My purpose in this presentation is to direct attention to a consideration of the importance of pathologic changes of the intervertebral disks, particularly those of the lower lumbar portion of the spine and of the lumbosacral junction, in the causation of pain in the lower part of the back. The intervertebral disks have until recently escaped careful investigation. Although the literature is full of papers on pain in the lower part of the back, they are, on the whole, concerned with the presentation of new theories, diagnostic procedures and methods of treatment. Few investigators have attempted to study the underlying pathologic condition. Schmorl1 was the first to undertake a careful and comprehensive study of the intervertebral disks at autopsy. His contributions have greatly increased the knowledge of the anatomy and pathology of the disks.
The normal adult intervertebral disk consists of a circumferential fibrous ring, called the annulus