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HYPERTROPHY OF THE LIGAMENTA FLAVA AS A CAUSE OF LOW BACK PAIN

R. GLEN SPURLING, M.D.; FRANK H. MAYFIELD, M.D.; JAMES B. ROGERS, M.D.
JAMA. 1937;109(12):928-933. doi:10.1001/jama.1937.02780380012004.
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Low back pain with or without radiation into one or both lower extremities has been studied with increasing interest in recent years. That many factors may be involved in the production of this group of symptoms is attested by a voluminous literature.1 Many recent authors have considered ligamentous strain about the lumbosacral and sacro-iliac regions from faulty posture to be the chief etiologic factor.2 Intraspinal pathologic changes have, however, received scant attention.

When this syndrome occurs in conjunction with objective neurologic changes, such as sensory or motor loss about the buttock, sexual impotence and possibly sphincteric disturbances, the lesion must be intraspinal, for bony disease peripheral to the neural canal simply cannot produce such a neurologic pattern. Any low intraspinal lesion, herniation of a nucleus pulposus, neoplasm or inflammatory disease may, of course, produce this clinical picture. Our purpose in this report is to discuss an intraspinal lesion

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