What Is Lumbar Retrolisthesis?

This post was written with Consensus AI Academic Search Engine – please read our Disclaimer at the end of this article. Lumbar retrolisthesis is a condition characterized by the backward displacement of a vertebra relative to the vertebra below it. This condition can lead to various clinical symptoms and is often associated with degenerative changes in the spine. Understanding the radiographic characteristics and developmental mechanisms of lumbar retrolisthesis is crucial for accurate diagnosis and effective treatment.

Radiographic Characteristics

Lumbar retrolisthesis can occur under different pelvic incidences (PI), which is a measure of the pelvic orientation. A study examining 887 subjects found that lumbar retrolisthesis can occur under both low-grade and high-grade PI. Specifically, 78 patients were identified with degenerative lumbar retrolisthesis, with 54 patients having a low-grade PI (Group L) and 24 patients having a high-grade PI (Group H)1.

In terms of radiographic features, 91.4% of patients in Group H exhibited a type 4 sagittal construction according to the Roussouly classification, while 92.6% of patients in Group L had a type 1 sagittal construction. The retrolisthesis in Group H was located approximately two vertebrae higher and had a larger backward slope compared to Group L. Additionally, patients with retrolisthesis under high PI showed significantly greater thoracolumbar kyphosis (TLK), sacral slope, sagittal vertical axis, T1 pelvic angle, and more severe disc degeneration and facet arthritis compared to the control group1.

Developmental Mechanism

The development of lumbar retrolisthesis, particularly under high-grade PI, is influenced by several factors. The increased backward sliding forces at the hypertilted vertebra in the large TLK segment and lumbar instability caused by disc degeneration and facet arthritis are primary contributors. Logistic regression analysis identified TLK as an independent factor predicting the development of retrolisthesis under a high-grade PI1.

Conclusion

Lumbar retrolisthesis is a complex condition influenced by pelvic incidence and other spinal parameters. The condition is more severe and located higher in the spine under high-grade PI, with significant associations with thoracolumbar kyphosis, disc degeneration, and facet arthritis. Understanding these characteristics and mechanisms is essential for developing targeted treatment strategies.

Disclaimer

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