Which statement best describes the degenerative spondylolisthesis?

• A. It results from facet joint and disc degeneration, common in older patients.
• B. It results from pars interarticularis defect and stress fracture, common in younger patients.
• C. It is caused by inflammation of lumbar muscles.
• D. It is never associated with older patients.

Answer: (D)

Degenerative spondylolisthesis happens when the joints and discs at the back of the spine wear down with age. As the facet joints become arthritic and the intervertebral discs lose height and function, one vertebra can slip forward over the one below. This pattern fits older adults, where wear-and-tear changes are common, and it often affects the lower lumbar levels, especially around L4–L5. The slippage is usually gradual and may be associated with back pain or neurogenic claudication if the canal narrows.

In contrast, a defect in the pars interarticularis causing a stress fracture is typical of isthmic spondylolisthesis and is more common in younger patients, such as athletes. Inflammation of lumbar muscles is not the cause of spondylolisthesis, and it’s not accurate to say this condition never occurs in older people, since degenerative spondylolisthesis is a classic age-related form.