Last reviewed by Dr. Raj MD on January 12th, 2022.
What is Retrolisthesis?
This is a medical condition in which a vertebra in your spine becomes displaced and moves forward or backward. In most instances of vertebrae slippage it will involve a forward movement of an upper vertebra, which will slip toward your chest. The backward movement is less common but in people with degenerative disorders it still occurs in considerable frequency. It can be:
- Acute — this means having severe symptoms and a short course, or time it occurs.
- Congenital — this means a condition that existed at or before the birth of the baby
- Degenerative — this means deterioration of your spine
Normally, in most cases, it occurs in the soft disc that separates and cushions the vertebrae either ruptures or deteriorates. If you do not have the support of this disc your upper vertebrae will slip out of place and then it puts pressure on the bone that is below it. It is most likely to affect a bone in your uppermost section of your spine called the cervical region. In your neck, the cervical vertebrae are smaller making them more susceptible to injury. All though you can have slippages in the lower and middle section of your spine they are less common in these areas.
Three Types of Retrolisthesis
- Complete — this is when the body of a vertebrae is posterior of your vertebral body of the underlying or overlying vertebra. Posterior mean at the rear or behind something.
- Stair-stepped — this is when your vertebra slips backward in relation to the vertebra above it.
- Partial — this is your vertebra has slipped backward in relation to your underlying or overlying vertebrae.
To classify retrolisthesis, the intervertebral foramina are divided from the anterior to posterior dimensions into four parts that are equal. Intervertebral foramina are the openings that are located between the adjacent vertebrae through which your spinal nerves exit. In the grades it refers to the posterior displacement of the percentage of the foramina.
- Grade 1 — up to one-fourth
- Grade 2 — from one-fourth to one-half
- Grade 3 — one-half to three-fourths
- Grade 4 — three-fourth to total occlusion
The displacement generally affects your lumbar or cervical vertebrae but it can also affect your thoracic vertebrae.
Retrolisthesis Picture 1
Retrolisthesis Picture 2
Symptoms of Retrolisthesis
When you have retrolisthesis you can have a variety of symptoms, which vary from person to person. The location of the displacement helps to determine the type of symptoms you might experience. Some of the symptoms that you might experience can include:
- Chronic back pain
If you have cervical retrolisthesis some of the symptoms you might experience can include:
- Tenderness in your neck area
- Dull neck pain
If it occurs in your lower spinal area you may experience some of these symptoms.
- Mobility that can be significantly limited
- Constant pain when walking, sitting, or standing
It is possible that the vertebrae that are damaged will put pressure on important nerves in your back and lead to a tingling sensation or numbness in your torso, legs, and arms. Overtime, without treatment, the symptoms tend to worsen, especially if degenerative disorders are responsible for causing retrolisthesis.
Causes of Retrolisthesis
The leading cause of retrolisthesis in older people is arthritis, which usually leads to deterioration of their disc tissue. It can also be caused by congenital spine defects and severe back injuries.
When you see your physician they will do a physical exam on your spine and then have x-rays taken to check for retrolisthesis. If they find slippage your physician may refer you to a specialist for a more thorough assessment and additional diagnostic testing.
Treatment for Retrolisthesis
The treatment used will depend on how severe the symptoms are but treatment will normally include a combination of physical therapy, pain medication, and surgery. Treatment involves correcting the posterior displacement along with realigning your affected vertebrae. The soft tissues in the surrounding areas will need to be strengthened or repaired so they can support your vertebrae.
If you are suffering from significant back pain you should visit your physician for a thorough examination. If you are diagnosed with retrolisthesis the spine specialist your physician might have referred you to will help with determining the appropriate treatment plan.
If there is a slight displacement it will often not require surgery but your physician will give you medications to help manage the swelling and pain along with getting plenty of rest for several weeks. If it is caused by arthritis you may have to take additional medications and supplements to help improve your bone health.
If is a severe case of retrolisthesis it can usually only be treated through an invasive surgical procedure. During the procedure the spine specialist will manually adjust the alignment of the vertebrae and then fuse them together permanently. There will be follow-up physical therapy, which can take years. Rehabilitation therapy is important to help you regain your strength.
When you have retrolisthesis you should make sure that you are keeping yourself well hydrated and eating a healthy diet that includes copper, amino acids, proteins, manganese, zinc, glucosamine, and vitamins A and C. You should also keep your weight in check so you are not putting extra pressure on your spine with extra weight. To help reduce the pain and inflammation along with facilitating the regeneration of the soft tissue your physician may use microcurrent therapy, which involves using low-level electrical currents in the area affected by retrolisthesis.
Physical therapy Exercises for Retrolisthesis
When seeing your physical therapist they will offer various range of motion exercises to perform. It may be in the form of assisted or self-directed exercises. Some of these exercises that might be used for your lower back can include stretching, and having your arms held in front of your chest or above your shoulders while you do a gentle twisting motion from side-to-side.
You should not attempt any type of exercise without the approval of your physical therapist or physician as doing the exercises incorrectly or doing the wrong ones, can cause more problems. Three of the physical therapy exercises you might perform include:
Lower back rolls
These can stretches for your lower back. If retrolisthesis has caused severe to moderate placement of your lower vertebrae you may not be able to do this exercise. If you can do this exercise it can help to relieve your pain. When doing this exercise you will slowly lift your knees to your chest and fasten your hands together behind the knees. Let your body roll to your left slowly and then go back to the original position. Rest for five seconds and do the same thing to your right.
If you have been diagnosed with issues in your lower back/spine area it is important to maintain support and strength of your hip joints and pelvis. Standing, place your hands onto a wall or chair to balance yourself. Use one of your legs to bear most of your weight. The other leg should be bent slightly at the knee. The leg bearing your weight should be touching the floor. Keeping the ball of the foot of your weight bearing leg on the floor and rotate your knee outward and then inward slowly. Change legs and repeat the exercise.
This is a lower back strengthening exercise that is low-impact and is done while lying down. It will help to relieve pain and loosen stiff joints that are caused by different lower-back medical conditions like arthritis and sciatica. It will also help to strengthen and tighten the lower muscles of your pelvis and abdominal wall. While lying on the floor bend your knees and pull your abdomen in toward the floor. Then rock the top of your pelvis upwards slightly. Hold for ten seconds and then relax.