. Lateral curvature of the spine and round shoulders . is.^ It oc-curs also as the result of lesssevere spinal defects, such ascervical ribs,^ spina bifida, andabnormal formation of the lastlumbar vertebra. Congenital scoliosis may beevident—(i) immediately afterbirth, as in the case of theseverest malformations (Col-ville^ in 1015 cases of new-bornchildren found only one case ofscoliosis); or (2) only when thechild begins to walk, in the case of malformations not severe enoughto cause a curve in the recumbent position. In these latter cases thecurvature appears as the result of the superincum
. Lateral curvature of the spine and round shoulders . is.^ It oc-curs also as the result of lesssevere spinal defects, such ascervical ribs,^ spina bifida, andabnormal formation of the lastlumbar vertebra. Congenital scoliosis may beevident—(i) immediately afterbirth, as in the case of theseverest malformations (Col-ville^ in 1015 cases of new-bornchildren found only one case ofscoliosis); or (2) only when thechild begins to walk, in the case of malformations not severe enoughto cause a curve in the recumbent position. In these latter cases thecurvature appears as the result of the superincumbent weight comingupon the defective spine or as the result of asymmetrical growth due to ^ Liining and Schulthess: Ajlas d. orth. Chir., Miinchen, 1901.^ Atlianassow: Archiv f. orth. Chirr, i, 3. ^Schmidt: Allg. Path, und path. Anat. d. Wirbelsaule, Liiberschs allg. Path., 4. Jahrg., 1897. ■ Schuhhess : Joachimsthals Hdbch. d. orth. Chir., Jena, 1903, iii, 708.^ Breuss and Kolisco, quoted by : Rev. d. Orth., 1896, Fig. 68.—Scoliosis due to CongenitalDefects in Spine and Thorax, theRibs Being Bifurcated and Defective. CONGENITAL SCOLIOSIS. 93 the malformation. Such cases as these are perhaps not strictly con-genital, but might be better spoken of as scoliosis due to a congenitalcause. The two most common locations of congenital defects are in thecervicodorsal and lumbar regions. In the former, cervical ribs are afrequent accompaniment (Halsrippenskoliose). The formation ofa cervical rib is often associated with a splitting of the vertebralbodies, as shown by the x-ray, and in some cases the cervical rib is ac-companied by a rudimentary extra vertebral body.^ The shoulder onthe side of the cervical rib is elevated, and the curve is a sharp cervico-dorsal one with a compensatory opposite curve below. In the lumbar region the curve is frequently associated with spinabifida, spina bifida occulta, or sacralization of one side of the last lumbar
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