Retrolisthesis is an uncommon joint dysfunction that occurs when a single vertebra in the back slips backward along or underneath a disc.
Retrolisthesis is the opposite of spondylolisthesis, which occurs when a vertebra slips forward. Retrolisthesis occurs in the neck and shoulder area, known as the cervical spine, or the lower back, known as the lumbar spine. The movement either way is of 2 millimeters (mm) or more.
Retrolisthesis occurs less often in the center area of the spine or the thoracic spine, although it is possible.
There are three types of retrolisthesis:
- Complete retrolisthesis occurs when one vertebra moves backward in relation to the one above and below it.
- Partial retrolisthesis involves one vertebra moving backward toward either the one above or below it.
- Staircase retrolisthesis happens when one vertebra moves backward from the ones above it and ahead of the ones below it.
Retrolisthesis happens when the space between the vertebrae decreases. Sometimes this happens if the discs between the vertebrae shrink. Scientists are not entirely sure what makes the discs and space between the vertebrae decrease.
However, they suspect the following factors may cause this shrinkage and lead to retrolisthesis:
Symptoms of retrolisthesis vary from person to person and range from mild to severe. Symptoms may include any combination of the following:
- back pain
- discomfort 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
Symptoms may extend beyond the back. Some people experience numbness or tingling in some of their extremities, including:
Spondylolisthesis is a similar condition, but the vertebra moves forward rather than back.
A doctor will start by reviewing a person's general health and the symptoms the person is experiencing. After the examination, if a doctor suspects retrolisthesis, they may recommend a lateral X-ray. A lateral X-ray is taken when the person is standing up because it is impossible to identify retrolisthesis if the person is lying down.
A doctor will examine the X-ray, likely drawing several lines on it to compare the positions of the vertebrae and measure how far the vertebrae has slipped out of position. Any slippage over 2 millimeters is considered an indication of retrolisthesis.
The X-ray can also outline any other symptoms that may indicate whether a person has retrolisthesis. Some additional signs may include:
- hardened arteries around the vertebrae
- shorter disc heights
- bone spurs
- gas trapped between vertebrae
Many different techniques and methods are available to treat retrolisthesis, but these depend on the severity of the retrolisthesis and other areas of concern around the site of the slippage.
Nonsurgical methods may include:
- physical therapy to help increase strength in the back and abdominal muscles
- targeted spin strengthening exercises
- massages designed to improve circulation and help with muscle tone
- applying heat to the area
- low-level electric currents (microcurrent therapy) that reduce swelling, pain, and inflammation
- pain medication, such as ibuprofen or aspirin
Doctors do not usually consider surgery as a treatment option. Surgery is usually only performed to treat retrolisthesis as a last resort if the other non-surgical methods are not working.
How serious is it?
If diagnosis happens early, the slippage can be stabilized, but without treatment, it can get worse and lead to complications.
Untreated it can lead to cervical spondylotic myelopathy (CSM), or spinal cord compression, especially in those aged over 50 years.
As the nerves become compressed, there may be:
- neck pain
- numbness and weakness in the arms and hands
- problems with balance and coordination
- reduced mobility
A person with retrolisthesis should talk to their doctor about ways to improve their nutritional intake.
Eating nutrient-rich foods can help the body heal naturally over time and promote bone and joint health. Some nutrients and foods to include in a diet include:
- vitamin A, found in spinach and carrots
- vitamin C, found in lemons and oranges
- vitamin D, found in milk, fortified cereals, and bread
- calcium, found in dairy products and green, leafy vegetables
- copper, found in peanut butter, nuts, and leafy vegetables
- zinc, found in nuts and pork
- proteins, found in nuts, meats, fish, and poultry
In conjunction with dietary changes, a person could consider an exercise routine that may help with recovery. Exercising will improve a person's flexibility, mobility, and strength and help reduce pain from the slipped disc. Some common exercises that may help include:
- crunches performed on an exercise ball
- hip exercises
- back exercises
Diet and exercise have an additional benefit. For people who are overweight or heavier, both exercise and diet can help reduce excess weight. The reduced weight will help alleviate some of the pain as there is less strain put on the back and neck.
Retrolisthesis is not always preventable. For example, a person may experience an injury that causes the back to slip out of alignment. For others, retrolisthesis may be caused by genetic factors.
For most people, following some of these basic tips can help prevent retrolisthesis:
- maintaining good posture while sitting and standing
- participating in yoga, pilates, or other core strengthening classes and routines
- avoiding straining the back with excessive weight
- stopping smoking, as it can lead to joint damage
- strengthening the lower core muscles through regular exercise
- eating a balanced diet
People can prevent retrolisthesis from occurring by taking proper care of their back with regular exercise, a balanced diet, and avoiding activities that may cause injuries.
People diagnosed with retrolisthesis often make a full recovery after following the treatment plan put in place by their doctor. Sometimes, surgery may be required to help the person heal.