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A 72 year-old man noted chronic low back pain, worst with standing and walking.
(Left) Mid-sagittal T1-weighted MRI; (Right) Mid-sagittal T2-weighted. Note the severe stenosis at the L4-L5 level. Also note that the L4 vertebral body is displaced anteriorly over L5. This is known as spondylolithesis. Spondylolithesis is graded as follows: Grade 1- up to 25% of the vertebral body; Grade 2 - 25 to 50% of the vertebra body; Grade 3 - 50 to 75% of the vertebral body; and Grade 4 - 75-100% of the vertebral body. This case is Grade 2.
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