Larger Lumbar Vertebral Body Osteophyte Volume Is Associated With Older Age and a More Caudal Vertebral Level in Individuals With Chronic Low Back Pain.

Background: Chronic low back pain (cLBP) is often accompanied by changes in lumbar spine bony morphology, including osteophyte growth. Knowledge of the volume and location of osteophytes could provide insight into habitual loading that may induce symptomatic disc degeneration and serve to guide treatment. The aim of this study was to develop an automated method to calculate osteophyte volume in lumbar vertebral bodies and to evaluate the relationships between osteophyte volume and vertebral level, age, and sex. Methods: Patients with cLBP received computed tomography (CT) scans of their entire lumbar spine. Lumbar bone models were created from the segmented CT scans. A Procrustes-based registration algorithm transformed vertebral bodies from a reference library of bones with no osteophytes to match the patient's vertebral bodies. The best-matched reference bone was then subtracted from the original bone to create a model of the osteophytes. Osteophyte volume and location were calculated from the model, and associations were explored between osteophyte volume, vertebral level, sex, and age. Regional differences in osteophyte volume were also evaluated. Results: The osteophyte identification algorithm was validated to have a bias of -4.7 mm Conclusions: Osteophyte volume increased with more caudal vertebrae, was greater in men than in women, and increased by approximately 40 mm