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The reader may question why there is a need to tell such a story. We believe strongly that, with disparities of standards of practice in pain medicine and poor recognition of advances in pain management, this scenario is quite common in many states and countries. The practitioners of pain management in these regions certainly must have considered getting together and forming a consensus on the standards of practice in their communities. This historical report of the Texas Pain Society provides the relevant information necessary and the efforts to be made for a society��s mission to achieve its goals and have an ongoing impact in [http://en.wikipedia.org/wiki/Diglyceride diglyceride] its own region. We hope that we have shed some light on a process for the formation of a regional pain society such as ours. ""2691"	"Background:? The precise localization of painful structures in the spine of patients with low back pain and/or pain radiating (LBP/RP) to the lower extremities is important for targeted therapeutic intervention. The aim of the study reported here was to determine and compare the spinal segment(s) where pain was elicited via endoscopic evaluation vs. the vertebral level from where the pain was thought to originate as determined by clinical evaluation and by MRI. Methods:? Observational cohort study of 143 patients 19 to 88?years of age undergoing spinal canal endoscopy (epiduroscopy) in a combined academic and private practice setting January 2008 to December 2008. Patients [http://www.selleckchem.com/products/ldn193189.html LDN-193189 in vivo] were asked whether pain generated by pressure upon epidural structures with the tip of an endoscope was [http://www.selleckchem.com/products/a-1210477.html A-1210477 cost] similar in character and distribution (concordant) to the pain for which patients sought treatment. Notes from clinical evaluation and MRI reports were reviewed, and segmental level determined to be the locus of pathology was tabulated. Results:? One hundred twenty-five (87%) patients reported maximal reproducible pain at a specific level during epiduroscopy. The most common level was at L4 to L5 (87 patients). The least common level was L5 to S1 (2 patients). In only 40 patients did the level determined by clinical evaluation correlate with the level at which pain could be reproduced during epiduroscopy. MRI indicated a specific vertebral level that corresponded to the level at which pain could be reproduced during epiduroscopy in 28 of 143 (20%) patients. The results of the 3 diagnostic methods were significantly different (P?