Backache: From Occiput to Coccyx

Gerald L. Burke, BSc MD FICS
ISBN 978-0-920406-47-2

Contents:
PUBLISHER'S NOTE     9
PREFACE     9
Chapter 1 THE BACKGROUND   13
Chapter 2 THE INTERVERTEBRAL DISC   23
The Function of the Intervertebral Disc   23
The Structure of the Intervertebral Disc   23
The Outer Covering   23
The Annulus   24
The Nucleus   25
The Nervus Sinu Vertebralis   30
Anatomical Notes   32
Surgical Notes   36
Blood Supply   38
Chapter 3 THE ANATOMY OF PAIN IN BACKACHE   41
The Two Keys   41
The Rupture of Fibrillae and The Change To Fibrous Tissue   41
The Normal Life of the Nucleus   43
The Pathological Life of the Nucleus   49
The Pathological Life of the Nucleus   49
The Remissions of Pain   52
The Forces Acting On the Intervertebral Disc   52
The Mathematics of the Relevant Internal Forces In the Disc   56
The Transmission of Pain   59
A Theory of the Radiation of Pain   59
An Aside On Electrical Investigations   61
Muscle Spasm   63
Protective Muscle Spasm Is Not Painful   64
The "Herniated Disc"   64
Herniation of the Nucleus Into the Spinal Canal Is Not the Cause of Spinal Pain   65
"Massive Herniation" of an Intervertebral Disc Does Not Occur   66
Pressure On a Nerve Root Is Not the Cause of Radiating Pain   66
Chapter 4 THE RECOGNITION OF NUCLEAR LESIONS   71
The Trivial Injury   71
The Course of the Lesion   71
The Symptoms:   73
        The Cervical Spine   74
        The Dorsal Spine   76
        The Lumbar Spine   77
The Flow of Pain in Nuclear Lesions   78
The History   89
The Age of the Patient   89
The Health of the Patient   90
The Frequency of Nuclear Lesions   91
The Physical Examination   92
X-Rays   97
The Progress of a Nuclear Lesion   98
Chapter 5 THE DIFFERENTIAL DIAGNOSIS OF A NUCLEAR LESION 101
In Orthopaedic Surgery 101
        Infections 101
                Febrile Illnesses 101
                Chronic Infections 102
        Severe Injuries 102
Other Orthopaedic Conditions: 102
        Sprains 102
        Kissing Spines 102
        Sprung Back 102
        Hypertropy of the Ligamentum Flavum 103
        Congenital Defects 103
        Foraminal Compression 104
        Osteoporosis 104
        Ankylosing Spondylitis 104
        Osteoarthritis 104
        Paget's Disease 105
Neurology 106
        Tumours 106
        Neuritis 106
Gynaecology 107
Urology 107
Psychoneurosis 108
Tension States: 109
        Headaches 109
        Backaches 109
        Pains In the Neck and Shoulders 109
Malingering 109
A Few Assorted Ailments 110
The Hapless Labels 110
The Mistaken Diagnosis and the "Miraculous Cures 111
References 112
Chapter 6 A MISCELLANY RELATED TO NUCLEAR LESIONS 113
Gas In the Nuclear Space 113
The Unstable Vertebra 114
Pseudo-Spondylolisthesis 117
Spondylolisthesis 117
The Narrowed Intervertebral Disc 118
Imbibition 119
Terms Which Should Be Discontinued: 120
        Dehydrated Disc 120
        Degenerated Disc 120
        Prolapsed Disc 121
        Ruptured Disc 121
        Spondylosis 121
        Root Pain 121
        "Root Signs" 121
Preferable Terms 121
The Inevitable Term 121
References 122
Chapter 7 THE VALUE OF MANIPULATION 123
Extracts From Experts' Opinions 127
        Bankart 127
        Mennell 128
        Mercer 129
        Burrows and Coltart 129
        Wiles 130
        Cyrtax 130
        Barbor 131
        Parsons and Cumming 132
        Wilson 133
A Consideration of Methods of Treatment At Present In Vogue 135
        Bed Rest 135
        Traction In a Hospital Bed 135
        The Plaster Jacket 136
        Injections 136
        Physiotherapy 136
References 136
Chapter 8 THE TECHNIQUES OF TRACTION AND MANIPULATION OF THE SPINE 137
Traction 137
Cervical Spine: 138
Manipulation Without Traction Apparatus 139
        Rotation 140
        Posterior 142
        Lateral 142
Cervical Spine: On Table Technique 144
        Rotation 144
        Posterior 144
        Lateral 144
Cervical Spine: With Traction 146
        Rotation 146
        Posterior 148
        Lateral 148
Lumbar Spine: On Table 150
        Rotation 150
        Posterior 150
Lumbar Spine: With Traction 155
        Posterior 155
        Rotation 156
Dorsal Spine: On Table 156
        Rotation 156
        Posterior 156
Dorsal Spine: With Traction 156
        Posterior 156
        Rotation 156
On Table 158
Coccyalgia 160
The Traction Table 160
The Sacral Extra-Dural Injection 161
References 163
Chapter 9 THE SURGICAL TREATMENT 165
The Indications For Surgery 165
X-Rays 166
Myelogram 166
The Operation 167
Chapter 10 BACKACHE IS A SIMPLE PROBLEM 168
The Diagnosis Is Easily Made 169
The Diagnosis Is Confirmed by Manipulation of the Spine 170
Traction-and Manipulation of the Spine Are Perfectly Safe 171
The Operation Is a Simple One 172
Bibliography 179


copyright©1964,2008 Gerald L Burke and Macdonald Publishing