. Orthopaedic surgery for students and general practitioners : preliminary considerations and diseases of the spine : 114 original illustrations. rocessestogether inseparably by ankylosis. I have illustrated this diagrammatically: Let Fig. 43 arepresent two healthy vertebrae seen in profile. The paral-lel lines represent the superior and inferior planes of thosebodies. The center of gravity or weight-bearing line isindicated by the dotted line, seen to pass through the centerof the vertebral bodies. The alignment of the spinous pro-cesses is seen to be straight. In Fig. 43 B we see the result
. Orthopaedic surgery for students and general practitioners : preliminary considerations and diseases of the spine : 114 original illustrations. rocessestogether inseparably by ankylosis. I have illustrated this diagrammatically: Let Fig. 43 arepresent two healthy vertebrae seen in profile. The paral-lel lines represent the superior and inferior planes of thosebodies. The center of gravity or weight-bearing line isindicated by the dotted line, seen to pass through the centerof the vertebral bodies. The alignment of the spinous pro-cesses is seen to be straight. In Fig. 43 B we see the result of an untreated tubercular TUBERCULAR LESIONS OF THE SPINE. 107 process where the bodies have collapsed, the planes of thesuperior and inferior surfaces converge and meet anterior tothe vertebral column and the spinous processes are widelyseparated. The center of gravity hne is thrown furtherforward, tending to increase the deformity. The separationof the spinous processes shows the characteristic contour ofthe humpback. In Fig. 43c is shown what should be the aim of treatment,viz: the separation of the vertebral bodies as far as the liga-. FiG. 43. Diagrammatic REPRESENTATiON of the Production of the Defor-mity OF Potts Disease. A, Normal. B, Potts Disease, and C, Aim ofTreatment. mentous and muscular attachments will permit, the throw-ing of the center of gravity back on the articular processesand the crowding together of the spinous processes. We cannot say that a true separation of the vertebralbodies really occurs by hyperextension before extensivebone destruction has taken place, but certainly interverte-bral pressure is lessened and in extensive unhealed disease, 108 ORTHOPEDIC SURGERY. where softening of the tissues still exists, such a separationcertainly occurs in hyperextension. With these principlesbefore us we are now in a position to take up TREATMENT IN DETAIL. Recumbency: The patient is to be placed prone on theface or supine on the back on a firm mattress; if o
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