1. Herniated Lumbar Disk - Herniated Lumbar Disc Description and the options for treatment. Dr. Humberto Trejos, Costa Rica.Category Health Conditions and Diseases Ruptured Disk......Herniated Lumbar Disc. What is it, how it is produced and treatment alternatives http://www.trejos.com/trejos/herniate.htm

2. JAMA -- Page Not Found JAMA. 285;18861888, April 11, 2001, Genetic Risk Factors for lumbar disk Disease, Joan C. Marini, MD, PhD http://jama.ama-assn.org/issues/v285n14/ffull/jed10013.html

Select Journal or Resource JAMA Archives of Dermatology Facial Plastic Surgery Family Medicine (1992-2000) General Psychiatry Internal Medicine Neurology Ophthalmology Surgery MSJAMA Science News Updates Meetings Peer Review Congress The page you requested was not found. The JAMA Archives Journals Web site has been redesigned to provide you with improved layout, features, and functionality. The location of the page you requested may have changed. To find the page you requested, click here HOME CURRENT ISSUE PAST ISSUES ... HELP Error 404 - "Not Found"

3. Lumbar Disk Disease LUMBAR (LOWER BACK) DISK DISORDERS by Carl Butterfield, M.D., assistant to Dr. Reid The lumbar region of the back, goes from the lower part of the chest (ribs) down to the pelvis (hips). The incidence of lumbar disk disorder increases the lower down the back one looks. http://www.brainsurgeon.com/LUMBAR.HTM

LUMBAR (LOWER BACK) DISK DISORDERS by Carl Butterfield, M.D., assistant to Dr. Reid Definition: The lumbar region of the back, goes from the lower part of the chest (ribs) down to the pelvis (hips). Most people have five lumbar vertebrae with disks between each and between the first lumbar vertebrae and the last thoracic vertebrae above, and the last lumbar vertebrae and the sacrum (back part of the pelvis) below. The incidence of lumbar disk disorder increases the lower down the back one looks. This is because the lower vertebrae have to support more weight and stress, and are less mobile. When ruptures in the disks occur, they are associated with flowing out of the disk material, most often in a postero-lateral direction. Symptoms: Diagnosis: To make a correct diagnosis, the physician uses a combination of information. This information may be from the patient in the form of a history and physical, from diagnostic studies (ex: MRI, nerve conduction studies) or from a combination of the above (myelogram with a post myelogram CT). The physician tries to tie together information from the above sources and to see if they correlate and support the findings of each other (ex: a disk herniation at a particular level may manifest itself in a particular pattern of pain distribution). Treatment: Risks involved with low back surgery: Any time a patient is considering a surgical option for a back/disk problem, they need to understand the risks associated with the procedure, and weigh them against the potential benefits. The surgeon will explain what are the risks, their frequency of occurrence, and compare them to the desired benefits. The risks include, but are not limited to: infection, bleeding, loss of life, loss of control of the bowels or bladder, sexual disfunction, recurrence, paralysis, weakness, numbness, epidural fibrosis, cerebral spinal fluid leak, nonrelief pain, meningitis, lumbar instability, poor wound healing and other serious complications. An example where a patient can influence the risk of bleeding, is to inform the surgeon what medications they are on, because some medications such as aspirin can increase the possibility of bleeding.

4. PBCC Student Project Template LOW BACK SLIPPED DISK (Herniated lumbar disk) Abnormal movement of the material (disk) that helps support the bones of the lower back. Disks are found between the bones of the back (vertebrae). http://www.pbcc.edu/eissweb/vshaver/disk.htm

Palm Beach Community College Radiography Program Pathology Respiratory Skeletal GI/Biliary Urinary ... PBCC Home Herniated Lumbar Disk The lumbar intervertebral disk is located between the bodies of a lumbar vertebrae. These discs are found along the entire spine from the neck all the way down to the lower back. This is what gives your spine the flexibility to move. The disk also acts as a shock absorber and a connecting link between each vertebral body. It is made off a fibrous outer ring called the annulus and the inner region, also know as the nucleus, is more of a gelatin material. Nerves branch out from the spinal cord and pass through the openings of the vertebrae. When a disk weakens, the outer ring may not be able to contain the material in the center of the disk. This will result in a herniated disk which can cause severe pain because of the bulge thats pushing against the nerves. The correct terminology for a herniated disk is referred to as a Herniated Nucleus Polpusus. (http://www.healthgate.com)

