Retrolisthesis

Causes

Retrolisthesis may occur for 2 reasons:

1. Mechanical damage from physical trauma. (accidents, falls, repetitive use, poor posture etc)
2. Nutritional deficiencies of the components that make possible the building of strength and repair of discs and ligaments.
   
   
   By the time you are seeing spinal segment translations of 2mm or more we can assume there is a failure of the disc to resist shearing forces. The most common way in which this happens is a horizontal tear in the annular portion of the disc cartilage. Generally the greater the tear, the greater the instability. This spinal segment will either already be at least in Phase 2 of spinal degeneration or will eventually end up that way.
   If you can't prevent the injury from happening in the first place and most of us cannot, then it is essential to take care of the subluxation before it progresses to the stage of a retrolisthesis.
   
   
   Translation less than 2 mm---Sublaxation.
   Translation 2 mm or more---Retrolisthesis.---Here we  can assume that there is failure of the disc to resist shearing forces.---The most common way in which this happens is a horizontal tear in the annular portion of the disc cartilage.
   
   This translation is more than 2 mm, so it is considered as a Retrolisthesis from which we can assume that there is failure of the disc to resist shearing forces applied on it where the most common way in which this happens is a horizontal tear in the annular portion of the disc cartilage, so further evaluation with MRI is recommended for such a case. 
   
   
   

   

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   Types of translation

   
   

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Complication of Retrolisthesis

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Causes of pain in Retrolisthesis

Evaluation & Measurement

This is done either by drawing lines using drawing instruments or by direct measurement using set squares:

 

There are always 2 vertebrae involved in measuring the magnitude of a retrolisthesis for translation (slippage). The lower segment is considered the position of stability. The upper segment rests on it. The upper segment is considered the segment of mobility and is the one being determined for retrolisthesis.

1) A line 1 is drawn along the top of the vertebral body of the lower spinal segment.

2) Then at the top-back most portion of the lower vertebral body, draw line 2 at 90 degrees to line 1, till it projects well into the body of the vertebra above.
3) Then draw another line 3 parallel to the line just drawn 2 this time at the posterior most lower portion of the upper vertebral body.

4) The distance between the upright lines 2 and 3 is measured. Any distance of 2mm or greater is a retrolisthesis. This measurement represents the degree of translation (slippage) of the upper of the two segments.

Significance Retrolistheses are caused by injury and resulting instability of the connecting soft tissues
especially ligaments, discs, muscles, tendons and fascia. 

The tissues involved in retrolisthesis are:

• Ligaments - their function is to prevent excess movement between the bones they are attached to.
• Discs (space the vertebrae apart also prevents excess movement similar to ligaments.
• Fascia provides subliminal signalling to muscles, spreads injury impact loading.
• Muscle tone is required for correct postural and spinal balance. Muscle tone is a product of a properly functioning nervous system that is subluxation free. Sensible exercise within the limits of your injuries is important for the maintenance of proper tone.
• Spinal vertebrae - when they move far enough, especially backward, can cause direct pressure to nerves.
• Nerves need to function pressure free (irritation free) so they can control and co-ordinate all tissues, organs and systems of the body. The experience of life is made possible through nerve impulses. An irritated life is created through nerve irritation. 
  
  
   

For reference click here