Volume 3 | Issue 1 | April-September 2022 | page: 42-46 | Bharat R. Dave, Shivanand C. Mayi, Ajay Krishnan, Ramneesh Kohli, Devanand Degulmadi, Ravi Ranjan Rai, Mirant B. Dave
Authors: Bharat R. Dave , Shivanand C. Mayi , Ajay Krishnan , Ramneesh Kohli , Devanand Degulmadi , Ravi Ranjan Rai , Mirant B. Dave 
 Department of Spine Surgery, Stavya Spine Hospital & Research Institute, Mithakali, Ahmedabad, Gujarat, India.
Address of Correspondence
Dr. Shivanand C. Mayi,
Consultant Spine Surgeon, Stavya Spine Hospital & Research Institute, Mithakali, Ahmedabad, Gujarat, India.
Objectives: The objectives of this study was to test the primary hypothesis that “retrolisthesis causes supine lying low back pain (LBP).”
Methods: Patients with history of chronic back pain (>12 weeks) who presented to the hospital outpatient department were evaluated. Patients with history of supine lying exaggeration of symptoms were specifically asked for duration, for which they can comfortably lie in supine position. Retrolisthesis in this study was measured on MRI mid sagittal image by measuring the slip percent. Slip percent of more than 8% was labeled as retrolisthesis. Statistical analysis was done using SPSS software.
Results: Average age of the study population was 41.46 ± 10.82 years. All the study participants had the history of supine lying LBP for 50 ± 54.51 weeks. About 94.78% (n = 115) of the study subjects had retrolisthesis on MRI. About 46.08% (n = 115) were house wives. L5-S1 was the most commonly involved level, three patients had no instability, and three patients had anterolisthesis. Duration of time up to which the patients can lie down in supine position was not statistically significant when analyzed with the VAS values for supine lying LBP and the slip percent.
Conclusion: The presence of supine lying LBP in an individual should be strongly considered for the underlying subtle instability at the lumbar intervertebral segments and diagnostic evaluation should be performed to rule out retrolisthesis.
Keywords: Retrolisthesis, Low back pain, supine lying, Lumbar instability, Vertebral slippage, Lateral stenosis, Dynamic radiograph.
1. Rothman SLG, Glenn WV Jr., Kerber CW. Multiplanar CT in the evaluation of degenerative spondylolisthesis. A review of 150 cases. Comput Radiol 1985;9:223-32.
2. Lee C, Woodring JH, Rogers LF, Kim KS. The radiographic distinction of degenerative slippage (spondylolisthesis and retrolisthesis) from traumatic slippage of the cervical spine. Skeletal Radiol 1986;15:439-43.
3. Ahmed A, Mahesh BH, Shamshery PK, Jayaswal A. Traumatic retrolisthesis of the L4 vertebra. J Trauma 2005;58:393-4.
4. Barrey C, Roussouly P, Le Huec JC, D’Acunzi G, Perrin G. Compensatory mechanisms contributing to keep the sagittal balance of the spine. Eur Spine J 2013;22 Suppl 6:S834-41.
5. Berlemann U, Jeszenszky DJ, Bühler DW, Harms J. Mechanisms of retrolisthesis in the lower lumbar spine. A radiographic study. Acta Orthop Belg 1999;65:472-7.
6. Shen M, Razi A, Lurie JD, Hanscom B, Weinstein J. Retrolisthesis and lumbar disc herniation: A pre operative assessment of patient function. Spine J 2007;7:406 13.
7. Iguchi T, Wakami T, Kurihara A, Kasahara K, Yoshiya S, Nishida K. Lumbar multilevel degenerative spondylolisthesis: Radiological evaluation and factors related to anterolisthesis and retrolisthesis. J Spinal Disord Tech 2002;15:93-9.
8. Barrey C, Roussouly P, Perrin G, Le Huec JC. Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms? Eur Spine J 2011;20 Suppl 5:626-33.
9. Barrey C, Jund J, Perrin G, Roussouly P. Spinopelvic alignment of patients with degenerative spondylolisthesis. Neurosurgery 2007;61:981-6.
10. Deyo RA, Bass JE. Lifestyle and low-back pain. The influence of smoking and obesity. Spine 1989;14:501-6.
11. Videman T, Battie M. A critical review of the epidemiology of idiopathic low back pain. In: Weinstein JN, Gordon S, editors. Low Back Pain: A Scientific and Clinical Overview. Rosemont, IL: American Academy of Orthopaedic Surgeons; 1996. p. 637-41.
12. Vogt MT, Rubin D, Valentin RS, Palermo L, Donaldson WF 3rd, Nevitt M, et al. Lumbar olisthesis and lower back symptoms in elderly white women. The study of osteoporotic fractures. Spine 1998;23:2640-7.
13. Vogt MT, Rubin DA, Palermo L, Christianson L, Kang JD, Nevitt MC, et al. Lumbar spine listhesis in older African American women. Spine J 2003;3:255-61.
14. Sihvonen T, Lindgren KA, Airaksinen O, Manninen H. Movement disturbances of the lumbar spine and abnormal back muscle. Electromyographic findings in recurrent low back pain. Spine 1997;22:289-95.
15. Kang KK, Shen MS, Zhao W, Lurie JD, Razi AE. Retrolisthesis and lumbar disc herniation: A postoperative assessment of patient function. Spine J 2013;13:367-72.
16. Kim HS, Ju CI, Kim SW, Kang JH. Lying down instability undetected on standing dynamic radiographs. J Korean Neurosurg Soc 2015;58:560-2.
17. Capasso G, Maffulli N, Testa V. Inter and intratester reliability of radiographic measurement of spondlylolisthesis. Act Orthop Belg 1992;58:188-92.
18. White AA 3rd, Panjabi MM. Clinical Biomechanics of the Spine. 2nd ed. Philadelphia, PA: Lippincot Williams and Wilkins; 1990
19. Friberg O. Lumbar instability: A dynamic approach by traction-compression radiography. Spine 1987;12:119-29.
20. Hayes MA, Howard TC, Gruel CR, Kopta JA. Roentgenographic evaluation of lumbar spine flexion–extension in asymptomatic individuals. Spine 1989;14:327-31.
21. Dvorak J, Panjabi MM, Novotny JE, Chang DG, Grob D. Clinical validation of functional flexion-extension roentgenograms of the lumbar spine. Spine 1991;16:943-50.
22. Stokes IA, Frymoyer JW. Segmental motion and instability. Spine 1987;12:688-91.
23. Shaffer WO, Spratt KF, Weinstein J, Lehmann TR, Goel V. 1990 Volvo Award in clinical sciences. The consistency and accuracy of roentgenograms for measuring sagittal translation in the lumbar vertebral motion segment. An experimental model. Spine 1990;15:741-50.
|How to Cite this Article: Dave BR, Mayi SC, Krishnan A, Kohli R, Degulmadi D, Rai RR, Dave MB | A Prospective Study to Find Out the Association Between Supine Lying Low Back Pain and Retrolisthesis | Back Bone: The Spine Journal | April-September 2022; 3(1): 42-46.