5. Lumbar Disk - Lumbar Disc Lumar Disk, what it is and what is it for lumbar disk. Herniated lumbar disk. Surgery for Herniated lumbar disk http://www.ampos.com/Trejos/Lumbardi.stm

Diagnostico.com Search key words MENU By Disease By System Pediatrics Other links Dr. Trejos Dr. Humberto Trejos Lumbar Disk Herniated Lumbar Disk Surgery for Herniated Lumbar Disk ... Surgery for Parkinson Lumbar Disks The lumbar disks are the shock absorbers of the spine, they are located between the vertebral bodies and allow soft movements, flexion and extension of the spine. They are composed by a spongy center and a a stronger outer fibrous ring or annulus that contains it. Lateral view of the spine A foramen is formed behind the inter vertebral disks and between the vertebrae above and below. Through these foramina exit the nerve roots that form the peripheral nerves on each side, like the sciatic nerves that run down to the legs. Top view What is a Herniated Lumbar Disk ? Click here to write to Dr. Trejos Email @Address P.O.Box 225-6151 Santa Ana 2000 COSTA RICA PHONE:+(506)-208-1407 FAX:+(506)-253-0761 Advertising Doctors Only

6. Dr. Humberto Trejos Learn about lumbar disks, Parkinson's disease, cerebral palsy and treatment alternatives.Category Health Medicine Neurosurgery Clinics and Practices...... lumbar diskS Normal lumbar disk. Herniated lumbar disk. TYPES OF lumbar diskSURGERY Classic Diskectomy. Percutaneous Laser Diskectomy. ABNORMAL MOVEMENTS http://www.trejos.com/trejos/

Diagnostico.com Search key words MENU By Disease By System Pediatrics Other links Dr. Trejos Dr. Humberto Trejos Lumbar Disk Herniated Lumbar Disk Surgery for Herniated Lumbar Disk ... Surgery for Parkinson Dr. Humberto Trejos Neurosurgeon Graduated from Medical School in Costa Rica and trained in Neurosurgery at Edinburgh University, Scotland. Appointed Consultant Neurosurgeon in Costa Rica since 1977. Main interests through the years have been the minimally invasive Neurosurgery and Pediatric Neurosurgery. Amongst these are Stereotactic Neurosurgery for Abnormal movements -including Parkinson and Cerebral Palsy-, Endoscopic Neurosurgery and LASER percutaneous procedures for herniated lumbar disks. Neurosurgery is the specialty of surgery that deals with diseases of the Central Nervous System; this means the Brain, Spinal Cord and Nerves. LUMBAR DISKS: Normal Lumbar Disk Herniated Lumbar Disk TYPES OF LUMBAR DISK SURGERY: Classic Diskectomy Percutaneous Laser Diskectomy ABNORMAL MOVEMENTS: Cerebral Palsy Surgery for Cerebral Palsy Parkinson's Disease Surgery for Parkinson OTHER LINKS: Click here to find other neurosurgeons home pages Write to Dr. Trejos Email @Address

7. San Antonio Spine Surgery - South Texas Spinal Clinic Surgical and nonsurgical treatment of spine and spinal disorders, including micro endoscopic surgery, back and neck injury, cervical thoracic and lumbar disk herniation. http://spinaldoc.com/

South Texas Spinal Clinic A Leader in the Innovation of Spinal Surgery and Medicine "Comprehensive Treatment with Compassion and Understanding" Welcome To spinaldoc.com Click Below to Meet Our Doctors General Information Appointments, Emergencies, Prescription ... Sponsors Dr. Gilbert Meadows Dr. David Dennis Dr. Charles Pipkin Dr. Gregg Gurwitz Dr. Jerjis Denno Dr. Paul Geibel Dr. David Hirsch South Texas Spinal Clinic - 7614 Louis Pasteur Suite 300 - San Antonio, TX 78229 210-614-6432 - Fax 210-614-7327 - Email info@spinaldoc.com (c) 1999- 2000 South Texas Spinal Clinic Part of the JMAN5 Family of Web Sites Teftec Mobility Wheelchairs Stinson Air Center South Texas Spinal ... Hyacinth Macaw document.write('<');document.write('! ');

8. Herniated Lumbar Disk - Herniated Lumbar Disc The first steps to deal with a herniated or prolapsed lumbar disk are conservative. http://www.ampos.com/trejos/herniate.stm

