Grade 1 retrolisthesis of l4 and l5

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Retrolisthesis: Types, causes, and symptoms

Frequently Asked Questions. Easy Exchanges. Free Shipping on U. View Cart 0 Items. View All Braces. Back Low Back Pain Spondylolisthesis. Do I Have Grade 1 Spondylolisthesis? Take our quiz, then try the 5 easy ex It can sap your energy and leav Customer Support Our customer support team is available Monday - Friday from a. Holidays BraceAbility.

An Overview of Degenerative Retrolisthesis

Degenerative retrolisthesis, if left untreated, can have serious neurological manifestations. It can lead to permanent numbness and weakness in the area intervened by the affected nerve root. It can limit mobility and can affect the ability to carry out daily functions and activities. If left untreated, degenerative retrolisthesis can also lead to bulged disc and disc herniation. An experienced orthopaedist evaluates the condition of degenerative retrolisthesis.

Retrolisthesis: What You Should Know

A physical examination of the spine is done along with taking a detailed patient history. Intervention by pain management specialist or chiropractor is required to manage the pain and discomfort caused by degenerative retrolisthesis. The treatment protocol includes:. It is advised to stay physically active and exercise on a regular basis to avoid degenerative retrolisthesis.

Physical activities help in maintaining the spine flexibility. A number of home exercises are recommended for improving and preventing degenerative retrolisthesis. These include simple stretching exercises followed by neck rolls, shoulder rolls and hip rolls and also isolation movements of each body parts to keep them active. For obtaining better results, one can take heat compress or warm shower. Special exercises may be recommended by the physician or physiotherapist based on the type and grade of degenerative retrolisthesis.

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Degenerative retrolisthesis is a bone disorder characterized by posterior displacement of the vertebral body causing pain and discomfort over the back. It affects the neck more commonly than the other lower portions of the spine. It is commonly seen with increased aging, as the incidence of rupture of spinal disc increases with aging. As the disc ruptures, the vertebrae above lose support and bulges outward. It can cause nerve compression and cause numbness and tingling in the extremities.

Spondylolisthesis L4-L5, L5-S1, Spondylolysis, Spondylolisthesis Treatment, Exercises- LOW BACK PAIN

If left untreated degenerative retrolisthesis can lead to permanent deformities. Intervention by chiropractor, pain management specialist and physical therapist is beneficial. Physical therapy is often recommended. In extreme cases, surgical intervention may be required. It is advised to follow a healthy lifestyle, exercise regularly, maintain appropriate posture and follow correct ergonomics at work place for preventing development of degenerative retrolisthesis. This article contains incorrect information.

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Log into your account. However, he has begun to develop left leg weakness. He is faithful with his exercise regimen and naproxen usage mg twice a day. Physical Examination at 3 Weeks He transfers to and from the exam table without difficulty or protective guarding. Sensation is intact to light touch throughout.

The Resolution of Grade I Lumbar Retrolisthesis with Prolotherapy: A Case Study

With repetitive single leg calf raises, there was definite subjective sense of weakness in the left leg compared with the right. The patient is offered selective nerve root injections or surgical consultation, and declines both. He is instructed to continue his home exercise regimen and naproxen.

If weakness progresses or pain worsens, a left L5 selective nerve root block will be performed. The patient is pain-free and has not needed non-steroidal anti-inflammatory drugs NSAIDs in the past 2 weeks. He has been working closely with his physical therapist and participated in some aquatic therapy. Occasionally, when ambulating upstairs, he has a sensation that his quadriceps are somewhat tired, but he has no detectable weakness on physical examination.

He does not trip or fall. Nerve root tension signs and SI joint and lumbar discogenic provocative maneuvers are negative bilaterally. Other neurological tests are normal. At 6-month follow-up, the patient reports he has experienced no pain in more than 3 months and has returned to usual activities, including motorcycling.

His pain relief and complete functional recovery has persisted for a 6-year follow-up interval. He has not found it necessary to take naproxen for pain. He is also working full-time and full-duty as a fluoroscopy technician without discomfort or limitations. Michael J. DePalma, MD Associate Professor Department of Physical Medicine and Rehabilitation Virginia Commonwealth University Medical College of Virginia Hospitals Richmond, Virginia This case illustrates a not too uncommon story for discogenic lumbar radiculopathy, whereby a patient who experiences intermittent axial low back pain, aggravated by prolonged sitting, eventually develops lower limb radicular pain.

His initial exam suggested involvement of an anterior column component. However, his subsequent examination after onset of left lower limb pain suggests nerve root involvement as dural tension reproduced his radicular leg pain. The acuity of straight leg raises has been shown to correlate with the presence of increased inflammatory markers at the nerve root-annular interface.

His imaging studies reveal multiple regions to explain injury of either the L5 or S1 nerve roots giving rise to his lower limb symptomatology. Given the acute onset of the leg pain after persistent central low back pain, without a clearly defined exacerbation of the leg pain with prolonged standing and walking, the L4-L5 intervertebral disc extrusion is the likely etiology for his left L5 or S1 radiculopathy or combination of both.

His plain films do not suggest sacralized L5 transitional anatomy, so it is less likely that he has one single nerve root involvement presenting as the other or both. Fortunately, for this patient, his symptoms improved with just functional restoration utilizing physical therapy to address spinal biomechanics and lower limb myotomal deficits and oral NSAIDs. An appropriate additional therapeutic intervention would have been 1 to 4 therapeutic selective nerve root blocks or transforaminal epidural steroid injections.


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The instillation of corticosteroid along the nerve root can effectively reduce disc herniation—related inflammation of the affected nerve root, while the body naturally resorbs the herniated nucleus pulposus. In addition to the diagnostic imaging studies, an electrodiagnostic evaluation could have added information about what type and the severity of the nerve root dysfunction. Jason M. It underscores the importance of NSAIDs, activity modification, and aggressive physical therapy as a primary course of treatment.

We would expect the patient to respond within 6 weeks, if therapy was going to be effective. Fortunately, for this young man, that was the case. However, the weakness he experienced after starting formal therapy is quite alarming. Had this patient gone for surgical consultation at that point as offered, I suspect most surgeons would have recommended a decompression and stabilization. The fact that his back pain, radicular leg pain, and strength all improved is surprising. I would suspect weight loss played a significant role in his recovery as well. Zaman's Response Dr. DePalma and Dr. Highsmith both make excellent points regarding the case above, and I agree with both wholeheartedly.


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