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July 24, 1967

Low Back Pain and Sciatica

JAMA. 1967;201(4):274. doi:10.1001/jama.1967.03130040070030

To the Editor:—  In "Low Back Pain and Sciatica" (200:705, 1967) John C. Wilson, Jr., states:The orthopedic surgeon, through training, interest, and motivation, should be prepared to perform whatever procedure is required. Arthrodesis of lumbar joints should be performed, generally, on patients less than 50 years of age and, specifically on patients with localized disease of the fifth lumbar level or with a long history of back pain due primarily to degeneration of the disks at the fourth and fifth levels.The percentage of patients with ruptured lumbar intervertebral disks falling into these categories is not mentioned, but must be high.Dr. Wilson pays warm tribute to his teacher in this area, the late Joseph Seaton Barr. Attention is called to a study of the end results of surgical treatment of 655 patients suffering from ruptured lumbar intervertebral disks on which Dr. Barr was working on the day