Diagnostico.com Search key words MENU By Disease By System Pediatrics Other links Dr. Trejos Dr. Humberto Trejos Lumbar Disk Herniated Lumbar Disk Surgery for Herniated Lumbar Disk ... Surgery for Parkinson Herniated Lumbar Disk Excessive weight, bad postures, undue movements, improper weight lifting and other kind of traumas may weaken the inter vertebral disks. When this occurs the pulpous nucleus (spongy center) will bulge against the annulus (outer ring), or even be squeezed through it. If this bulged, or herniated disk, presses one of the nerves, it will produce pain going down the leg, in the distribution of the nerve, and maybe in the lower back. Sciatic pain occurs when the disk presses one of the nerves that form the sciatic nerve. Other symptoms could be weakness, tingling or numbness on the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency. The first steps to deal with a herniated or prolapsed lumbar disk are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point it is convenient to have some plain X-rays done, in search of some indirect evidence of the disk problem, as well as of degenerative changes on the spine.

9. Herniated Lumbar Disk - Herniated Lumbar Disc Herniated lumbar disk. Excessive weight The first steps to deal with aherniated or prolapsed lumbar disk are conservative. These include http://www.diagnostico.com/Trejos/herniate.stm

Diagnostico.com Search key words MENU By Disease By System Pediatrics Other links Dr. Trejos Dr. Humberto Trejos Lumbar Disk Herniated Lumbar Disk Surgery for Herniated Lumbar Disk ... Surgery for Parkinson Herniated Lumbar Disk Excessive weight, bad postures, undue movements, improper weight lifting and other kind of traumas may weaken the inter vertebral disks. When this occurs the pulpous nucleus (spongy center) will bulge against the annulus (outer ring), or even be squeezed through it. If this bulged, or herniated disk, presses one of the nerves, it will produce pain going down the leg, in the distribution of the nerve, and maybe in the lower back. Sciatic pain occurs when the disk presses one of the nerves that form the sciatic nerve. Other symptoms could be weakness, tingling or numbness on the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency. The first steps to deal with a herniated or prolapsed lumbar disk are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point it is convenient to have some plain X-rays done, in search of some indirect evidence of the disk problem, as well as of degenerative changes on the spine.

10. Lumbar Disk - Lumbar Disc Top view. What is a Herniated lumbar disk ? Click here to write to Dr. Trejos Email@Address. PO.Box 2256151 Santa Ana 2000 COSTA RICA, PHONE+(506)-208-1407, http://www.diagnostico.com/Trejos/Lumbardi.stm

Diagnostico.com Search key words MENU By Disease By System Pediatrics Other links Dr. Trejos Dr. Humberto Trejos Lumbar Disk Herniated Lumbar Disk Surgery for Herniated Lumbar Disk ... Surgery for Parkinson Lumbar Disks The lumbar disks are the shock absorbers of the spine, they are located between the vertebral bodies and allow soft movements, flexion and extension of the spine. They are composed by a spongy center and a a stronger outer fibrous ring or annulus that contains it. Lateral view of the spine A foramen is formed behind the inter vertebral disks and between the vertebrae above and below. Through these foramina exit the nerve roots that form the peripheral nerves on each side, like the sciatic nerves that run down to the legs. Top view What is a Herniated Lumbar Disk ? Click here to write to Dr. Trejos Email @Address P.O.Box 225-6151 Santa Ana 2000 COSTA RICA PHONE:+(506)-208-1407 FAX:+(506)-253-0761 Advertising Doctors Only

11. Herniated Lumbar Disk Herniated lumbar disk. (Please click on pictures for a more detailed view) http://www.buffaloneuro.com/lumdisk/hernlum.htm

