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April 13, 1940


JAMA. 1940;114(15):1454-1455. doi:10.1001/jama.1940.02810150040011

The concept that a protruded intervertebral disk is the etiologic factor in cases of low back pain and sciatica was evolved as the result of accumulated facts and observations. The contributions of Luschka (1858) on the anatomy and physiology of this structure and the more recent studies of Schmorl, Andrae and their co-workers (1927-1932) on the pathology of the intervertebral disk as seen in their necropsy studies of more than 3,000 spinal columns provide scientific basis for the role assumed by this structure in a number of clinical conditions. The significance of the posterior propulsion of the disk in causing pressure on the contents of the neural canal grew out of the isolated but none the less important and convincing observations of Kocher, Middleton and Teacher, Goldthwaite, Adson, Dandy, Bucy, Stookey and others. Mixter and Barr established the clinical relationship between the protruded nucleus pulposus and certain cases of intractable

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