Lumbosacral Structural Changes in Patients Presenting with Low Back Pain on LS X-Ray and Its Association with Clinical Symptoms

Abstract

Background: Low back pain is a common musculoskeletal complaint frequently evaluated with plain lumbosacral radiography, although the relationship between radiographic abnormalities and clinical symptoms remains uncertain. Objective: To assess lumbosacral structural changes on plain X-ray in patients with low back pain and determine their association with clinical findings and pain characteristics. Methods: This cross-sectional observational study was conducted in the Radiology Department of Gurkee Hospital, Lahore, and included 150 patients aged above 20 years presenting with low back pain and referred for lumbar spine X-ray. Demographic and clinical variables were recorded, including radiating pain, numbness/tingling, pain duration, onset, pain type, and pain severity. Radiographic assessment included disc space narrowing, osteophyte formation, spondylolisthesis, facet joint degeneration, sacroiliac joint changes, vertebral body deformity, and spinal level involvement. Data were analyzed using descriptive statistics and chi-square testing. Results: The mean age of participants was 46.8 ± 15.7 years, and 53.3% were male. Radiating pain to the legs was reported by 48.7%, while 51.3% had numbness or tingling. Vertebral body deformity was the most frequent radiographic finding (57.3%), followed by spondylolisthesis (53.3%). No statistically significant association was observed between the most prevalent radiographic findings and pain severity or pain duration. Conclusion: Lumbosacral structural changes are common in patients with low back pain, but plain X-ray findings alone do not reliably correspond to symptom severity or duration.