Which imaging finding is commonly associated with degenerative spondylolisthesis at L4?

• A. Central canal stenosis and neurogenic claudication
• B. Osteoporosis
• C. Scoliosis
• D. Discitis

Answer: (A)

Degenerative spondylolisthesis at L4 typically produces forward slippage of one vertebra over the one below, and that slip narrows the spinal canal. This central canal narrowing compresses nerve roots, which is what leads to neurogenic claudication—leg pain or cramping with walking that improves with rest or bending forward. On imaging, you’d look for signs of canal narrowing at the affected level along with the slippage and degenerative changes in the facets and discs that accompany this condition.

Osteoporosis isn’t a direct imaging hallmark of the slip itself, though it can predispose to fractures. Scoliosis can appear with degenerative changes, but it’s not the characteristic imaging finding that defines degenerative spondylolisthesis. Discitis is an infection, which shows different imaging features like endplate destruction and disc space changes, not the stenosis pattern seen with this condition.