A treatise on orthopedic surgery . aused anincreased concavity below. The variations in the anteropos-terior contour of the spine in lateral curvature may be ac-counted for in the same manner. In the one instance theprimary deformity is of the lower region, and with its accom-panying backward twist of the vertebral bodies it lessens thelumbar lordosis and tends to flatten the back (Fig. 93). If, onthe other hand, the deformity begins in the thoracic region, theprimary effect is to increase the backward projection, and thisin turn tends to exaggerate the lumbar lordosis (Fig. 94 L 156 ORTHOPEDI
A treatise on orthopedic surgery . aused anincreased concavity below. The variations in the anteropos-terior contour of the spine in lateral curvature may be ac-counted for in the same manner. In the one instance theprimary deformity is of the lower region, and with its accom-panying backward twist of the vertebral bodies it lessens thelumbar lordosis and tends to flatten the back (Fig. 93). If, onthe other hand, the deformity begins in the thoracic region, theprimary effect is to increase the backward projection, and thisin turn tends to exaggerate the lumbar lordosis (Fig. 94 L 156 ORTHOPEDIC SURGEEY. Thus, the shortening of the trunk in the lumbar region causedby the lateral deviation may be to a certain extent compensatedin the first instance, while in the other both the primary andsecondary distortions tend to reduce the height. The High Shoulder and the High Hip.—If the convex-ity of the primary curve is, for example, to the left in the lum-bar region the trunk is displaced somewhat to the left, conse- FiG. Scoliosis with extreme lateral deviation. quently the right pelvic crest becomes abnormally prominent, aprominence that is usually mistaken for an elevation, and incompensation there is a corresponding twist in the opposite direc-tion above. The spine bending, and at the same time rotatingtoward the right, carrying with it the ribs, raises the shoulderand makes the scapula prominent. Thus it is that in theordinary S-shaped cur^e the high shoulder and the prominent LATERAL CUBVATUBE OF THE SPINE. 157 hip appear usually upon the same side of the body. But in lessregular varieties of distortion, when, for example, there ismarked general lateral deviation of the trunk as a whole, thehigh shoulder may be on the opposite side (Fig. 102). It isprobable that the primary curvature is in most instances to theleft in the lumbar region, the compensation to the right appear-ing at a later time. This is certainly true of the milder typesof postural curvature. Path
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
