, IS, and LDH groups (31.6%, 39.3%, and 29.4%, respectively; p>0.05). However, all three groups demonstrated higher degeneration rates than the NLV group (18.2%; p<0.05). Although the IS group was significantly older than the NLV group (p<0.001), there was no significant correlation between age and degeneration at the upper lumbar levels. Conclusion: IS and L5-S1 LDH are associated with higher rates of cranial lumbar disc degeneration than in asymptomatic individuals. These findings may suggest that altered biomechanical factors contribute beyond chronological aging; however, causal inference is limited by the retrospective design.
