Main articles about back mice from the middle part of the 20th century
Images from the articles with links to the notes about them
Article published in 1935. Author C.J. Sutro. Titled SUBCUTANEOUS FATTY NODES IN THE SACROILIAC AREA. Sutro got intrigued by Stockman’s work an the presence of low back tender nodules.Article published in 1937. Author E. Ries. Titled EPISACROILIAC LIPOMA. Dr. Ries got intrigued by a patient with disabling low back pain that got relieved by removing surgically a fatty tumor in the sacroiliac area, he called it episacroiliac lipoma.He explored 1000 patients to find out more about these lipomas.Article published in 1942. Author MacDermot. Titled SACRO-ILIAC LIPOMATA. This is an excellent article from Dr. MacDermot that warns the medical community that there are at least 3 pain syndromes related to the sacro-iliac lipomata: low back pain, leg pain and low quadrant abdominal pain.Published in 1944. Authors Copeman and Ackerman. This is a rather long article published in 1944 in a magazine named Quarterly Journal of Medicine by Copeman and Ackerman. This article had a big impact on those days and many posterior articles related to back mice refer to this one I would say “this was the article that changed everything”. Unfortunately, due to what I call the “discopathy fever”, Copeman’s works and many others have been completely neglected in the last 50 years. As the role of fibro-fatty tissue (as back mice) as a causative agent in “rheumatic pain” or the role of the peripheral cutaneous nerves in explaining certain pain syndromes (as cluneal neuropathy) have, too.Article published in 1945. Author Mylechreest. Titled AN INVESTIGATION INTO THE AETIOLOGY AND PATHOLOGY OF FIBROSITIS OF THE BACK. Mylechreest dissected 12 bodies 1945 and concluded that fatty tissues may play an important part in the pathology of the fibrositis of the back (also known as back mice).Article published in 1945. Author Clavero-Núñez. This is a short article from a known Spanish gynecologist that published this article titled Las afecciones del panículo adiposo como causa de lumbosacralgia en la mujer.It just presents ONE CASE REPORT (about backmice) that they diagnosed thanks to the influence of Copeman and Ackerman’s published work in 1944. The article does not show any photo. Dr. Clavero-Núñez insists that the adipose tissue should be better studied to explain certain pain syndromes. It also explains that it is a tissue that can easily present edema.Article published in 1945. Authors Pugh and Christie. Titled A STUDY OF RHEUMATISM IN A GROUP OF SOLDIERS WITH REFERENCE TO THE INCIDENCE OF TRIGGER POINTS AND FIBROSITIC NODULES. This is a short article about trigger points and fibrositic nodules (also known as back mice) from 1945 signed by Pugh and Christie. They studied the back, the shoulders and the buttocks of 522 healthy soldiers in Holland.Article published in 1946. Author R. Herz. Titled: Herniation of subfascial fat as a cause of low back pain. This is a relevant article about subfascial fat herniation (also known as back mice or mouse) from 1946. Ralph Herz presents his personal anatomical observations from the dissecting room and he studied 109 medical cases related to subfascial fat herniation and low back pain.Article published in 1946. Author P. Hench. Titled DISCUSSION OF THE PAPER BY RALPH HERZ. HERNIATION OF SUBFASCIAL FAT AS A CAUSE OF LOW BACK PAIN.This is a short discussion signed by P. Hench about the article of Ralph. Hench comments that Dr. Herz has presented the first public confirmation of the recent work of Copeman and Ackerman (1944). He comments on the differences between Great Britain and America, the scepticism of America about the entity called fibrositis or fibrositic nodules or subfascial fat herniation.LETTER from 1946. Author Lifvendahl. Titled HERNIATION OF FASCIAL FAT AND LOW BACK PAIN. Richard