Spondylolisthesis : with description of a case / by Robert W. Lovett.

  • Robert W. Lovett
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Spondylolisthesis : with description of a case / by Robert W. Lovett. 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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    more widely separated than normal in severer cases and the incli- nation of the pelvis is diminished (Neugebauer). The essential point, it may be repeated, in spondylolisthesis is not so ranch the subluxation of the body of the vertebra as the antero- posterior elongation of the body of the lumbar vertebra. This exists always, and is apparently the pathological condition peculiar to this situation and this condition. In comment on this it should be remembered that each vertebra develops from three centres of ossificatiou, one for the body and one for each lamina and its processes. The vertebral arch forms during the first year by the joining of the two posterior centres of ossification, but this is not joined to the centre of ossification of the vertebral body until the third year (Gray). The causes of separation of the anterior and posterior parts of the lumbar vertebrae are classified by Neugebauer, and generally accepted to be as follows : I. Separation on one or both sides between the body and the lamina? of the vertebra. (a) Due to a defect in development. (b) Due to fracture. II. Primary disease of the sacro-vertebral articulation. III. Vertebral deformity, due to superimposed weight and bony changes resulting from pressure. Each of these divisions will be briefly considered in turn. I. (a) The Separation of the Vertebral Arch due to Congenital Defect. Deficient union or absence of union between the vertebral lamina? and the bodies is recognized under the formidable names of spondylolysis or spondyloschisis (Lambl6). Such lack of union, or imperfection of union, might, under the circumstances of injury or excessive weight-bearing, predispose to spondylolisthesis. That such congenital deficiency of vertebral union is not excessively rare is shown by the statement of Neugebauer that Langer estimates this defect as occurring in 10 per cent, of skeletons, and Jendrzich- inskiz in 5 per cent. Neugebauer has found two hundred and forty anatomical specimens in European museums illustrating the con- dition, and a good deal has been written on the subject.* * Broca: Bull, rle la Soc. d'anat. de Paris, 1884, p. 448. Treub : Nouv. arch, d'obst. et de gyn., 1889, Iv. 410, with figures. Turner : Report on Human Skeletons. Challenger's He- ports, xvi., 188fi.