The Clinical Diagnosis of Lumbar Disc Disease

Abstract

Lecturing on the clinical diagnosis of lumbar disc disease is a difficult task. Since every one of you is experienced in this field, it seems to me that I am carrying coal to Newcastle, so to speak. On the other hand, the role of a neurologist has changed somewhat from the days of Gowers, who asked Alexander Horsley to operate on a tumor that he diagnosed clinically without the aid of technical methods. Nowadays the neurologist often gets the impression that patients are being operated upon for disc disease diagnosed by imaging procedures that might have benefited more from conservative measures. Sometimes we are even faced with the fact that a patient has been operated on for a disc prolapse that was completely unrelated to his complaints. Thus it might be of interest to delineate the diagnostic strategies a neurologist uses to choose the best treatment for a given patient.