Herniated Lumbar Disk (Please click on pictures for a more detailed view) Fig. 1: Artists rendering of herniated disk Fig. 2: CT scan showing herniated disk Fig. 3: MRI showing herniated disk The lumbar intervertebral disk is made up of a fibrous outer ring called the annulus and a gelatinous inner portion called the nucleus (fig. 1). The disk acts as a cushion between the vertebral bodies. When herniation occurs, the nucleus pushes through the annulus of the disk producing pressure on the nerve root and/or cauda equina. This is demonstrated on the CT scan (fig. 2), the MRI (fig. 3) and the myelogram (fig. 4). Nearly all patients complain of leg pain (sciatica) in the distribution of one or more nerve roots. Some have back pain as well. Frequently, patients can be treated conservatively with success. However, when their ability to perform normal day to day functions is degraded for a substantial period of time (4-6 weeks), or in the presence of progressing neurological deficit (i.e. foot drop, loss of control of bowel and bladder, cauda equina syndrome), lumbar microdiskectomy is the most effective treatment. During microdiskectomy, the offending disk fragment and much of the loose nucleus are removed through a small, one to two inch incision (figs. 5-8). With success rates of around 90%, patients are able to return to work and full activity in an average of about 10 weeks. Our group has the most extensive experience in Western New York performing outpatient microdiskectomy. In the past 3 years, we have performed more than 1000 of these procedures successfully. Patients prefer this to overnight stay in the hospital.

12. Herniated Lumbar Disk Herniated lumbar disk. (Please click on pictures for a more detailed view). Fig.1 Artists rendering of herniated disk. Fig. 2 CT scan showing herniated disk. http://buffaloneuro.com/lumdisk/hernlum.htm

Herniated Lumbar Disk (Please click on pictures for a more detailed view) Fig. 1: Artists rendering of herniated disk Fig. 2: CT scan showing herniated disk Fig. 3: MRI showing herniated disk The lumbar intervertebral disk is made up of a fibrous outer ring called the annulus and a gelatinous inner portion called the nucleus (fig. 1). The disk acts as a cushion between the vertebral bodies. When herniation occurs, the nucleus pushes through the annulus of the disk producing pressure on the nerve root and/or cauda equina. This is demonstrated on the CT scan (fig. 2), the MRI (fig. 3) and the myelogram (fig. 4). Nearly all patients complain of leg pain (sciatica) in the distribution of one or more nerve roots. Some have back pain as well. Frequently, patients can be treated conservatively with success. However, when their ability to perform normal day to day functions is degraded for a substantial period of time (4-6 weeks), or in the presence of progressing neurological deficit (i.e. foot drop, loss of control of bowel and bladder, cauda equina syndrome), lumbar microdiskectomy is the most effective treatment. During microdiskectomy, the offending disk fragment and much of the loose nucleus are removed through a small, one to two inch incision (figs. 5-8). With success rates of around 90%, patients are able to return to work and full activity in an average of about 10 weeks. Our group has the most extensive experience in Western New York performing outpatient microdiskectomy. In the past 3 years, we have performed more than 1000 of these procedures successfully. Patients prefer this to overnight stay in the hospital.

13. Temple University Neurosurgery Department: Lumbar Disk Almost all lumbar disk herniations affect only the nerve roots because the spinalcord actually ends near the level of the first lumbar disk and upper lumbar http://www.temple.edu/neurosurgery/html/lumbar_disk_herniation.html

To reach staff, make an appointment, get directions. Learn more about our residency program. Related sites Intervertebral Disk Disease What is a disk herniation? The spine is a column of bones, called vertebrae, that are separated by shock absorbing disks with elastic properties. Each vertebra has a large, central opening. All of these aligned openings form the spinal canal. The spinal cord resides in the spinal canal. At the level of each vertebra, nerves that branch from the spinal cord exit the spine through other openings called foramen. The seven uppermost vertebrae are called cervical vertebrae. Collectively, they comprise the cervical spine. The lumbar spine is composed of five vertebrae in the lower spine. The intervertebral disks (denoted as cervical disks in the cervical spine and lumbar disks in the lumbar spine) are composed of a tough outer ring and a soft center. Sometimes the soft center extrudes through weaknesses in the tough outer ring – much the same way that jelly can be squeezed from a jelly doughnut. This material can impinge on a nerve root as it branches from the spinal cord (called a radiculopathy when symptoms are present) or it can impinge on the spinal cord (called a myelopathy when symptoms are present).

14. Herniated Lumbar Disk-DynoMed.com Return Records. Herniated lumbar disk. Causes Symptoms Treatment http://www.dynomed.com/encyclopedia/encyclopedia/spine/herniated_lumbar_disk.htm

Return Records Herniated Lumbar Disk Causes Symptoms Treatment A Quick Overview of the Spine: The cervical vertebrae are the seven vertebrae that form the upper part of your spine, between the skull and the chest. The thoracic vertebrae are the 12 bones between your neck and your lower back.  Thoracic vertebrae have cup-shaped surfaces called facets, in which the ribs rest and connect to the spine.  These ‘joints’ help the ribs to move up and down during breathing. The lumbar vertebrae are the five largest and strongest of all vertebrae.  They are found in your lower back between the chest and hips.  The strong muscles of the back are attached to the lumbar vertebrae. Your sacrum and coccyx are the bones found at the base of your spine.  The triangular sacrum—made up of five vertebrae fused together—supports the spine and connects it to the pelvis.  Your coccyx, or tailbone, is formed from four fused vertebrae and has little function. The vertebral foramen is the hollow part of the vertebrae where the spinal chord (nerve tissues) attaches to your brain and sends signals all over your body.

