Prior to the identification of lumbar disc herniation as a verifiable cause of sciatica in 1934 by Mixter and Barr, the cause of buttock and thigh pain was often

ascribed to sacroiliitis. In a publication eight years before Mixter and Barr described sciatica from HNP, the famous orthopaedic surgeon, Dr. M. N. Smith-Petersen, reported on twenty-six patients fused for traumatic arthritis of the sacroiliac joint. He reported that x-rays were not much help in making a diagnosis. He did however produce a table of symptoms and signs that together, strongly suggested the sacroiliac joint as the source of pain. Further, he said that if a sacroiliac belt helped reduce pain, then he didn’t think patients needed the fusion operation. In his publication, he reported two total failures in his series, however, twenty-two of the twenty-six patients were reported able to resume full activity. This was considered a great success, as it would be by today’s standards as well. Yet, inspite of his success, many surgeons of his day still believed that there was no such condition astraumatic sacroiliac arthritis. Based on my experience, 75 years later this opinion still holds firm in the opinion of medical science in many places. [Read more…]