In Reply.—
Because of the demands of space, I will answer only Dr. Sussman's serious charges.
1. There has been a fairly large group of investigators in Long Beach working at the Long Beach Memorial Hospital for the past seven years. This accounts for the rather large number of patients in our series. Every patient received a very adequate trial of conservative therapy that usually included a period of traction in the hospital.
The classical indications for laminectomy (or laminotomy, if you prefer) have been well established. When severe low back pain and sciatica of long duration are coupled with organic findings such as an abnormal myelogram, neurological changes, and elevation of the spinal fluid protein concentration, surgical intervention becomes necessary.
Of course, at least 85% and probably as much as 95% of episodes of low back pain and sciatica will remit with or without treatment. There is, however, a
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