In previous papers I have called attention to variations in the lumbosacral region. These are so numerous and varied that it is difficult to determine the normal. In a paper read before the American Orthopedic Association in 1925, I1 reported a series of so-called normal spines in patients who had never had backache. Fifty-five per cent of these showed varying degrees of abnormality and 4 per cent showed, according to the roentgenogram, variations in the transverse processes that might cause backache. In conclusion, I said: "It would seem from this study that variations in the lumbosacral region occur frequently in persons who have never had any symptoms of backache, and that some of these variations are very marked and severe. They also occur in persons who lead an active life and work hard. It is probable that these variations predispose to backache, but that posture, muscle relaxation and ligamentous
O'REILLY A. ABNORMALITIES OF THE LOWER PART OF THE BACK. JAMA. 1927;89(14):1128–1131. doi:10.1001/jama.1927.02690140024007
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