Dynamic foraminal stenosis implies intermittent lumbar extension-provoked nerve root impingement, osteophytosis, and vertebral body slippage. Such dynamic stenosis with associated intermittent position-dependent symptoms may not manifest on imaging studies, thereby confounding diagnosis. Other factors promoting the development of LSS include shortened gestational age and synovial facet joint cysts with resulting radicular compression. Adult degenerative scoliosis, secondary to induced instability with subsequent vertebral rotation and asymmetric disk space narrowing, promotes facet hypertrophy and subluxation in the curve concavity. Degenerative spondylolisthesis, when combined with facet hypertrophy, causes central canal and lateral recess stenosis.