The Spine

The majority of adults, at some point in their lives, are affected by disorders of the spine. Every physician should have a basic knowledge of the potential pathology and be able to distinguish a serious problem from a minor condition. Disastrous sequelae such as paralysis and neurologic deficit, while rare, can occur if this differentiation is not appreciated. This chapter will first address the cervical spine and then present the lumbar spine. In each area, the history, physical, and appropriate diagnostic studies will be reviewed. Next, a standardized protocol or algorithm for the diagnosis and management of these patients will be described. Finally, several of the most common conservative treatment modalities will be presented with special attention given to their efficacy.