Retrolisthesis
Retrolisthesis | |
---|---|
Grade 1 retrolistheses of C3 on C4 and C4 on C5 | |
Specialty | Orthopedics |
A retrolisthesis is a
Retrolistheses are found most prominently in the
Classification
Retrolisthesis can be classified as a form of spondylolisthesis, since spondylolisthesis is often defined in the literature as displacement in any direction.[1][2] Yet, medical dictionaries usually define spondylolisthesis specifically as the forward or anterior displacement of a vertebra over the vertebra inferior to it (or the sacrum).[3][4] Retrolisthesis is also called retrospondylolisthesis.[5]
Signs and symptoms
Retrolisthesis may lead to symptoms of greatly varying intensity and distribution. This is because of the variable nature of the impact on nerve tissue and of the mechanical impact on the spinal joints themselves.[citation needed]
Structural instability may be experienced as a local uneasiness through to a more far reaching structural compensatory distortion involving the whole spine. If the joints are stuck in a retrolisthesis configuration there may also be changes to range of motion.[citation needed]
Pain may be experienced as a result of irritation to the sensory nerve roots by bone depending on the degree of displacement and the presence of any rotatory positioning of the individual spinal motion segments. The soft tissue of the disc is often caused to bulge in retrolistheses. These cannot be determined by plain films, as the x-ray passes through the soft tissue. A study by Giles et al., stated that sixteen of the thirty patients (53%) had retrolisthesis of L5 on S1 ranging from 2–9 mm; these patients had either intervertebral disc bulging or protrusion on CT examination ranging from 3–7 mm into the spinal canal. Fourteen patients (47%) without retrolisthesis (control group) did not show any retrolisthesis and the CT did not show any bulge/protrusion. On categorizing x-ray and CT pathology as being present or not, the well positioned i.e. true lateral plain x-ray film revealed a sensitivity and specificity of 100% ([95% Confidence Interval. = [89%–100%]) for bulge/protrusion in this preliminary study.” (7)[citation needed]
Spinal cord compressions are also possible with patients experiencing pain, rigidity and neurologic signs that may follow some distance along nerves to cause symptoms at some distance from the location of the retrolisthesis.[citation needed]
Diagnosis
Complete Retrolisthesis - The body of one vertebra is posterior to both the vertebral body of the segment of the spine above as well as below.[citation needed]
Stairstepped Retrolisthesis - The body of one vertebra is posterior to the body of the spinal segment above, but is anterior to the one below.[citation needed]
Partial Retrolisthesis - The body of one vertebra is posterior to the body of the spinal segment either above or below. (3)[citation needed]
Grading
Since the vertebral body in a retrolisthesis moves in a posterior direction, the grading used for spondylolistheses is of little use. It is however useful to divide the anterior to posterior dimension of the
Retrolistheses can be caused by injury[citation needed] and the resulting instability of the connecting soft tissues especially ligaments, discs, muscles, tendons and fascia. They may also involve muscles through spasm as a result of nerve malfunction due to pressure caused by the posterior displacement of the vertebra encroaching on the contents of the IVF. The IVF's contents include spinal (sensory and motor) nerves, arteries, veins and lymphatic vessels which cater to the nutritional and waste removal needs of the spinal cord.[citation needed]
Degenerative spinal changes are often seen at the levels where a retrolisthesis is found. These changes are more pronounced as time progresses after injury, and are evidenced by end plate osteophytosis, disc damage, disc narrowing,
Associated radiological findings include a vacuum phenomenon (in the nucleus pulposis of the adjacent intervertebral disc), reduction of disc height with corresponding loss of the disc space, marginal sclerosis of the adjacent vertebral bodies,
Joint stability
Joint stability is easily evaluated by the use of
Translation is a gliding motion where one bone of a joint glides over its neighbour.[citation needed]
Management
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References
- ISBN 9781416033721.)
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: CS1 maint: multiple names: authors list (link - ISBN 9780323222723.)
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: CS1 maint: multiple names: authors list (link - ^ "spondylolisthesisplay". Merriam-Webster medical dictionary. Retrieved 2017-09-07.
- ^ "spondylolisthesis". Farlex medical dictionary. Retrieved 2017-09-07., in turn citing:
- Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. Copyright date 2003
- Dorland's Medical Dictionary for Health Consumers. Copyright date 2007
- The American Heritage Medical Dictionary. Copyright date 2007
- Mosby's Medical Dictionary, 9th edition
- McGraw-Hill Concise Dictionary of Modern Medicine. Copyright date 2002
- Collins Dictionary of Medicine. Copyright date 2005
- ISBN 978-1-4160-6257-8.
- 6. Hadley, Lee A. (MD), (1973) “Anatomicoroentgenographic Studies of the Spine”. 390.
- 7. Cocchiarella L., Andersson, G. “American Medical Association Guides to the Evaluation of Permanent Impairment”, 5th edition, Tables 15- 3, 15-4, 15-5.
- 8. Giles, L.G.F.; Muller R.; and Winter G.J. (2006) “Lumbosacral disc bulge or protrusion suggested by lateral lumbosacral plain x-ray film – preliminary results.” Journal of Bone and Joint Surgery. British Volume, Vol 88-B, Issue SUPP_III, 450.