A. Lifvendahl refers to Herz’s article in the Journal July 28, 1945 (Herz, 1945) that just points to previous work references about the lumbar fat herniation from Copeman and Ackerman’s work (omitting that Dr Emil Reis published work in 1937).Editorial published in 1946. Titled UNA CAUSA FRECUENTE DE LUMBAGO: LAS HERNIAS DE LA GRASA SUBFASCIAL.This is an editorial from the medical magazine El día médico. The medical article summarizes the work from Copeman and Ackerman and Herz, so they think it is relevant for the general doctor to know. They mainly focused on HERZ’s publication from 1946, published in The Journal of the International College of Surgeons (May, 1946)Article published in 1947. Authors Copeman and Ackerman. Titled EDEMA OR HERNIATIONS OF FAT LOBULES AS A CAUSE OF LUMBAR AND GLUTEAL “FIBROSITIS”. The authors explain that certain pain syndromes related to the entity called back and gluteal fibrositis (also known as back mice) were related to the oedema or herniation of fat lobules. They found that the pain arise from a fibro-fatty tissue and not from the muscles, as it had often been stated.Article published in 1947. Author Moes. titled NODULATION OR HERNIATION OF FAT AS A CAUSE OF LOW BACK PAIN. Dr. Moes presents 2 CASE REPORTS that obtained a dramatic cure after surgical removal. In one case they did not find herniation signs, that’s why maybe Moes titled the article “Nodulation or Herniation of Fat”. On the other case report, they found clear signs of herniation through the thoracolumbar fascia.Article published in 1948. Authors L. Orr et al. Titled SOMATIC PAIN DUE TO FIBROLIPOMATOUS NODULES, SIMULATING URETERO_RENAL DISEASE: A PRELIMINARY REPORT. The authors WARN that the clinicians had so long been conditioned to think as VISCERAL PAIN being referred to the EXTERNAL DERMATOMES of the body that they might have become NEGLECTFUL to understand SOMATIC STRUCTURES as being the site of the pain impulses. They present a NOT UNCOMMON mechanism for the production of symptoms SIMULATING disease of the urinary tract, which are usually OVERLOOKED and had SOMATIC ORIGIN.Article published in 1948. Authors Hucherson and Gandy. Titled HERNIATION OF FASCIAL FAT; A CAUSE OF LOW BACK PAIN. They mention the previous work of Herz, Copeman and Ackerman about the painful fatty tumors causing low back pain. They present the result of the operation upon 42 patients that have corroborated the findings of Copeman and Ackerman about the tumors being herniations of fat through the fascia of the back.Article published in 1949. Author Hittner. Titled EPISACROILIAC LIPOMAS. First, Hittner summarizes the clinical picture of the episacroiliac lipomas. Later, he presents his results of 50 cases that he managed with local infiltration with three different drugs: novocaine, cyclopropane and penthotal before surgery.Article published in 1949. Author Copeman. Titled FIBRO-FATTY TISSUE AND ITS RELATION TO CERTAIN “RHEUMATIC” SYNDROMES. In this article, Copeman exposes his observations that the pain occurring in fibrositis is related to “A PAINFUL DISTENSION OF FAT LOBULES within a confined space”. He states that the fat tissues of the body are subject to pathological variations that cause pain usually labelled as “rheumatic” or “fibrositic”. If this occurs in the neighbourhood of joints, the condition is often wrongly termed arthritic. Copeman noticed that the OEDEMA showed NO SIGN of being inflammatory in nature.Published in 1950- Author Rubens-Duval.This is an article written in French about what Dr. Rubens-Duval called CELLULALGIE, related to the process of cellulite. Let’s say he named the “painful cellulite” as cellulalgie. But it seems this term has not been used subsequently. The back mice would have been referred as “lumbago from cellulalgic origin” or “lumbar cellulalgie” or a “lumbar subcutaneous cellulalgic infiltrate”.ARTICLE published