What is Retropulsion?

The medical term “retropulsion” is used to describe two different phenomena, both referring to something being pushed or forced backward. In the first sense, it is a gait abnormality most commonly observed in patients with Parkinson's disease, where people step or fall back involuntarily. The term can also refer to a specific problem seen in spinal burst fractures where fragments of the spine are forced into the spinal canal. There are treatments available for these medical issues.

In patients with Parkinson's disease, a number of gait and balance abnormalities can be seen as a result of progressive damage to the brain. It is not possible to reverse, but medications can be used to slow the damage. Patients can also benefit from walking aids and physical therapy to help them develop better balance. A big concern with Parkinson's is increased susceptibility to falls and the subsequent damages associated with falls, such as hip fractures. Keeping patients as stable as possible while on their feet can limit fracture risk and help patients complete daily tasks more effectively.

Patients often exhibit retropulsion when they are naturally stepping back, as seen when a patient steps back from a mirror and stumbles, or when pushed off balance. Patients can inadvertently fall or step backward when they are jostled or when they collide with an object. Retropulsion can be triggered by something relatively simple, like a rock on the ground, because the patient's sense of balance is so poor and the body has difficulty correcting for balance disturbances.

Retropulsed fragments of bone in spinal fractures can be a cause for concern. They can impinge upon the spinal cord, potentially causing nerve damage and other problems. When patients are evaluated for fractures, medical imaging studies are used to explore the extent of the damage and to check for complications like retropulsion. If fragments of bone have become displaced, surgery may be necessary to address the problem.

In surgery, the fragments on bone associated with spinal retropulsion can be carefully removed and the fractured bone can be stabilized. It may be necessary to fuse a bone or to set it with external fixators. Patients can discuss treatment options with a spinal surgeon after they have been fully evaluated to learn about the extent of their injuries. If a person with a spinal injury is incapacitated, a designed proxy can make decisions about treatments and care while medical personnel work to stabilize the patient.