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INCARCERATION OF THE FIRST SACRAL NERVE IN A LATERAL BONY RECESS OF THE SPINAL CANAL AS A CAUSE OF SCIATICA
Philip T. Schlesinger
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Glens Falls Hospital, Glens Falls
1955 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1955; 37:115-124 
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Abstract

1. There exists a lateral bony recess of the spinal canal at the level of the fifth lumbar dise. This is fairly deep in some insdividuals.

2. The lateral recess may be narrowed from before backward by degenseration and thinning of the fifth lumbar disc, especially if there is backward displacement of the fifth lumbar body or if there is a hypertrophic rim on its inferior border.

3. The first sacral nserve can become caught in this recess and sciatica may result.

4. Myelography will probably not be helpful in diagnsosing this lesions.

5. Compressions of the first sacral nerve in the lateral recess or of the fifth lumbar nserve in the intervertebral foramen shounld be considered as possibilities in patiensts of about fifty or over with sciatica, especially if roentgenograms show thinning of the fifth lumbar disc.

6. It is useful to conceive of disc surgery in this age group in terms of root exploration rather than simple removal of a herniated disc.

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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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