Retrolisthesis, or backward slippage of a vertebra, is an uncommon joint dysfunction.
A vertebra is a small bony disc that makes the vertebrae, a series of small bones that form the backbone.
Each vertebra is separated by a cushion of intervertebral discs. These discs consist of an inner core called the nucleus pulposus. They’re held intact by a strong outer ring of ligament fibers called the annulus fibrosus.
Retrolisthesis occurs when a single vertebra slips and moves back along the intervertebral disc underneath or above it. It’s not the same as a dislocation. If the vertebra slips forward, it’s called spondylolisthesis.
There are three types of retrolistheses. They’re based on the displacement of the vertebra in relation to adjacent vertebra.
- Complete retrolisthesis. One vertebra moves backward to both the spinal segments above and below.
- Partial retrolisthesis. One vertebra moves backward to a spinal segment either below or above.
- Stairstepped retrolisthesis. One vertebra moves backward to the body of a spinal segment located above, but ahead of the one below.
Retrolistheses are typically found in the cervical spine (shoulder and neck region), lumbar region (lower back and pelvis), and thoracic spine (stomach region), although this is less common. Doctors measure the displacement in millimeters.
The symptoms depend on factors including your overall health, where the slippage occurs, and which nerve tissues, spinal joints, and other tissues were affected.
Signs and symptoms may include:
- uneasiness in one area of your back
- spine distortion or a bulge in your back
- limited range of motion
- back pain
- other forms of pain in the region of displacement
You may also feel numbness, tingling, or a sharp, pinched pain in your:
- hips
- thighs
- legs
- buttocks
- neck
- shoulders
- arms
Retrolisthesis is caused by decreased height between vertebrae, or decreased height of the intervertebral discs. Scientists don’t fully understand what causes the intervertebral discs to shorten, but some conditions and factors include:
- birth defects in children
- arthritis, which weakens bones
- stress and traumatic fractures
- nutritional deficiencies of the materials that maintain bone strength and repair discs, cartilage, and nerves
- injury to the spine or surrounding area
- infections in the blood or bone
- weak core muscles that don’t stabilize the back enough
- other diseases that weaken the bones, including osteoporosis and rickets
Your doctor will conduct a physical exam and ask about your symptoms. But the best way to diagnose retrolisthesis is with a lateral X-ray of the spine. Your doctor won’t be able to see retrolisthesis if the X-ray is taken when you’re lying down.
Your doctor will evaluate your X-rays by measuring the slippage between vertebral discs. They’ll draw several lines over the image of your vertebra and measure the distance between the lines. A distance of 2 millimeters or more is a sign of retrolisthesis.
Other X-ray findings associated with retrolisthesis include:
- vacuum phenomenon, or the accumulation of gas between discs and vertebra
- reduction of disc height
- bone spur formation
The goal of treatment for retrolisthesis is reduction of inflammation and pain. Treatment involves a variety of methods depending on how severe the condition is and how other tissues and discs may be affected.
Surgery is only needed if nonsurgical treatments aren’t effective. Your orthopedists and doctor will see if there will be long-term spinal and neurological damage before recommending surgery. Spinal surgery aims to reduce slippage, pain, and instability, prevent or reverse any neurologic loss, and more.
Nonsurgical treatments involve:
- physical therapy to strengthen your spine, back, and core muscles
- myofascial release, or massages that help restore muscle tone and improve circulation
- microcurrent therapy, which uses low-level electric currents to reduce swelling, inflammation, and pain
- applying heat compresses for pain
Nutrition
Get enough nutrition so that your body can repair damaged soft tissues. Eat foods that are rich in:
- copper, such as green vegetables, peanut butter, and peas
- calcium, such as dairy, dark green vegetables, and sardines
- vitamin D, such as fortified cereals, milk, and bread
- manganese, such as bananas
- vitamin A, such as carrots, cantaloupe, and spinach
- vitamin C, such as lemons, oranges, and broccoli
- zinc, such as pork, lamb, and nuts
- proteins and amino acids, such as meats, soybeans, and lentils
It might be helpful to talk with a dietitian to learn which levels of each nutrient are best for you. Eating right can also help with weight management. If you’re overweight, losing weight can help reduce the pressure on your vertebra.
Your doctor can recommend a physical therapist who can teach you techniques for lifting, bending, and sitting. Exercise and physical therapy can help with weight management. They can also improve:
- mobility
- flexibility
- strength
- pain relief
Workouts that target the correct areas include walking, yoga, and Pilates. Exercises you can try at home include:
- sitting pelvic tilts on a ball
- ab crunches
- hip extensions
- lower back rolls
To learn how to do these exercises, check out exercises for lordosis.
You can also practice good posture while at work and avoid sitting with flexed hips and knees.
Retrolisthesis isn’t always preventable, but there are steps you can take to minimize your risk. Try these tips.
Prevention tips
- Maintain a healthy diet and weight for optimal bone health and reduced back strain.
- Strengthen your core muscles with pelvic tilt exercises. A strong core lowers the strain on the back.
- Practice good posture when sitting and standing.
- Practice yoga, which improves posture, core strength, and back alignment.
- Avoid straining the back by hyperextension or by placing too much weight on it.
- Refrain from smoking. Tobacco can cause joint damage over time.
Many of these methods also benefit your overall health. Talk to a doctor if you suspect problems with your spine.