The medical term "retropulsion" is used to describe two different phenomena, both of which refer to something being pushed or forced backwards. In the first sense, it is a gait abnormality most commonly seen in Parkinson's disease patients, where people involuntarily take a step or take a step back. 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. Treatments are available for these medical problems.
In patients with Parkinson's disease, various gait and balance abnormalities can be seen as a result of progressive damage to the brain. It is not possible to reverse it, but medications can be used to lessen the damage. Patients may also benefit from walking aids and physical therapy to help them develop better balance. A major concern with Parkinson's is the increased susceptibility to falls and the subsequent damage associated with falls, such as hip fractures. Keeping patients as stable as possible while standing can limit fracture risk and help patients complete daily tasks more effectively.
Patients often exhibit retropulsion when they recoil naturally, as seen when a patient steps back from a mirror and stumbles, or loses balance. Patients may inadvertently fall or recoil when pushed or colliding 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 very poor and the body has difficulty correcting balance disturbances.
Retropulsed bone fragments in vertebral fractures can be a cause for concern. They can affect the spinal cord, which can cause 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 such as retropulsion. If bone fragments have been displaced, surgery may be necessary to address the problem.
At surgery, the bone fragments associated with spinal retropulsion can be carefully removed and the fractured bone can be stabilized. A bone may need to be fused or fixed with external fixators. Patients can discuss treatment options with a spine surgeon after they have been fully evaluated to understand the extent of their injuries. If a person with a spinal injury is incapacitated, a designated representative may make treatment and care decisions while medical staff work to stabilize the patient.