Radiological Assessment of Lumbar Spine Degeneration: Correlation with Age and Lumbar Level in Pakistani population

Lumbar Spine Degeneration and Age Correlation

Abstract

Objective: To evaluate the utility of X-rays in grading lumbar spine degeneration and its correlation with age and lumbar levels in the local Pakistani population to enhance diagnostic accuracy and management of low back pain

Methodology: This study examined 59 lumbar motion segments (L1-L5) from 13 male human cadavers aged 21-80 years. Ethical approval was obtained, and only segments without deformities, fractures, infections, or metastasis were included. Radiological degeneration scores were assigned based on osteophytes, sclerosis and disc height from X-rays.

Results: Radiological findings showed increased sclerosis and osteophyte formation with advancing age, while Schmorl’s nodes were observed in 16% of cases. Mean overall degeneration scores, along with sclerosis and osteophyte scores, correlated positively with both age and spinal level. Mean overall degeneration scores showed significant associations with age (p<0.001) and spinal level (p=0.001). Spearman’s rank correlation revealed significant increases in overall degeneration and osteophyte scores with age (p<0.001), whereas sclerosis showed a positive but non-significant association (Rho=0.7). A strong positive correlation was also found between spinal level and overall degeneration (p=0.01) as well as sclerosis scores (p=0.04). Osteophyte scores increased with spinal level (Rho=0.82) but without statistical significance (p=0.089).

Conclusion: Lumbar spine degeneration increased with age, with L5 most affected, while sclerosis and osteophytes progressed independently. Findings support X-rays as a reliable diagnostic tool, aligning with global studies and highlighting the need for further research on Modic changes and ethnic variations.