How is spinal retrospondylolisthesis of l4-l5 managed?

Spondylolisthesis: What is the cause? Usually if associated with pain a progressive functional physical therapy program is used. If no pain we do nothing as you don't treat the x-ray or mri. We treat the symptoms.

Depends on symptoms: Retrolisthesis occurs from degenerative changes in the disc and facet joints of the spine. It is generally considered more stable than a forward slippage and therefore a fusion is not always recommended if you are having nerve pain. Instead a simpler laminectomy can be done. If the slippage is significant leading to narrowing of the nerve exits (foramen), then a fusion is sometimes warranted.