Spine: degenerative spondylolisthesis: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Spine: degenerative spondylolisthesis

Sample item

A 62-year-old woman has back pain and leg pain on walking relieved by sitting. A radiograph shows forward slip of L4 on L5 with an intact pars interarticularis. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Degenerative spondylolisthesis

Degenerative spondylolisthesis occurs in older adults, more in women, most commonly at L4-L5, because of facet joint and disc degeneration with an intact pars. It narrows the canal and causes neurogenic claudication. Isthmic slips occur at L5-S1 through a pars defect and present earlier.

Option by option

  • A. Degenerative spondylolisthesis (correct)

    Correct. An intact pars with an L4-L5 slip in an older woman is degenerative.

  • B. Traumatic spondylolisthesis

    Traumatic slips follow fractures of the posterior elements.

  • C. Isthmic spondylolisthesis

    Isthmic slips have a pars defect and are commonest at L5-S1.

  • D. Dysplastic spondylolisthesis

    Dysplastic slips are congenital and occur in the young.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Degenerative spondylolisthesis. Degenerative spondylolisthesis occurs in older adults, more in women, most commonly at L4-L5, because of facet joint and disc degeneration with an intact pars.

Why is "Traumatic spondylolisthesis" not the answer?

Traumatic slips follow fractures of the posterior elements.

Why is "Isthmic spondylolisthesis" not the answer?

Isthmic slips have a pars defect and are commonest at L5-S1.

Why is "Dysplastic spondylolisthesis" not the answer?

Dysplastic slips are congenital and occur in the young.

What concept does this question test?

It tests Spine: degenerative spondylolisthesis in Orthopaedics. It narrows the canal and causes neurogenic claudication. Isthmic slips occur at L5-S1 through a pars defect and present earlier.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Spine: degenerative spondylolisthesis?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.