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October 3, 1959

The Degenerative Back and Its Differential Diagnosis

JAMA. 1959;171(5):626. doi:10.1001/jama.1959.03010230124032

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This extensive volume is interesting but difficult to read, because the style is often confusing. This is mentioned to emphasize the fact that this is not a book to be hastily read but rather to be carefully and slowly digested, chapter by chapter. The whole volume deals with degenerative lesions in the back; early in the book, the author states that, although most of the backs he sees have degenerative lesions, the patients should not be told this. The reason for this approach is not clear.

The first few chapters are general in nature and deal with the causes of the multiple degenerative changes that may appear in the spine, including those of the bony structures, changes in the mineral content of bone, facet changes, changes within the disk, and changes in the associated muscles, blood vessels, and nerves. Several excellent colored photographs show many of the anomalies in the

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