Anterolisthesis and retrolisthesis can be very painful disorders. Fortunately, chiropractic care is an available treatment.
What are Anterolisthesis and Retrolisthesis?
Anterolisthesis is really a type of spondylolisthesis that refers to the forward slippage of the vertebra. Backward slippage is called retrolisthesis.1 The vertebrae of the spine not only protect the spinal cord, but they have spaces for nerves to pass through them so that the rest of the body is connected to the spinal cord. Sometimes, the spine is not properly aligned. Anterolisthesis is graded on a 1-4 scale, from 20% to 100% slippage. Symptoms can range from having trouble with the sensations of temperature and position, to the loss of bladder and bowel control, to poor posture and pain. Anterolisthesis is often due to bone fractures.2 Retrolisthesis is also a type of spondylolisthesis, where the vertebra moves backward. This can happen when the discs that cushion and separate the vertebrae rupture or deteriorate. Symptoms of retrolisthesis include stiffness, numbness, and chronic back pain. Most vertebral slippage concerns the forward movement, but the backward movement of retrolisthesis, while not as common, is still a factor in patients with degenerative diseases, such as arthritis, and for those with severe back injuries. Retrolisthesis is most likely to occur in the cervical vertebrae of the neck.3 Anterolisthesis is most often found in the 4th and 5th lumbar vertebrae.4
Doctors may take X-rays or use MRI to demonstrate the anterolisthesis. Some of the medical treatments can include “interbody fusion and surgical instrumentation”. In interbody fusion surgery, doctors remove a disc from between vertebrae and then fuse the vertebrae together. The fusion occurs with pedicle screws and bone grafting.5 Pain medications, physical therapy, and also surgery may be medical treatments recommended for retrolisthesis.6 Conservative treatments for anterolisthesis can include rest and physical therapy, but some doctors proceed immediately with surgery. Surgery carries the risks of nerve damage or infection.7
Chiropractic Care for Spondylolisthesis
Before taking medication or having surgery, patients with spondylolisthesis can seek chiropractic care. Rest and activity restriction can be part of the early treatment. Patients can be taught corrective exercises for their posture issues that resulted from spondylolisthesis. Exercise will help patients support their back better, especially for lumbar (lower back) muscles. Patients can work on their general fitness, and they can use “heavy-duty elastic tubing (for) isotonic resistance exercises”. Some patients may benefit from orthotics, especially if they have low arches or flat feet. It is important to strengthen the spine and improve stability. “Spinal stabilization exercises” include abdominal bracing, lower abdominal hollowing, and posterior pelvic tilt. Particular chiropractic manipulations that may help spondylolisthesis include side-posture manipulations, adjustments below or above the misaligned segment, flexion-distraction, and sacroiliac (SI) joint adjustments.8 Other chiropractic treatment options for spondylolisthesis include electrical stimulation, ultrasound, trigger point therapy, and instrument-assisted soft tissue therapy and manipulation.9
Find out more about chiropractic therapy for spondylolisthesis.