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July 17, 1948

Chronic Structural Low Backache Due to Low-Back Structural Derangement

JAMA. 1948;137(12):1096. doi:10.1001/jama.1948.02890460092044

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This book represents keen observations and intensive study on a subject that involves a small, though important, part of the body. The author discusses spondylolisthesis and its associated pathologic changes, i. e., neurovascular and visceral symptoms and defects of ossification. Since most of the present writings by gynecologists, urologists, abdominal surgeons, internists and psychiatrists pay little attention either to the pain of spinal origin which may simulate visceral pain or to the neurovascular symptoms which can arise through sympathetic nerve irritation by skeletal lesions, the author believes that there is a need for a radical reassessment of differential diagnoses. In the vast majority of these variations in structure, there is little or no consequent weakening of the skeletal architecture.

The pars interarticularis is situated between the superior and inferior articular processes. Laterally it joins the base of the transverse process. It is only on the neural canal aspect that it