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January 3, 1959

Lumbar Disc Lesions: Pathogenesis and Treatment of Low Back Pain and Sciatica

JAMA. 1959;169(1):90. doi:10.1001/jama.1959.03000180092030

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This monograph is well written and illustrated with line drawings, photographs, and reproductions of roentgenograms. The first two chapters, devoted to the anatomy and the functions of lumbar intervertebral disks, present the best descriptions that have so far been written. Of particular importance, however, are the chapters related to the pathological changes in lumbar disk lesions. The author clearly shows the various stages of degeneration that take place in a disk and particularly the changes that may take place before true herniation occurs. This prepropulsion or preherniation stage could be generally termed the degenerative phase of disk pathology in contrast to the true herniated phase. The next sections, devoted to the clinical findings and the differential diagnosis of lumbar disk lesions, are extremely comprehensive. The latter portion of the book is devoted to treatment: first, the conservative treatment with which there is relatively little disagreement and, second, the operative treatment.

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