From the Guidelines
Your X-ray results indicate a common variation in spine structure and signs of age-related wear, which may be contributing to your back pain, but are also found in many people without symptoms. You have four lumbar vertebrae instead of the typical five, with your lowest vertebra (L5) partially fused to your sacrum (tailbone), a condition known as lumbosacral transitional anatomy 1. This variation is often asymptomatic and not a cause for concern. Your X-ray also shows degenerative changes throughout your lower back, with the most significant narrowing between your L2 and L3 vertebrae, where there's also a slight backward slippage of one vertebra on another, known as mild retrolisthesis. These findings are consistent with degenerative disc disease, a common condition that occurs naturally as we age due to wear and tear on the discs that cushion your spine 1.
Some key points to consider:
- Degenerative changes on lumbar imaging are usually considered nonspecific, as they correlate poorly with symptoms 1.
- Many people have similar findings without pain, and treatment should focus on managing symptoms and improving quality of life.
- Treatment typically includes physical therapy, pain management, and sometimes anti-inflammatory medications, as well as maintaining good posture, regular exercise to strengthen core muscles, and weight management to help reduce symptoms and prevent worsening 1.
- It's essential to note that routine imaging provides no clinical benefit in acute uncomplicated low back pain, and imaging should only be considered if there are red flags or if conservative treatment has failed 1.
In your case, the X-ray results provide useful information about the structure of your spine, but the focus should be on managing your symptoms and improving your quality of life, rather than solely on the imaging findings 1.
From the Research
Explanation of Lumbar Spine X-ray Results
The lumbar spine X-ray revealed several key findings that are important to understand:
- Lumbosacral transitional anatomy with 4 lumbar-type vertebral bodies and partial sacralization of L5, which means that the lower spine has an extra vertebra and the L5 vertebra is partially fused to the sacrum 2, 3.
- Multilevel degenerative changes, particularly in the lower lumbar spine, which indicates wear and tear on the spine 4, 3.
- Significant intervertebral disc space narrowing at L2-L3, which suggests that the disc between these two vertebrae is degenerating and may be causing pain or discomfort 4, 3.
- Mild retrolisthesis at L2-L3, which means that one of the vertebrae is slightly out of place and is putting pressure on the surrounding discs and nerves 4, 3.
Implications of Findings
These findings suggest that the patient may be experiencing back pain due to the degenerative changes in the spine, particularly at the L2-L3 level 4, 2, 3. The presence of a lumbosacral transitional vertebra may also be contributing to the degeneration of the adjacent discs 2, 3. However, it's worth noting that some of these findings may be considered benign or clinically unimportant, and may not necessarily be causing symptoms 5.
Next Steps
The patient should discuss these findings with their doctor to determine the best course of action for managing their back pain. This may involve further testing, physical therapy, or other treatments to address the underlying causes of the pain 4, 2, 3. Additionally, the patient should be aware that some of the findings on the X-ray may be incidental and not necessarily related to their symptoms 5, 6.