What is Lumbar Spondylosis?

Wondering what exactly is the meaning of lumbar spondylosis? Lumbar spondylosis is a term commonly used to describe the degenerative changes in the spine, associated with ageing.

Everyone of us has suffered from back pain at one point or another. Globally it remains one of the most important causes of loss of work and disability. If you have undergone MRI for back pain, there is high chance that your report would have term “Lumbar spondylosis” written in it multiple times. Lumbar spondylosis is a loosely used term for most back pains. That is why it is important to know the exact meaning of Lumbar spondylosis.

What is the exact meaning of lumbar spondylosis?

Lumbar spondylosis is used to describe degenerative changes in the spine associated with ageing, or certain factors that increase stress on the spine. Lumbar spondylosis prevalence is very high, and roughly 80% of adults will be affected by these degenerative changes.

Spondylosis occurs at all levels of the spine, but is commonest in the lumbar spine. 

Is lumbar spondylosis a disease?

Lumbar spondylosis is not a disease. These are normally occurring changes that are associated with ageing, just like osteoarthritis in knee joints. A common example is skin. As we grow up, we can see more and more wrinkling, thinning and roughening of skin. Just like the skin all organs in the body undergo changes with age, and spine is no exception. These changes are inevitable, and the changes keep progressing with time. However, certain factors are associated with an increased rate of degeneration, like obesity, abnormal posture, and disc herniation. So an obese person at 40 years of age may have degenerative changes like those seen in persons at 50 years of age.

What are the changes that our spine undergoes with ageing?

Vertebrae in our spine are connected to the vertebra above and below at facet joints, and in front a disc, which acts like a cushion separating two adjacent vertebrae. With time the facet joints lose their lubrication and get damaged. The damage increases with repeated movements. This is the reason why mobile segments of our spine like cervical and lumbar spine are more affected as compared to relatively immobile thoracic segments of the spine. 

Ageing also causes loss of disc hydration and cushioning effect. When the intervertebral disc is damaged, or removed surgically for disc prolapse, it increases stress on the joints and increases rate of degeneration. Similarly factors like obesity or abnormal posture also increase stress on the spine joints. 

What are the symptoms of lumbar spondylosis?

Lumbar spondylosis per se does not cause any symptoms. However, back pain is often attributed to it. Roughly 80% of adults over 40 years of age will have lumbar spondylosis changes on radiology. On the other hand, not all individuals with these radiological changes will have back pain. 

What x-ray changes are seen in the spondylotic spine?

Over time new bone formation occurs at areas of insertion of ligaments into bones. These bony protuberances are called osteophytes. These are the most easily recognisable changes on radiology. Some clinicians attributed pain to these osteophytes, but it is not so. Osteophytes are mostly asymptomatic. Sometimes osteophytes growing  towards the foramen carrying nerve roots may impinge and cause pressure effects, presenting as pain along the distribution of that nerve root, called sciatica. 

Disc space height reduces with age, and facet joints become larger. These changes also do not produce any symptoms, unless they compress the nerve roots. The discs between the vertebral bones also show reduction of their water content, called desiccation. This is commonly picked up on MRI.

What is the treatment of lumbar spondylosis?

Lumbar spondylosis does not require any treatment. It is inevitable with ageing. The rate of degeneration can be slowed by regular exercise, weight control and maintenance of physiological posture of the spine. These precautions reduce excess stress on the spinal joints. 

How is it different from Lumbar Spondylolysis?

Lumbar spondylolysis or medically also known as Spondylolisthesis is a specific cause of back pain. It is caused by a defect in the pars of the vertebra which joins the anterior body with the posterior bony structures of the vertebra. This defect results in relative motion of one vertebral body over another, causing back pain. It can be diagnosed on plain X-ray films, with bending forward and backward views showing relative motion. Since the exact mechanism of the pain is known in such cases, surgical stabilisation will yield good results in such patients. 

Other common lumbar spine problems- Sciatica, MIS Lumbar decompression for Lumbar canal stenosis, L5S1 Lumbar microdiscectomy for disc prolapse

Disclaimer- This is for the general awareness of the patients and cannot replace expert medical advice. Patient treatments need to be individualised and that can be decided based on clinical examination and evaluation by a trained physician.

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