There is very limited research published in the literature that applies content-based image retrieval (CBIR) techniques to retrieval of digitized spine X-ray images using a combination of inter-vertebral disc space and shape profiles. We present a novel technique to retrieve vertebra pairs that exhibit a specified disc space narrowing (DSN) and inter-vertebral disc shape profile. DSN is characterized using spatial and geometrical features between two adjacent vertebrae. Initial retrieval results are clustered and used to construct a voting committee to retrieve vertebra pairs with the highest DSN similarity. Experimental results show that the proposed algorithm is a promising approach for disc space-based spine X-ray image retrieval. The overall retrieval accuracy validated by a radiologist is 82.25%.