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THE LUMBOSACRAL REGION A Correlation of the Roentgenographic and Anatomical Observations
Homer C. Pheasant; Paual C. Swenson
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Departments of Surgery and Radiology of the Presbyterian Hospital and College of Physicians and Surgeons, Columbia University, New York
1942 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1942; 24:299-306 
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Abstract

An attempt has been made to correlate the roentgenographic and anatomical findings at the lumbosacral junction by careful comparison with dissected specimens. Besides the statistical data on the various anomalies which occur in this region, two findings were of interest. The first was that the degree of osteo-arthritis present in a given case is always great deal more advanced than the roentgenograms would indicate, particularly as far as the posterior elements of the vertebral segments are concerned. The second was that there are confusing findings in the roentgenograms at times which, because of the varying projection of the central roentgen-ray beam and the asymmetrical development of the articular processes, will produce an appearance suggestive of failure of fusion, but in reality the segments will be found quite intact. The variations in the anatomical structure have been briefly discussed.

The oblique, coronal (curved) plane is perhaps the most desirable for the human lumbosacral articulations, and the approach to the coronal plane should be considered the "evolutionary normal".

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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