This study was conducted on 50 patients from 10 October , 2022 to 1 March ,2023 at Al-Hussein teaching hospital , Al-Muthanna, Iraq. 72 % male and 28 % female . All patients sent for complete investigation such as CBC ,ESR, CRP , and rheumatologic factor and also sent for imaging such as plain xray of spine , CT scan and MRI . We study the risk factor such as age, sex, occupation , smoking associated disease (such as arthritis , cancer ),obesity , psychological condition .we find that.80% Of patient treated conservative and.20% treated with surgery and we find that conservative treatment is better than operative Objectives: Assess Outcome of the treatment back pain.