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This monograph analyses all aspects related to the
etiopathogenesis, pathomorphology, diagnosis and treatment of
lumbar disc herniation. It includes 24 chapters, over 500
illustrations, partly in colour, and 2800 bibliographic entries,
going from the historical to the most recent ones. Five chapters
are dedicated to biological and pathomorphologic aspects both of
lumbar disc herniation and the conditions most often associated
with herniation. The etiopathogenesis is analysed in the light of
the most significant and recent studies. Five chapters deal with
the clinical presentation and diagnostic tests in an extremely wide
and detailed way. Large space is reserved to conservative
management. The chapters on invasive treatments and on the results
and complications of surgery define the advantages and limitations
of the old and new percutaneous or surgical treatments. Two
chapters are dedicated to surgical management of patients with
spinal conditions associated with herniation, and two other deal
with the surgical failure. This monograph is aimed at satisfying
the requirements of both experts and young doctors. Some chapters
are of particular interest to the spine specialist, whilst others
are useful to the novice to acquire a general knowledge of the
subject.
Up until two decades ago, clinical interest in the etiopathogenetic
interpretation of lumbo-radicular syndromes was prevalently
concentrated on the pathology of the inter vertebral disc. This
vision gradually changed and grew as a result of the affirmation of
the concept of pathological narrowing of the osteoligamentous
vertebral canal as a cause of compression of the lumbar nervous
structures. Finally, in the last ten years, lumbar stenosis has
become more and more a subject of current interest not only as a
result of problems related to nosography, diagnosis, and therapy,
but also as a result of the increasing frequency with which
vertebral canal or nerve root canal stenosis syndromes are
recognized and treated. At the same time there was a tendency to
include in stenotic pathology other pathological conditions
responsible for lumbo-radicular syndromes. This led to dilation of
the concept of stenosis, which perhaps no longer responded to
reality, and which was not useful from a practical point of view.
The need to define stenotic pathology and to correctly locate it
within the vast field of lumbar pathology inspired the writing of
this volume. This monograph gathers many diagnostic and therapeutic
concepts matured at our In stitution over the years. Some of these
concepts have already been defined in scientific meet ings or in
publications."
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