Low Back Disorders: A Medical Enigma Book

	Preface
	Foreword
1	The Current Concern with the Low Back	1
	Diagnosis	1
	Symptoms Related to the Low Back	2
	Specific Tissue of the Low Back: Sites of Nociception	6
	Factors of Examination to Determine the Pathoanatomic Basis of Symptoms	8
	Tissue Sites of Pain and Impairment	9
	The Intervertebral Disc	9
	Spinal Instability	10
	Radicular Symptoms and Findings	11
	Confirmatory Tests	13
	Myogenic Low Back Pain	13
	Tension Myositis Syndrome	14
	Facet Etiology of Low Back Pain	18
	Spinal Stenosis	18
	Neurologic Determination of Nerve Root Involvement	18
	Clinical Measurement and Muscle Function	20
	Test of an Increase in Intrathecal Pressure	21
	Electromyography	22
2	The Vertebral Column	25
	The Lumbosacral Spine	27
	Components of the Ligamentous Spine	29
	The Intervertebral Disc	29
	Collagen Fibers	30
	Posterior Spinal Elements	31
	The Zygapophyseal Joints: The Facets	33
	Ligaments in Spinal Function	35
	Muscular System of the Low Back	35
	The Static Spine	39
	Stability of the Static Spine	40
	The Kinetic Lumbar Spine and the Lumbar-Pelvic Rhythm	42
	Preparatory Trunk Motions	46
3	The Intervertebral Disc	58
	Collagenous Plates	61
	Nuclear Material Causing Nociception	65
	Clinical Manifestations of Disc Disease	66
4	The Role of the Facets in Low Back Pain	71
	Facet Joint Innervation	74
	Degenerative Facet Disease	75
	Clinical Manifestations of Facet Disease	75
5	Muscular Control of the Low Back	81
	Spasm	82
	Myogenic Pain	85
	Fatigue	87
	Myalgia	87
6	Miscellaneous Abnormal Conditions of the Low Back	90
	Spondylolysis and Spondylolisthesis	90
	Types of Mechanical Listhesis	90
	Symptoms of Spondylolisthesis	92
	Spinal Stenosis	94
	Scoliosis	96
	Piriformis Syndrome	97
	Sacroiliac Disease	100
	Sacro-iliac Pathology Secondary to a Pelvic Fracture	101
	Sacralization of a Transverse Process	101
7	Treatment Protocols for Low Back Disorders	104
	Management of Acute Symptoms of Low Back Disorders	110
	Steroids and Nonsteroidal Medications	111
	Physical Modalities for Treatment of Low Back Pain	112
	Exercise in the Treatment of Low Back Disorders to Regain Spinal Stability	115
	Psychologic Aspects of Low Back Disorders	123
	Biologic Treatment of Sciatica	134
	Subject Index	143