A contribution to the surgery of the spinal cord.

  • Thorburn, William, Sir, 1861-1923.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A contribution to the surgery of the spinal cord. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    47/246 (page 35)
    At the post-mortem examination was found a fracture of the anterior and upper part of the body of the first dorsal verteljra, a small portion being chipped off and remaining attached to the disc above. The seventh cervical vertebra was displaced forwards, carrying with it the above-mentioned fragment of the first dorsal. The laminas of these two vertebree were separated behind, the articular processes of the first dorsal being posterior instead of anterior to their fellows of the seventh cervical. On opening the spinal canal, there was found slight effusion of blood between the bone and the dura mater. The cord was compressed at the level of the first dorsal vertebra, and softened for a short distance above and below the site of compression, its centre being occupied by an effusion of blood reaching as high as the fifth cervical nerve-roots, in the form of a narrow cone. There was some sup- puration between the anterior common ligament of the spine and the fiith cervical vertebra, and at exactly corre- sponding points on the anterior and posterior walls of the pharynx. Sketch of section of spine in case of J. S., showing fracture-dis- location of the seventh cervical vertebra. This interesting case is in itself aL most a demonstration of the greater part of our Table. The injury was at the extreme lower part of the cervical region, and must at first have involved the origin of the first dorsal nerves, and probably to some extent that of the eighth cervical. Thus at first we had paralysis only of the intrinsic fio. 7 muscles of the hand and the interossei, but thereafter from day to day we were able to watch the extension upwards of myelitis, picking out muscle by muscle in the following order :— I. The flexors of the wrist. The extensors of the wrist. The triceps and pectoralis major. The latissimus dorsi. The teres major and subscapularis. the humerus (supra- and infra-spinati) remained until the last. The dates at which the pronators failed could not be obtained. 2. 3- 4- 5-