Anatomical Basis of Low Back Pain.

Anatomical Basis of Low Back Pain

By Giles LGF. Baltimore, MD 21202, Williams & Wilkins, 1989, hardback, 197 pp, illus, $61.95

The author of this text is an Australian and a research fellow; he also is a chiropractor. He has written an innovative text describing his postgraduate doctoral studies on the lumbosacral spine. His investigations focus primarily on the zygapophyseal joints (paired diarthrodial articulations located between the vertebral arches) of L4-5 and L5-S1.

The purpose of the investigations was to study both the clinical and anatomical aspects of the leg-length discrepancy of postural scoliosis. The author presents a detailed description of the gross dissection and histological preparations of osseous tissue and nerve tissue. He also presents a literature review that includes studies on leg-length discrepancy associated with low back pain and on methods of measuring leg length and the relationship between leg-length discrepancy and angle of curvature of postural scoliosis and the sacral base. The author reports the findings of his clinical studies of shoe raise therapy versus shoe raise and manipulation plus shoe raise therapy, but no statistical analyses were performed on the groups. He relates his anatomical findings about the structures of the zygapophyseal joints of L4-L5 and L5-S1 to structural changes caused by leg-length inequality.

Each chapter has a reference list. The text has appendixes that provide the reader with definitions and abbreviations and cover preparation of cadaveric spinal blocks of tissue sections and surgical material for histological examination. The text is sometimes redundant. The illustrations and roentgenograms are excellent.

This book would be useful to researchers who wish to study the osseous tissue and nerve tissue of the spine. Physical therapy practitioners, osteopaths, chiropractors, and medical practitioners who are interested in leg-length discrepancy and its possible impact on structural changes in the lumbosacral spine and low back pain could use the text as a reference.

Donna Keefe Marzouk