. Manual of operative surgery. with cerebrospinal low specific gravity of the mixture prevents it affecting the higher centresof the cord while the child is inverted, and of course most of it escapes duringthe operation so subsequent danger is averted. Step 2.—If the sac is not too thin dissect away all abraded and ulcerated areasand disinfect again. By transillumination note the position of nerve filamentsand of portions of spinal cord so as to avoid them. Free the skin from the sacand retract the former. Step 3.—Puncture the sac. Resect redundant sac if there is room betweenadheren
. Manual of operative surgery. with cerebrospinal low specific gravity of the mixture prevents it affecting the higher centresof the cord while the child is inverted, and of course most of it escapes duringthe operation so subsequent danger is averted. Step 2.—If the sac is not too thin dissect away all abraded and ulcerated areasand disinfect again. By transillumination note the position of nerve filamentsand of portions of spinal cord so as to avoid them. Free the skin from the sacand retract the former. Step 3.—Puncture the sac. Resect redundant sac if there is room betweenadherent nerve elements, otherwise let it collapse into the spinal cavity. Witha continuous fine (00 to 000) chromicized catgut suture fix the sac so that itcannot unfold. Step 4.—Incise the edge of the dura where it blends with the inner surface 778 OPERATIONS ON THE SPINE of the lamincX and strip it from the bony canal for the entire length of the the mobilized dura over the cord thus restoring the dural I. Skin Ilc. q,-i6.—(Bahcork.) 1 1 ^is; ;; l,.,,!. 1,
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