Clinical and Radiological Anatomy of the Lumbar Spine

The lumbar vertebrae
The inter-body joints and the intervertebral discs
The zygapophysial joints
The ligaments of the lumbar spine
The lumbar lordosis and the vertebral canal
The sacrum
Basic biomechanics
Movements of the lumbar spine
The lumbar muscles and their fascia
Nerves of the lumbar spine
Blood supply of the lumbar spine
Embryology and development
Age changes in the lumbar spine
The sacroiliac joint
Low back pain
Instability
Radiographic Anatomy Appendix: Identification of the lumbar vertebrae
Index

I commenced research into spinal pain, in 1972, when essentially nothing was known about the problem. There being no established groups or departments working on this problem, I forged my own career, using borrowed resources. I commenced in a Department of Anatomy, where I pursued the innervation of the vertebral column as a fundamental element in understanding the sources and mechanisms of spinal pain. Professor Jim Lance fostered this interest, and accommodated my PhD studies. In his department I continued my anatomy studies but was able also to commence clinical applications. I developed and tested new diagnostic and surgical procedures for back pain and for neck pain. While in Professor Lance's Department, I participated in laboratory studies of the mechanisms of migraine. At the University of Queensland I continued to develop and apply the diagnostic and surgical techniques that I started at the University of NSW, serving as an honorary medical officer at the Pain Clinic of Princess Alexandra Hospital. Meanwhile I supervised science and medicine postgraduate students who undertook basic science studies into the biomechanics of the back and neck. At the University of Newcastle, I had established a reputation sufficient to attract a grant from the Motor Accidents Authority of NSW to investigate the cause and treatment of neck pain after whiplash. The grant supported three PhD students over a six year period. They performed studies that validated the diagnostic procedures and which tested the surgical procedures in a placebo-controlled double-blind randomized trial. Having established an international standing in the development and testing of treatments for spinal pain, I participated in the design and analysis of controlled trials conducted elsewhere in Australia and in the USA. These tested the efficacy of: lumbar radiofrequency neurotomy for back pain, intradiscal electrothermal anuloplasty for back pain, prolotherapy for back pain, exercises for neck pain.

"This publication can be considered a classic for those clinicians involved in the care of patients with lower back problems. The purpose of the book is given in the foreword and the first paragraph of the author's preface to the 4th edition: "There have been no changes in the anatomy of the lumbar spine in the past 20 years, but our understanding of some of the controversial issues has...it is an excellent resource for all those who have an interest in the lumbar spine, from surgeons to interventionists, anatomists, physiotherapists, chiropractors and osteopaths."

British Journal of Sports Medicine, Online