A treatise on orthopedic surgery . r of the spine andupon the attitudes of the patient. Therefore, in the study ofnormal spine the standard with which that suspected of diseasemust be compared, mobility and contour, at different ages andunder different conditions should receive especial consideration. The sj^ine as a whole is a flexible column presenting certainconstant curves, forward in the upper, backward in the middle, TUBEECULOUS DISEASE OF THE SPINE. 31 and forward again in tbe lower region. These curves are essen-tially the effect of the force of gravity and of the action of themuscles
A treatise on orthopedic surgery . r of the spine andupon the attitudes of the patient. Therefore, in the study ofnormal spine the standard with which that suspected of diseasemust be compared, mobility and contour, at different ages andunder different conditions should receive especial consideration. The sj^ine as a whole is a flexible column presenting certainconstant curves, forward in the upper, backward in the middle, TUBEECULOUS DISEASE OF THE SPINE. 31 and forward again in tbe lower region. These curves are essen-tially the effect of the force of gravity and of the action of themuscles in balancing the weight of the body in the upright atti-tude. In the adult they are practically fixed; in early childhoodthey can be nearly obliterated by traction in the horizontal posi-tion ; and in infancy they do not exist. If the newborn infantis placed in a sitting posture the head falls forward and thespine bends in one long backward curve, characteristic of weak-ness. If when it lies on the back the legs are drawn down Fig. Incipient Potfs disease. Showing the brealj in the contour of the spine, ofwhich the normal flexibility is but slightly impaired. from their habitual attitude of semiflexion, it will be noticedthat the range of extension is somewhat limited because of theabsence of the lumbar curve and the inclination of the the gain in muscular power is sufficient to enable the in-fant to raise and to control the head, the curve of the neck ap-pears. Later, when the child stands, the erector spinas muscleshold the body upright against the resistance of the iliopsoas 32 OBTHOPEDIC SUBGEBY Fig. 8. group and of the ligaments of the hip-joints; thus the lumbarcurve and the inclination of the pelvis result, and the normalcontour of the spine is established. If from the odontoid process of the axis of a normal indi-vidual in the erect posture a line be dropped to the ground, this perpendicular or v^^eight line, aboutwhich the weight of the body is bal-anced, w
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