From sciatica to intervertebral disk displacement. On the history of a disease concept

Abstract

Since antiquity low back pain spreading down to the buttock and the leg with or without neurological symptoms has repeatedly been described by medical authorities. To extract well defined nosological entities out of the medley of "sciatica" was a demanding process within a labyrinth of often misleading clues. Although the herniated intervertebral disk was recognised about the middle of the 19th century the causal nexus between intervertebral disk displacement and sciatica was only demonstrated in the thirties of the 20th century. The critical appraisal of pathomorphological lesions in patients suffering from sciatica was, as it still is, a challenging task even for experienced physicians. Key texts and their authors recall the main steps towards our modern concept of lumbar intervertebral disk displacement to the readers mind.