A New Culture System to Study the Metabolism of the Intervertebral Disc In Vitro
Kazuhiro Chiba, Gunnar B. J. Andersson, Koichi Masuda, Shigeki Momohara, James M. Williams, and Eugene J-M. A. Thonar

The authors determined whether entrapment of a rabbit intervertebral disc in alginate gel promotes the retention of normal cellular activities. When compared with culture in liquid medium, culture of the disc in alginate gel was more effective in maintaining matrix metabolism, both in the anulus fibrosus and the nucleus pulposus, at an acceptable level.

Functional Outcome of Surgically and Conservatively Managed Dens Fractures
Eric A. Seybold and James C. Bayley

The purpose of this study was to determine by age and fracture type which treatment regimen provided the best clinical functional outcome for patients with dens fracture. Fifty-seven dens fractures were analyzed, and stratified according to age and fracture type. It was found that halo thoracic immobilization was well tolerated by all age groups and resulted in a high union rate regardless of fracture type.

Regional Correspondence Between the Ventral Portion of the Lumbar Intervertebral Disc and the Groin Mediated by a Spinal Reflex: A Possible Basis of Discogenic Referred Pain
Yuzuru Takahashi, Akio Sato, Shin-Ichiro Nakamura, Kaoru Suseki, and Kazuhisa Takahashi

Electrical stimulation of the ventral portion of rat L5-L6 disc elicited a spinal reflex in the genitofemoral nerve innervating the groin. Groin pain in patients with low back pain may indicate a lesion in the ventral portion of the disc.

The Saskatchewan Health and Back Pain Survey: The Prevalence of Low Back Pain and Related Disability in Saskatchewan Adults
J. David Cassidy, Linda J. Carroll, and Pierre Côté

The prevalence of low back pain was investigated in a population-based mailed survey. Almost half of the adult population experienced mild, nondisabling low back pain in the 6 months before the survey. Twelve percent experienced high intensity/low disability low back pain, and an additional 11% were disabled because of their low back pain during the previous 6 months.

Degenerative Displacement of Lumbar Vertebrae: A 25-Year Follow-Up Study in Framingham
Leena I. Kauppila, Stephen Eustace, Douglas P. Kiel, David T. Felson, and Alexander M. Wright

A population-based cohort of 217 men and 400 women showed the prevalence of degenerative displacement of lumbar vertebrae to be 12% in old men and 25% in women. Slippage increased the prevalence of daily back symptoms, but did not predispose to long-term back pain or physical disability.

One-Year Follow-Up Comparison of the Cost and Effectiveness of Chiropractic and Physiotherapy as Primary Management for Back Pain: Subgroup Analysis, Recurrence, and Additional Health Care Utilization
Elisabeth I. Skargren, Per G. Carlsson, and Birgitta E. Öberg

The effectiveness and costs were compared between chiropractic, a new form of treatment in public care, and the established physiotherapy in the treatment of patients with back pain visiting primary care. Patients with acute, uncomplicated problems benefited more from chiropractic, and those with chronic problems gained more from physiotherapy. Recurrence of pain and the need for additional health care were common.

L5 Root Compression Caused by Degenerative Spinal Stenosis of the L1-L2 and L2-L3 Spaces
Angel M. Hidalgo-Ovejero, Serafín García-Mata, Manuel Martinez-Grande, Elias Maravi-Petri, and Tomás Izco-Cabezón

A rare case of L5 root compression at L1-L2 and L2-L3, caused by spinal stenosis, is presented. The authors call attention to the need for evaluating the upper levels when radiologic studies reveal no clear pathology in the area where inferior lumbar root compression usually occurs.

Lumbar Intervertebral Disc Involvement in Chronic Lymphocytic Leukemia: A Case Report
Timothy U. Jiya, Barend J. Van Royen, Shinsuke Sugihara, Paul Y. Van Diest, Radu A. Manoliu, and Paul I. J. M. Wuisman

A case of lumbar intervertebral disc involvement in chronic lymphocytic leukemia with neurologic injury is presented. Clinical findings, radiographic findings, histology, and the method of treatment are discussed in this previously unreported chronic lymphocytic leukemia involvement pattern. Diagnostic difficulties are also discussed.

Costal Osteochondroma: A Rare Cause of Spinal Cord Compression
W. M. Tang, K. D. K. Luk, and J. C. Y. Leong

Expansion of a costal osteochondroma into the spinal canal through an intervertebral foramen is very rare, with only four cases reported previously. The authors here describe a 16-year-old female patient with hereditary multiple exostoses presenting with spinal cord compression by an osteochondroma, which originated from the right 12th rib with extension into the spinal canal through the right T12-L1 intervertebral foramen. It was clearly demonstrated that the size of both the intraspinous and extraspinous components of the tumor were underestimated on the computed tomography scan. The importance of imaging the cartilage cap using magnetic resonance imaging to help achieve better preoperative planning and to avoid incomplete excision of the tumor is illustrated.

Herophilus of Alexandria (325-255 B. C.): The Father of Anatomy
Leon L. Wiltse and T. Glenn Pait

Herophilus, a Greek physician of the third century B. C. is considered the greatest anatomist of antiquity. His contributions are phenomenal. For a brief 30-40 years, he performed the first scientific dissections of human cadavers. Human dissection then was forbidden and was not allowed again for 1800 years.