Clinico-radiologic patterns and BMI association in degenerative disease of the lumbosacral spine: A retrospective MRI study from a tertiary care hospital in Pakistan.

Abstract

Objective: To assess the clinico-radiologic patterns of lumbar spine degeneration as seen on MRI and to examine their association with different BMI categories among adult patients presenting with backache at a tertiary care hospital in Peshawar, Pakistan. Study Design: Retrospective study. Setting: LRH, Peshawar. Period: September 2022 to September 2024. Methods: Included 140 patients who reported lower back pain and underwent lumbosacral spine MRI. MRI findings were assessed at each spinal level and analyzed in relation to patients' BMI, which was classified according to WHO standards. Descriptive statistics, chi-square tests, and BMI-based distribution analyses were carried out. Results: The average age of participants was 41.8 years (SD = 13.3), with females making up 51% of the sample. The mean BMI was 28.6 kg/m² (SD = 4.98), and 68.5% of patients were either overweight or obese. MRI results showed a progressive increase in degenerative changes from the upper to the lower lumbar spine. The L4–L5 level exhibited the most frequent findings (72.1% diffuse bulge), followed by L5–S1 (28.6% diffuse bulge and 21.4% central herniation). Significant associations were observed between BMI and disc pathology at the upper lumbar levels, specifically at L1–L2 (p = 0.0207) and L2–L3 (p = 0.0048). No statistically significant correlation was found at the lower lumbar levels. Conclusion: Higher BMI appears to be linked with early-stage disc degeneration, particularly in the upper lumbar spine. Encouraging weight control and early lifestyle modifications may help reduce the burden of lumbar disc disease, especially in overweight and obese individuals.