Analysis of Risk Factors for Lumbar Spondylolisthesis: A Logistic Regression Study

Lumbar spondylolisthesis is the forward displacement of one vertebra over another, commonly occurring at the L4/5 or L5/S1 levels. The condition is influenced by various risk factors, including age, BMI, long-term physical labor, pelvic incidence (PI), and facet joint osteoarthritis. This study aims to identify the significant risk factors associated with lumbar spondylolisthesis through univariate and multivariate logistic regression analyses. A retrospective analysis of 531 patients diagnosed with lumbar spondylolisthesis between September 2019 and September 2024 was conducted. Data were collected on age, BMI, PI, history of lumbar trauma, long-term physical labor, congenital pedicle dysplasia, osteoporosis, intervertebral disc degeneration, and facet joint osteoarthritis. Univariate logistic regression was used to screen for significant variables, followed by multivariate logistic regression to adjust for confounding factors. ROC curve analysis was performed to assess the sensitivity of significant factors. Univariate analysis identified age, BMI, long-term physical labor, PI, and facet joint osteoarthritis as significant risk factors. Multivariate analysis confirmed that age (p = 0.035), BMI (p = 0.005), and facet joint osteoarthritis (p = 0.002) remained statistically significant. Interaction effect analysis did not reveal any significant interactions between variables. ROC curve analysis showed that age, BMI, and facet joint osteoarthritis were key predictors of lumbar spondylolisthesis. Age, BMI, and facet joint osteoarthritis (Grade III or above) were observed as potential risk factors for lumbar spondylolisthesis, with facet joint osteoarthritis showing the highest odds ratio. These findings indicate that degenerative changes in the spine, particularly those involving the facet joints, may contribute significantly to the development of lumbar instability, although further research is needed to establish causal relationships.