Retrolisthesis: When a Vertebra Slips Backward Instead of Forward
When discussing slipped vertebrae in the spine, most clinical attention centers on
spondylolisthesis—a condition where an upper vertebra slips forward over the bone beneath it.
However, a less common condition called retrolisthesis occurs when a vertebral body slips backward
relative to the adjacent spinal segment below.
Though less frequently discussed, retrolisthesis can lead to localized back pain, joint
instability, and nerve compression that requires specialized spine evaluation.
Causes and Mechanisms of Retrolisthesis
Retrolisthesis occurs primarily in the cervical (neck) and lumbar (lower back) regions, where
spinal flexibility is highest. The primary factors contributing to backward slippage include:
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Degenerative Disc Disease: Significant loss of spinal disc height causes the space between vertebrae to collapse. As the disc thins, the alignment of the posterior facet joints shifts, allowing the upper vertebra to slide backward.
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Facet Joint Instability: Arthritic degradation or ligament laxity within the stabilizing joints at the back of the spine reduces their ability to hold the alignment of the spinal column.
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Spinal Trauma or Osteopenia: Prior injury or structural weakness in the pedicles and vertebral endplates can permit backward displacement.
Recognized Symptoms of Retrolisthesis
Symptoms depend on the degree of slippage and whether surrounding nerve tissue is compressed:
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Localized Structural Pain: Deep, aching back or neck pain aggravated by motion, standing, or extending the spine backward.
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Nerve Impingement (Radiculopathy): As the vertebra slips backward, it narrows the intervertebral foramina—the exit passages for spinal nerves. This causes sharp, radiating pain, numbness, or tingling into the arms (cervical) or legs (lumbar).
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Spinal Canal Stenosis: Severe retrolisthesis can encroach on the central spinal canal, leading to neurogenic claudication or cord compression.
Management and Surgical Interventions
Initial treatment focuses on relieving symptoms through interventional pain management, targeted
therapeutic regimens, and activity modification.
When retrolisthesis causes progressive instability, severe mechanical pain, or persistent nerve
compression, surgical intervention may be recommended. Spine surgeons utilize decompression and
spinal fusion techniques (such as TLIF, PLIF, or anterior approaches) to reposition the bone,
restore disc height, and permanently stabilize the spinal segment.
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Book Online: Visit igeaneuro.com to request a comprehensive diagnostic consultation with our neurosurgical team.
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Call Our Team Today: Speak directly with our dedicated patient care coordinators at (866) 467-1770.