in 1950. Authors Dal Lago and Vera. Titled LA FRECUENCIA DE LAS HERNIAS GRASAS CON LESIONES NECRÓTICAS como causa de lumbago. They present 4 photos as graphic information from the macroscopic findings of the excised fatty hernias. The objective of the authors seems to be to CONVINCE the medical community that the fatty hernias (back mice) are a REAL entity.Article published in 1950. Author Katz. Titled EPISACROILIAC LIPOMA AS A CAUSE OF LO BACK PAIN. This is a short article from 1950 about the episacroiliac lipomas or back mice as a cause of low-back pain written by Kermit Katz and Morton Berk from the Boston City Hospital. -It is important to notice that they presented 5 cases of OBESE WOMEN that DID NOT improve with the local injection of anesthetic as other authors pointed out. The patients did a PROMPT IMPROVEMENT with the surgical removal of the fatty mass.Article published in 1951. Author Rouhier. Titled LES LIPOMES DOULOUREUX DE L’ÉCHANCRURE SCIATIQUE DET DE LA RÉGION PARA-SACRRÉE.This is a VERY SHORT article published in 1951 about painful lipomas (or back mice) in 3 women that got better after surgical removal. The author, Dr. Rouhier, was a French surgeon who, not knowing previous publications about this entity, found it worthy to publish these cases. He is intrigued and says “In principle there are no tumors more benign, more painless and better tolerated than lipomas, as long as they do not become troublesome or disfavourous by their volume. However, in some areas where the development of lipoma is constricted by aponeurosis and where it is in contact with nerve trunks, it can become the cause of painful syndromes”.Article published in 1952. Author Herz. Titled SUBFASCIAL FAT HERNIATION AS A CAUSE OF LOW BACK PAIN: DIFFERENTIAL DIAGNOSIS AND INCIDENCE IN 302 CASES OF BACKACHE. He presents a study of 302 cases of low back pain, many of whom were undiagnosed low back pain and were related to the presence of painful nodules in the lower back. He explains the surgical technique, the anesthetic injection diagnostic test and the differential diagnosis that has to be done.Article published in 1952. Author Ficarra and McLaughlin. Titled LOW BACK PAIN DUE TO PANNICULAR HERNIAS. REPORT CASE. This is a short case report from 1952 of one woman with multiple pannicular hernias or back mice with low back pain. The patient thought they could be cancer and insisted to have them removed. The low back pain was resolved. The authors JUST had two references of what these fatty painful tumors could be.Article published in 1952. Author Raymond. Titled SACRO-ILIAC LIPOMATOSIS (HERTER’S DISEASE) A RELATIVELY NEW CLINICAL ENTITY.This is a very short article titled Sacro-iliac Lipomatosis or Herter’s Disease (also known as back mice) published in the editorial of the Pennsylvania Medical Journal in 1952. Apparently, Dr. Raymond was not aware of the previous studies of Ries, Copeman or MacDermot and thought that it was the first time there was a publication about this entity. Some years before, a doctor called Herter from Cleveland explained them about it, so in a homage to him he decided to name it Herter’s disease.Article published in 1952. Authors Donati and Bidoni. Titled: LIPOMI DELLA REGIONE SACROILIACA.This long article (15 pages). It was published by two surgeons from the “Univertsità di Pavia” in Italy. They present 5 observations of patients with Sindromi lombo-sciatalgische and lombo-sacralgiche [lumbo-sciatalgic and lumbo-sacralgic syndrome].They present an extensive bibliography and an interesting review from the literature. Donati and Bidoni present black and white pictures of 3 of the episacral lipomas or back mice that they removed from patients. And they describe them histologically as a lipoma with a bright fibrous capsule in the deep subcutaneous planes.Article published in 1953. Author Sheehan. Titled EPISACROILIAC LIPOMA