During the past two years it has been the routine procedure of my associates and myself to take anteroposterior and lateral x-ray pictures of the dorsal, lumbar and sacral spine, as well as an anteroposterior view of the pelvis, of all patients complaining of a painful back. The procedure was instituted because many conditions of the spine gave neither subjective symptoms nor objective findings at the level of the lesion.
As a result of the complete roentgen study, a lesion consisting of a narrowing or a complete loss of the intervertebral disk between the fifth lumbar and the first sacral vertebra was noted in the majority of patients suffering with symptoms of sciatic irritation. Ayers1 reported thirty-six cases of low back pain, in twenty-seven of which the patients had pain down one or both extremities, and all showed a thinning of the lumbosacral cartilage or an arthritic involvement of
WILLIAMS PC. REDUCED LUMBOSACRAL JOINT SPACEITS RELATION TO SCIATIC IRRITATION. JAMA. 1932;99(20):1677–1682. doi:10.1001/jama.1932.02740720031009