A preliminary paper upon the causes of lateral curvature of the spine : with the report of a case of lateral deformity due to occupation / by Newton M. Shaffer.

  • Newton Melman Shaffer
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A preliminary paper upon the causes of lateral curvature of the spine : with the report of a case of lateral deformity due to occupation / by Newton M. Shaffer. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    lO etiology of scoliosis, why it is that the curve and twisting occur most frequently in the mid-dorsal region. The thorax forms a pedestal for extensive extrinsic muscular action,—and none of these extrinsic muscles are in a posi- tion to produce a thoracic or vertebral deformity, unless their distal extremity becomes a fixed point. Again, there is scarcely any motion at the first five dorsal vertebrae, and the remaining ones—down to the tenth dorsal vertebra— also possess very little mobility. The location of these ten vertebrae, their costal as well as their ligamentous and •muscular attachments, the shape of their inter-vertebral discs, their almost interlocking spinous processes, their vertical articular processes, and their situation as regards the centre of gravity (which passes anteriorly to the bodies, in the mid-dorsal region, in the erect position),—all tend to make this the region of the least mobility in the whole spinal column. If the primary curvature were to occur in this region from gravity, would it not be a posterior one, as in chronic spondylitis,—this being the normal direction of the spinal curve at this point ? And would not the curve occur, if gravity were the factor, at the point of the least resistance, rather than at the point of the greatest resist- ance—in other words, between the thorax and the pelvis, as it did in the case here recorded ? And yet, true scolio- sis, with twisting, occurs most frequently in this mid-dorsal region, where there are so many obstacles to its occurrence. To make gravity, with predisposing atonic conditions, ac- countable for a curve which finds its principal expression at this doubly locked region, seems to the writer wholly un- tenable. In the case I have recorded the cause, or causes, are not hard to find. They exactly accord with Dr. Little’s graphic description of the cause of adolescent knock-knee. There are many reasons why Dr. Little’s etiology, as applied to