15. Herniated Lumbar Disk-DynoMed.com Browse Categories, Return 5 Records. Herniated lumbar disk, What isa lumbar disk Herniation? The vertebrae in the lower http://www.dynomed.com/encyclopedia/encyclopedia/spine/Herniated_Lumbar_Disk.htm

Return Records Herniated Lumbar Disk Causes Symptoms Treatment A Quick Overview of the Spine: The cervical vertebrae are the seven vertebrae that form the upper part of your spine, between the skull and the chest. The thoracic vertebrae are the 12 bones between your neck and your lower back.  Thoracic vertebrae have cup-shaped surfaces called facets, in which the ribs rest and connect to the spine.  These ‘joints’ help the ribs to move up and down during breathing. The lumbar vertebrae are the five largest and strongest of all vertebrae.  They are found in your lower back between the chest and hips.  The strong muscles of the back are attached to the lumbar vertebrae. Your sacrum and coccyx are the bones found at the base of your spine.  The triangular sacrum—made up of five vertebrae fused together—supports the spine and connects it to the pelvis.  Your coccyx, or tailbone, is formed from four fused vertebrae and has little function. The vertebral foramen is the hollow part of the vertebrae where the spinal chord (nerve tissues) attaches to your brain and sends signals all over your body.

16. JAMA -- Page Not Found Vol. 285 No. 14, April 11, 2001 Original Contribution See Related Articles Authors' Articles Return to Table of Contents Author/Article Information Author/Article Information Identification of a Novel Common Genetic Risk Factor for lumbar disk http://jama.ama-assn.org/issues/v285n14/abs/joc01517.html

Select Journal or Resource JAMA Archives of Dermatology Facial Plastic Surgery Family Medicine (1992-2000) General Psychiatry Internal Medicine Neurology Ophthalmology Surgery MSJAMA Science News Updates Meetings Peer Review Congress The page you requested was not found. The JAMA Archives Journals Web site has been redesigned to provide you with improved layout, features, and functionality. The location of the page you requested may have changed. To find the page you requested, click here HOME CURRENT ISSUE PAST ISSUES ... HELP Error 404 - "Not Found"

17. EMedicine - Lumbar Disk Problems In The Athlete : Article By Annie Collier, MD lumbar disk Problems in the Athlete Back pain is a common complaint.Numerous causes of lumbar disk disease in athletes exist. http://www.emedicine.com/sports/topic8.htm

(advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Sports Medicine Spine Lumbar Disk Problems in the Athlete Last Updated: December 12, 2001 Rate this Article Email to a Colleague Synonyms and related keywords: back pain, low back pain, strained back, back is out, herniated disk, slipped disk, herniated nucleus pulposus, ruptured disk, degenerative disk disease, lumbago, mechanical low back pain, LBP AUTHOR INFORMATION Section 1 of 11 Author Information Introduction Clinical Differentials ... Bibliography Author: Annie Collier, MD , Staff Physician, Department of Emergency Medicine, Lincoln Medical Center, Cornell University School of Medicine Coauthor(s): John Munyak, MD , Associate Program Director, Director of Sports Medicine, Clinical Instructor, Section of Emergency Medicine, Lincoln Medical and Mental Health Center, Cornell Medical School Annie Collier, MD, is a member of the following medical societies: American College of Emergency Physicians Editor(s): Andrew D Perron, MD

18. Herniated Lumbar Disk Links From RXAddict.com All about Herniated lumbar disk from RXAddict.com Herniated lumbar disk Injury Law. Research your legal rights and find an attorney for a herniated lumbar disk injury. http://www.rxaddict.com/g/conditionpage/Herniated_Lumbar_Disk

