Weekly Image Challenge – April 23, 2022

Which of the following statements best describe the images?

  1. L3-4 non-dynamic spondylolisthesis & L1 to L5 stenosis
  2. L3-4 dynamic spondylolisthesis & L1 to L5 stenosis
  3. Degenerative lumbar spine with multi-level stenosis
  4. Degenerative spine with non-dynamic spondylolisthesis at L3-4 & mild stenosis
  5. L1 to L5 spondylolisthesis and stenosis


Congratulations to those who had chosen option B – L3-4 dynamic listhesis and L1-L5 stenosis.

The L3 and L4 vertebrae are not aligned like other levels, and this is called spondylolisthesis, or simply listhesis. There is movement of vertebra at L3-4 on comparison of flexion and extension X-ray. Hence, it is dynamic listhesis. The MRI sagittal section T2-weighted image shows multi-level stenosis due to disc bulge as well as ligamentum flavum hypertrophy. The axial section of one of the level shows complete obliteration of central canal, lateral recess and the neural foramina. This signifies severity of spinal stenosis.