<b>Role of Spinal X Ray in Obese and Non-Obese Patients Presenting with Backache Between the Ages of 18-35 Years Old in Pakistan</b>

Background: Low back pain (LBP) is a leading cause of disability worldwide, with obesity recognized as a major risk factor for both symptom severity and early degenerative spinal changes. In resource-limited settings, where MRI access is restricted, plain radiography remains a primary diagnostic tool, yet comparative data on radiographic abnormalities between obese and non-obese young adults are scarce. Objective: To assess the prevalence and pattern of lumbar spine abnormalities on plain radiography among obese and non-obese adults aged 18–35 years presenting with LBP in Pakistan, and to examine the association between obesity status and abnormal findings. Methods: A cross-sectional observational study was conducted on 82 consecutive patients undergoing lumbar spine X-ray at a tertiary hospital. BMI classification followed WHO criteria. Standard anteroposterior and lateral views were interpreted independently by blinded radiologists. The association between obesity status and abnormal findings was analyzed using Chi-square tests, with odds ratios (OR) and 95% confidence intervals (CI) calculated. Results: Abnormal findings were observed in 61 patients (74.4%), more frequently in obese (86.7%) than non-obese (67.3%) individuals (p = 0.036; OR 3.44, 95% CI 1.07–11.07). Muscle spasm, disc space narrowing, and osteophytes were the most common abnormalities. Conclusion: Obesity is significantly associated with a higher prevalence of lumbar spine abnormalities in young adults with LBP. Plain radiography provides clinically valuable early detection in this population.