Retrolisthesis : Types, Symptoms, Causes, Treatment and Prevention

Overview

Lumbar retrolisthesis occurs when parts of your backbone are slipping backwards on one another. Although this condition generally causes few symptoms, there’s evidence that lumbar retrolisthesis can lead to back pain and impaired back function. Retrolisthesis is an uncommon dysfunction and usually develops in the neck and shoulder area (the cervical spine) or the lower back (the lumbar spine).

This blog deals with retrolisthesis, its causes, symptoms, treatment, and prevention. 

What is retrolisthesis? 

As mentioned earlier, retrolisthesis is an uncommon joint dysfunction occurring when a single vertebra slips backwards along or beneath the disc. A series of small tiny bones, known as vertebrae, joined together form the backbone. Between each vertebra is a cushion of intervertebral discs consisting of an inner core known as the nucleus pulposus. They are held intact by a robust outer ring of ligament fibres known as the annulus fibrosus.

Retrolisthesis occurs if a single vertebra slips and moves back along with the intervertebral disc beneath or above it. This condition is not the same as a dislocation. When the vertebra slips forward, it is known as spondylolisthesis. 

What are the types of retrolisthesis? 

There are three types of retrolisthesis based on the displacement of the vertebra: 

1. Complete retrolisthesis occurs when one vertebra moves backwards with relation to the concerning one above and below.
2. Partial retrolisthesis occurs when one vertebra moves backwards towards  a vertebra either below or above.
3. Stair-stepped retrolisthesis occurs when one vertebra moves backwards from the ones above it and ahead of the ones below it.

What are the symptoms of retrolisthesis?

The symptoms of retrolisthesis differ from each individual and vary from mild to severe. They can include any combination of the following:

• Back pain
• Uneasiness in one specific area of the back
• Limited range of motion
• Pain in the area of dislocation
• Sharp pinching pain
• A bulge in the spine 

The symptoms can extend beyond the back. Certain patients experience numbness or tingling in the buttocks, thighs, arms, hips, legs, shoulders, and neck.

When should you contact the doctor?

You must call the doctor if you experience the symptoms of retrolisthesis.

Request an appointment at Apollo Hospitals

What are the causes of retrolisthesis?

Retrolisthesis occurs when the space between the vertebrae becomes less. It sometimes occurs when the discs between the vertebrae shrink. Scientists are not entirely sure about the causes of shrinkage of the intervertebral discs. However, some conditions and factors include:

• Arthritis
• Osteoporosis
• Degenerative spinal problems
• Weak muscles around the spine
• Congenital disabilities
• Damage to or near the spine
• Blood or bone infections
• Weak abdominal muscles
• Nutritional deficiencies

How is retrolisthesis treated?

The goal of treating retrolisthesis is to reduce inflammation and pain. The treatment involves various methods based on the severity of the condition and how other tissues and discs could be affected.

Surgery

Surgery is only required if non-surgical treatments fail. The orthopaedist and doctor may check if there is a chance of developing a long-term spinal and neurological damage before suggesting surgery. Spinal surgery minimises slippage, pain, and instability and prevents or reverses any neurologic loss.

Non-Surgical Treatments 

The non-surgical treatments include:

1. Physical therapy to strengthen the back, spine, and core muscles
2. Myofascial release, or massages that aid in restoring muscle tone and improving circulation
3. Microcurrent therapy utilises low-level electric currents to minimise inflammation, swelling, and pain
4. Applying heat to the area

Nutrition

Patients must get adequate nutrition so their bodies can repair the damaged soft tissues. They must consume foods rich in:

1. Copper, including green vegetables, peas and peanut butter
2. Calcium, including dairy, dark green vegetables, and sardines
3. Vitamin A, including carrots, spinach, and cantaloupe
4. Vitamin C, including oranges, lemons, and broccoli
5. Vitamin D, including fortified cereals, bread, and milk
6. Manganese, including bananas
7. Zinc, including nuts, pork, and lamb
8. Proteins and amino acids, including meats, lentils, and soybeans 

Patients should consult a dietitian to learn about the required portion of each nutrient to meet their needs. A correct diet could also help with weight management. Weight loss can help overweight patients reduce the pressure on their vertebras.

Exercises and physical therapy

The doctor may suggest patients consult a physical therapist to teach the correct lifting, bending, and sitting techniques. Exercise and physical therapy may help with weight management. They can also improve mobility, flexibility, strength and pain relief.

Workouts that target the right areas include walking, pilates, and yoga. Patients can try exercises at home, including sitting pelvic tilts on a ball, hip extensions, lower back rolls, and ab crunches. They can also practice good posture at work and avoid sitting with flexed hips and knees.

How can retrolisthesis be prevented?

Retrolisthesis cannot always be prevented. However, there are measures that the patient can take to minimise their risk. They must:

1. Maintain a healthy diet and weight for optimal bone health and minimal back strain.
2. Strengthen the core muscles through pelvic tilt exercises. A strong core minimises the strain on the back.
3. Practise good posture when they are sitting and standing.
4. Practise yoga because it improves posture, core strength, and back alignment.
5. Avoid straining the back by hyperextension or exerting too much weight on it.
6. Avoid smoking because tobacco may cause joint damage over time.

Conclusion

People can prevent retrolisthesis by taking good care of their back through regular exercise, consuming a balanced diet, and avoiding activities that can cause injuries. Often, those diagnosed with retrolisthesis make a complete recovery after following the treatment plan decided by their doctor. Sometimes, patients can need surgery to help them heal.

Frequently Asked Questions (FAQs)

1. How is retrolisthesis diagnosed?

Doctors diagnose retrolisthesis by a physical examination and neurological evaluation that includes details about the patient’s medical history and symptoms. Afterwards, a standing X-ray imaging of the spine ( anterior, posterior, lateral) helps doctors check and measure a displacement. When the displacement is more than 2 millimetres, the doctor can diagnose people with retrolisthesis (e.g., Grade 1). Depending on the results of the neurological exam and review of symptoms, the doctor can ask for additional imaging tests, including a CT Scan or MRI scan.

2. How serious is retrolisthesis?

Doctors can stabilise the slippage if they diagnose the condition early. However, without treatment, it may worsen and cause complications,including cervical spondylotic myelopathy (CSM) or spinal cord compression. People aged over 50 years are susceptible to this condition. As the nerves become compressed, people can suffer from neck pain, numbness and weakness in the arms and hands, reduced mobility, and problems with balance and coordination.