The problem of treating patients with the primary complaint of low back pain, often with sciatic radiation, continues to harass the orthopedic surgeon. This is true not only because of the difficulties in diagnosis so aptly expressed by Steindler1 when he states that "It [back-ache] shares with the symptoms of headache the distinction of having almost unlimited possibilities of interpretation" but also because "So long as surgeons disagree in regard to the pathogenesis of chronic low back pain, there cannot be any uniformity of opinion concerning treatment" (Compere2). In spite of these limitations, the orthopedist is repeatedly called on to determine the etiology of this syndrome and then must he decide on whether to follow conservative or radical therapy.
Among younger patients with low back pain due to an unstable lumbosacral joint we at the clinic have been impressed with the results obtained from lumbosacral fusion and dismayed
HAGGART GE. EARLY OPERATION (SPINE FUSION) IN UNSTABLE LUMBOSACRAL JOINTS. JAMA. 1940;115(25):2129–2132. doi:10.1001/jama.1940.02810510005002
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