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March 28, 1959


JAMA. 1959;169(13):1437-1442. doi:10.1001/jama.1959.03000300033007

In 222 patients examined for degenerative arthritis of the vertebral column, the lumbosacral joint was involved in 160 and the other lumbar joints in only 62. A study was made of 125 patients with lumbosacral arthritis. Some had had symptoms as long as 40 years. Only 14 gave histories of real trauma or heavy lifting. Among 11 treated after industrial injuries, roentgenograms showed preexisting lumbosacral arthritis in 10. Usually the acute attack of pain came on during simple movements such as bending forward to wash hands or make a bed. Patients with acute symptoms were treated conservatively with bed rest, anodynes, and physical therapy. They were usually relieved of pain in three to seven days. In the chronic phase the wearing of a brace often gave remarkable relief from pain. Forty-two patients were treated by lumbosacral fusion with varying results; complete relief from pain and recovery of motion was achieved in 18. The major cause of severe low back pain, with or without sciatic radiation, is therefore believed to be degenerative disease of the lumbar vertebral joints, especially the lumbosacral.