AND SCIATICA. This is an article about the epi-sacro-iliac lipoma and sciatica (these lipomas are also known as back mice). Sheehan starts presenting 6 illustrative cases with these lipomatous masses and low back pain and sciatica. He descibes the BASIC FAT PADS.ARTICLE published in 1953. Author Nunziata. Titled LUMBOCIATICAS POR HERNIAS DE GRASA.Dr. Nunziata explains that, in 1948, they met Dr. Caruso, who told them about the publication from Copeman and Ackerman. Then he operated on the first patient. The nodule of that patient was located at the level of the 12th rib; it was the size of a chickpea and adhered to the deep aponeurosis. They removed it and the patient got better. Then they got excited about it and they operated on more patients. They knew that Dr. Pedro Noti (Mendoza) had operated by then more than 100 cases. They themselves had been operating more than 50 cases. After 3 years, they got no recurrences from the operated patients. Generally, the pain disappeared immediately; in some other cases it took a while.Published in 1953. Author Schmidt-Voigt. Titled: Das lipomatose Kreuzbeinsyndrom. Ein Beitrag zur Pathogenese des Kreuzschmerzes. This article about the “lipomatose kreuzbeinsyndrom” is the only German article we found for the time being about the entity back mice. The author called it LKS –Lipomatose Kreusbeinsyndrom– (Lipomatose crossbone (sacral) syndrome) They found 47% of prevalence of lipomatose nodules (what we call back mice) in 153 low back pain patients that had previously other diagnosed entities. The author warns that due to the lack of awareness about these nodules of many doctors the patients are diagnosed with other labels.Published in 1952. Author Sicard. Titled: Lipomes épisacro-iliaques et lombo-sciatiques. In their conclusions they stated that the lipomes épisacro-iliaques are a FREQUENT and COMMON observation, and in some cases can be responsible for causing lumbosacralgia and lumbosciatalgia BUT it is still DIFFICULT to assert the relationship between the fatty nodule and the pain syndrome. The awakening of the pain by the pressure of the lipomas is, according to them, the best suspicious sign.Article published in 1953. Authors Rimbaud and Thevenet. Titled LOMBO-SCIATIQUE ET LIPOME ÉPISACROILIAQUE. This is a short article written in French about the lipome épisacro-iliaque and lombo-sciatique (French name for back mice and lumbosciatalgia).They also present a case report about a woman that suffered from long incapacitating low back pain until it could be found and treated, due to back mice. The patient presented a L5 type lumbosciatic pain syndrome in relation to a fatty nodule of the sacroiliac region. The treatment of lipoma by 5 novocainic infiltrations (separated by a week) resulted in healing while all the methods that had been undertaken before failed.They suspect that the etiopathogenic factors are a disturbance in the water balance. But they do not discuss deeper about it.
Article published in 1955. Author BJ Ficarra. Titled Pannicular lumbosacral hernia. The authors reviewed the literature and presents 6 cases with good surgical outcome.Article published in 1955. Author Joyeux. Titled LIPOMES ET LOMBO-SCIATIQUES. The author presents a CASE REPORT about a singular patient that suffered from a pituitary tumor. The author concludes that the lombo-sciatic pains that the patient suffered were related to the fatty tumors that she presented and compressed the nerves. Since after excision of the fatty tumor the patient improved. Joyeux thinks that a VASOMOTOR PHENOMENA brings the fatty mass to become turgid, by tissue edema and then cause compression of adjacent nerves, but not intranodular nerves. This vasomotor process could explain the intermittence of this painful phenomenon. It could be explained by an endocrine disorder that affected the water balance of the adipose tissue.
