Classification[ edit ] Retrolisthesis can be classified as a form of spondylolisthesissince spondylolisthesis is often defined in the literature as displacement in any direction. This is because of the variable nature of the impact on nerve tissue and of the mechanical impact on the spinal joints themselves. Structural instability may be experienced as a local uneasiness through to a more far reaching structural compensatory distortion involving the whole spine.
Neither the prevalence of this condition in individuals with lumbar disc herniations nor its possible relation to pre-operative back pain and dysfunction has been well studied.
Disc degeneration was defined as any loss of disc signal on T2 imaging. Modic changes were graded 1 — 3 and collectively classified as vertebral endplate degenerative changes. The presence of facet arthropathy and ligamentum flavum hypertrophy were classified jointly as posterior degenerative changes.
Retrolisthesis combined with posterior degenerative changes, degenerative disc disease, or vertebral endplate changes had incidences of 4. The prevalence of retrolisthesis did not vary by sex, age, race, smoking status, or education level when compared to individuals with normal sagittal alignment.
MRI scans of the lumbar spine were assessed at spinal level L5–S1 for all patients. Retrolisthesis was defined as posterior subluxation of 8% or more. Disc degeneration was defined as any loss of disc signal on T2 imaging. Modic changes were graded 1 – 3 and collectively classified as vertebral endplate degenerative changes. The researchers say that a small degree of lumbar lordosis and/or a small pelvic tilt angle can instigate the formation of a retrolisthesis. Back Surgery and Retrolisthesis In a study published in Spine Journal, researchers evaluated patients who underwent an L5-S1 discectomy. Retrolisthesis. is the term used to define a degenerative and an acute spine condition in which a single vertebra gets displaced and moves backwards onto the vertebra lying immediately below it.
However, individuals with retrolisthesis were more likely to be receiving worker compensation than those without retrolisthesis. Increased age was found to be associated with individuals having vertebral endplate Degenerative retrolisthesis lumbar spine changes both alone and in conjunction with retrolisthesis and degenerative disc disease.
Individuals who had retrolisthesis with concomitant vertebral endplate degenerative changes were more often smokers and had no insurance. The presence of retrolisthesis was not associated with an increased incidence of having degenerative disc disease, posterior degenerative changes, or vertebral endplate changes.
No statistical significance was found between the presence of retrolisthesis on the degree of patient pre-operative low back pain and physical function. Patients with degenerative disc disease were found to have increased leg pain compared to those patients without degenerative disc changes.
It is possible that the contribution of pain or dysfunction related to retrolisthesis was far overshadowed by the presence of symptoms due to the Degenerative retrolisthesis lumbar spine disc herniation.
It remains to be seen whether retrolisthesis will affect outcome following discectomy in these patients. Few studies have been done to date and little is known about this condition. The literature has found a possible association between retrolisthesis and increased back pain and impaired back function.
Do individuals with lumbar disc herniations have increased levels of back pain, back dysfunction, and decreased quality of life pre-operatively if they have concomitant retrolisthesis at the involved herniated disc level?
The purposes of this study were as follows: All individuals in the current study population had complete sets of MRI scans confirming a L5-S1 level disc herniation and subsequently underwent L5-S1 discectomy.
Individuals with anterolisthesis were excluded from this study. Clinical scans were collected, so there was no predefined magnet strength or acquisition protocol.
All images were done supine. Vertebral Measurements and Assessment There are many published methods for determining the amount of listhesis radiographically expressed in mm of subluxation or percent slippage.
The central sagittal image was determined by presence of the lumbar spinous processes within the view, having a symmetrical progression of MRI images from laterally based foraminal views to the central image and having the largest measured value for the anteroposterior diameter of L5 and S1 vertebral bodies.
Points were then placed along the posterior margins of L5 and S1 on the central sagittal image to measure the amount of backward slippage to the nearest 0. All measurements were done electronically. Percent retrolisthesis was calculated by dividing the backwards subluxation of L5 by the anteroposterior diameter of S1.
T1 and T2 axial and sagittal images were also used to assess for degenerative changes at the L5 - S1 level.
Three areas of L5 — S1 evaluated for degenerative changes included the disc space, vertebral endplates, and posterior elements.
Loss of disc signal intensity on T2 imaging — signifying disc dehydration — was classified in this paper as a sign of early disc degeneration and categorized as a degenerative change.
Vertebral endplates were assessed for degenerative changes and classified under the Modic scale. For analytical purposes, stratification between Modic one, two, and three changes was not done in this paper, and all Modic changes were combined and categorized collectively as a degenerative change of the vertebral endplates.
Signs of posterior element degenerative changes included signs of facet joint arthropathy and ligamentum flavum hypertrophy.
Stratification between different posterior element degenerative changes was not done and all changes were collectively classified together as a sign of posterior element degenerative change.
SPORT Study Surveys Information obtained from the surveys included basic demographics, life style variables, medical history, medical status, emotional status, and patient self-assessment of low back pain, leg pain, sciatica, and other symptomology. Answers given allowed calculation of SF health status, mean leg pain score rated0 being not bothersome and 6 extremely bothersomemean back pain score rated0 being not bothersome and 6 extremely bothersomeand Sciatica Bothersome Index rated0 being not bothersome and 24 being extremely bothersome.
Definition of Retrolisthesis and Symptomology Measurement for posterior subluxation was done on all patients. Percent subluxation was calculated for any individual with greater than or equal to 3 mm of posterior displacement. A cut-off point of 3 mm was chosen because this criterion has been used previously both in orthopaedic research and clinical practice.
Evaluation of Reproducibility To test for intraobserver reliability, 50 of the cases previously reviewed were picked at random for re-evaluation. The reader was blinded as to the results obtained from previous readings.
Following review, the kappa coefficients for presence or absence of retrolisthesis, T2 disc signal changes, posterior element degenerative changes, and Modic changes were calculated.
The kappa coefficient is designed to assess the degree of agreement observed between the readers above and beyond what could be expected by chance agreement alone.The researchers say that a small degree of lumbar lordosis and/or a small pelvic tilt angle can instigate the formation of a retrolisthesis.
Back Surgery and Retrolisthesis In a study published in Spine Journal, researchers evaluated patients who underwent an L5-S1 discectomy. Mar 20, · Lumbar degenerative spondylolisthesis is a major cause of spinal canal stenosis, In contrast, other authors have reported that retrolisthesis was more common in men and in the upper lumbar (L2 and 3) spine 18).
Retrolisthesis is typically limited . Note. Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition. A retrolisthesis may involve the spine’s vertebra, discs, ligaments, tendons (fascia), muscles, and nerves.
It may cause symptoms related to other spinal disorders, such as spinal stenosis, facet joint dysfunction, cauda equina syndrome (lumbar spine), and intervertebral disc bulge or herniation. Retrolisthesis. is the term used to define a degenerative and an acute spine condition in which a single vertebra gets displaced and moves backwards onto the vertebra lying immediately below it.
When damaged discs in the lumbar spine cause symptoms of pain, it is called lumbar degenerative disc disease. Watch: Lumbar Degenerative Disc Disease Video Intervertebral discs are tough, fibrous structures that act as ligaments between vertebrae, absorbing pressure and providing cushioning for the spinal column.