Addict Sites Search Directory Weather Travel ... Stock Quotes Herniated Lumbar Disk Featured 'Herniated Lumbar Disk' Links: Specializing in Minimally Invasive Spina Minimally invasive cervical and lumbar spinal surgery, outpatient procedure, under local anesthesia - San Francisco bay area.. Herniated Lumbar Disk Injury Law Research your legal rights and find an attorney for a herniated lumbar disk injury. Fill out a simple form and an experienced attorney will review your concern. Whitee Patch from Wei Laboratories, Inc Whitee Patch together with Lc Balancer can eliminate symptoms of herniated disc in multiple two week treatment cycle. Lumbar Disc Pain Relief with Back Seat The Back Seat patented seated spinal unloading, relieves back pain and sciatica while sitting. It takes the pain out of sitting. Recommended by world leading back experts. Guaranteed. Herniated Disk The source of information and listings regarding herniated disk. General 'Herniated Lumbar Disk' Links: Orbitz: Airlines, Hotels, Rentals, Travel Deals The most low fares for airline tickets, hotels reservations, car rentals, travel deals, cruises and vacation packages. Search: Related: Herniated Lumbar Disk Herniated disc ... AddictSites.com

19. Virtual Hospital: Radiology Resident Case Of The Week: Lumbar Disk Herniation An lumbar disk herniation and conjoined nerve root sleeve (lumbar). EricFitzcharles, MD Peer Review Status Not Internally Reviewed. http://www.vh.org/adult/provider/radiology/RCW/051597/051597.html

For Providers Radiology Resident Case of the Week, May 15, 1997 Lumbar disk herniation and conjoined nerve root sleeve (lumbar) Eric Fitzcharles, M.D. Peer Review Status: Not Internally Reviewed Clinical Sx: 53-year-old male with several-month history of increasing right lower extremity weakness and numbness. Etiology/Pathophysiology: Disk degeneration is noticeable by the age of 20. The process consists of desiccation, or water loss in the nucleus pulposus and decreased tissue resiliency with decrease in the height of the disk space. With age, the initially soft and gelatinous nucleus pulposus is replaced by fibrocartilage and the distinction between nucleus pulposus and annulus fibrosis becomes less distance. The annulus becomes fissured and negative pressures bring nitrogen out of solution causing vacuum phenomenon. Disk height loss leads to malalignment and all of these processes permit disk material to bulge and subsequently herniate. The second finding in this patient was a conjoined nerve root sleeve. This is a congenital anomaly that is considered a normal variant and is found in 1-3% of the population. Pathology: The terminology of disk disease is at times muddy, however the following definitions are helpful: bulge: concentric smooth circumferential expansion of softened disk material beyond the confines of endplates. Protrusion = herniation: focal protrusion of disk material maintaining broad base with parent disk due to weakened or ruptured annulus fibrosus but intact posterior longitudinal ligament (herniation implies ruptured annulus fibrosus but protrusion doesn't necessarily). Extrusion: prominent focal extrusion of disk material with only an isthmus of connection with the parent disk due to ruptured annulus and intact or ruptured posterior longitudinal ligament. Free fragment: frank separation of disk material from parent disk (may migrate). There was no resected pathologic specimen from this patient.

20. Virtual Hospital: Atlas Of Human Anatomy In Cross Section: Topography Of The Tho Superior Portion of Duodenum. The highest part of the duodenum varies from aboutthe lower third of the tenth thoracic vertebra to the first lumbar disk. http://www.vh.org/adult/provider/anatomy/HumanAnatomy/Topography/Duodenum.html

For Providers Atlas of Human Anatomy in Cross Section: Appendix: Topography of the Thorax and Abdomen Duodenum, Jejunum, and Ileum Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew, M.D., and Paul C. Reimann, B.S. Peer Review Status: Externally Peer Reviewed Superior Portion of Duodenum The highest part of the duodenum varies from about the lower third of the tenth thoracic vertebra to the first lumbar disk. The average position is at a level between the twelfth thoracic disk and the upper third of the first lumbar vertebra, according to Eycleshymer and Schoemaker. Merkel, Cunningham, and Piersol place it at the level of the first lumbar vertebra, and Joessel places it at the same level but states that this is the position when empty. The present study places the highest level at the lower third of the tenth thoracic vertebra. Transverse Part Eycleshymer and Schoemaker reported that the lower margin of the transverse part of the duodenum varies in location from the middle of the third lumbar vertebra to the fourth lumbar disk. The average position is opposite the middle of the fourth lumbar vertebra.

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