ARTICLE published 1956. Authors Nocentini and Rosati. Titled: ANATOMICOCLINICAL PICTURE OF EPISACROILIAC LIPOMAS. This is a long italian article of 37 pages with an extended reference list about the lipoma episacroiliac or the “lipomi episacroiliaci”. The article shows many photos of the “lipomi episacroliiaci” extracted by surgery.ARTICLE from 1957. Authors Gomez et al. Titled HERNIAS FROM THE PANNICULUS ADIPOSUS IN LUMBOSACRAL FIBROSITIS. This is an article from Chile about the hernia of the panniculus adiposus (another name for back mice) and its relation to lumbo-ciatalgic pain in cases of lumbosacral fibrositis. They operate 12 patients with good results. They considered that they had good surgical results, and when facing any lumbar or lumbociatalgic syndrome, the presence of herniae or nodules should be considered and not just be considered as idiopathic pains.ARTICLE published in 1959. author Tibaudin. Titled HERNIAS GRASAS LUMBARES COMO CAUA DE LUMBOCIÁTICAS REFLEJAS. This is an extended Argentinian article written in SPANISH about the lumbar fat hernias (back mice) as a cause of low back pain and reflex lumbosciatic pain. The author presents a long bibliography of many articles from the 50s about these fatty nodules. He also refers to Steindler’s theories to explain the pain to the leg by a REFLEX pain, that’s why they called it reflex lumbosciatic pain. He presents the results with 11 patients that were treated by repeated local anesthetic injection or surgical excision.Article published in 1959. Author Kanan. Titled HERNIAS DE LA FASCIA SACRA. Summary: A study of 160 patients presenting fatty hernias mainly managed by local anesthetic; maximum 3 infiltrations; just 7 underwent surgery with good results. Reference to the work of Copeman and the studies of many surgeons from the 50s (Dittrich, Herz, Hucherson, Hittner…). ARTICLE WRITTEN IN SPANISH, published in the Argentinian medical magazine “El día médico”. Dr. Kanan starts saying that the hernias of the lumbosacral region can give rise to low back pain with or without radiation VERY SIMILAR to the pains of vertebral origin.ARTICLE published in 1960. Author Raymond. Titled SACROILIAC LIPOMATOSIS. He presents the results in 30 operated patients that underwent surgical removal from the sacroiliac nodules.
Thesis published in 1962. Author Duval. Titled Sciatiques et lipomes épi-sacro-iliaques. It focuses on the lumbosciatalgic syndrome that the lipomes épi-sacro-iliaques can cause. Warning that the patients present as middle-aged menopausal women with “rebel sciaticas” that have certain characteristic presentation. He related the sciatic pain to the affection of the posterior peripheral lumbosacral nerves.Article published in 1963. Author Sedwitz & Thomas. Titled: Hernia adiposa – A cause of low back pain. It is a small article about 20 patients that underwent surgical removal from their tender nodules in low back related to long history of unknown low back pain. The nodules were considered fatty hernias. They all had good outcome.ARTICLE published in 1963. Author Dittrich. Titled LUMBODORSAL FASCIA AND RELATED STRUCTURES AS FACTORS IN DISABILITY. Dittrich states that the basic anatomical lesion is “a rupture of the lumbodorsal fascia with subfascial fat fibrosis”. This lesion can cause referred pain and referred tenderness; somatic and autonomic nerve symptoms. The edematous fat lobules wouldn’t be related to pain.
Article published in 1968. Author Baciu. Titled PAINFUL LUMBAR SCLEROLIPOMA (SYNDROME COPEMAN-ACKERMAN). They studied 60 cases and presented the hypothesis that the entity has a HORMONAL ORIGIN (pituitary or ovarium) with a DISTURBANCE OF THE WATER DISTRIBUTION and presents as painful lipomas in the lumbo-sacral region. Surgical removal is the best solution, closing the possible fascial gap (they present as fatty hernias). There is a relapse rate of 25%.ARTICLE published in 1969. Author Baciu. Titled LES LOMBOSCIATALGIES DU TYPE COPEMAN AND ACKERMAN. It is a short and interesting article where the author makes the statement that he thinks this syndrome is NOT a local problem but a more LOCAL MANIFESTATION of a generalized problem of the “water balance of the fatty tissue”. The histological findings, like other authors’ work, point out the presence of the fibrous capsule and the thickened walls of the vessels.
