J Korean Neurosurg Soc.  2015 Mar;57(3):178-184. 10.3340/jkns.2015.57.3.178.

Retrolisthesis as a Compensatory Mechanism in Degenerative Lumbar Spine

• Jeon I
• Kim SW

• KMID: 2191218
• DOI: http://doi.org/10.3340/jkns.2015.57.3.178

Abstract

OBJECTIVE
Posterior vertebral translation as a type of spondylolisthesis, retrolisthesis is observed commonly in patients with degenerative spinal problems. Nevertheless, there is insufficient literature on retrolisthesis compared to anterolisthesis. The purpose of this study is to clarify the clinical features of retrolisthesis, and its developmental mechanism associated with a compensatory role in sagittal imbalance of the lumbar spine.
METHODS
From 2003 to 2012, 230 Korean patients who underwent spinal surgery in our department under the impression of degenerative lumbar spinal disease were enrolled. All participants were divided into four groups : 35 patients with retrolisthesis (group R), 32 patients with simultaneous retrolisthesis and anterolisthesis (group R+A), 76 patients with anterolisthesis (group A), and 87 patients with non-translation (group N). The clinical features and the sagittal parameters related to retrolisthesis were retrospectively analyzed based on the patients' medical records.
RESULTS
There were different clinical features and developmental mechanisms between retrolisthesis and anterolisthesis. The location of retrolisthesis was affected by the presence of simultaneous anterolisthesis, even though it predominantly manifest in L3. The relative lower pelvic incidence, pelvic tilt, and lumbar lordosis compared to anterolisthesis were related to the generation of retrolisthesis, with the opposite observations of patients with anterolisthesis.
CONCLUSION
Retrolisthesis acts as a compensatory mechanism for moving the gravity axis posteriorly for sagittal imbalance in the lumbar spine under low pelvic incidence and insufficient intra-spinal compensation.

Keyword

Spondylolisthesis; Retrolisthesis; Sagittal imbalance; Lumbar spine

MeSH Terms

Animals
Axis, Cervical Vertebra
Compensation and Redress
Gravitation
Humans
Incidence
Lordosis
Medical Records
Retrospective Studies
Spinal Diseases
Spine*
Spondylolisthesis

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