A case of spondylitis deformans / by W. Allen Sturge.

  • Sturge, William Allen, 1850-1919.
Date:
[1879]
Catalogue details

Licence: Public Domain Mark

Credit: A case of spondylitis deformans / by W. Allen Sturge. 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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    neck liave been getting stitf, rendering it difl&cult for him to stoop forward, or to turn his head to one or the other side. He has noticed, also, that for some years his chest has been getting stifF, so that it does not move properly when he breathes. The legs, too, have been getting somewhat weak, the right rather more so than the left. From time to time there have been pains in the arms, rendering it somewhat difficult for him to move them about freely. No history of a fall or of accident of any kind. At the present time he is a somewhat anaemic and weakly- looking man, about 5 feet 5 inches high. The spinal column is remarkably fixed throughout. The lumbar and dorsal regions together form a curve with the convexity backwards; but the angle between the sacrum and the last lumbar vertebra appears to be more acute (backwards) than in the normal condition; for the spine as a whole is on a plane much further back than that of the sacrum. A plumb-line dropped from the most projecting part of the spine falls several inches behind the buttocks; the lower part of the abdomen projects somewhat forwards, whilst the legs are placed somewhat backwards in order to catch the centre of gravity of the body. The curve in the spine is a regular one of large radius, and there is nothing in its appearance to suggest angular curvature. The neck is bent somewhat forwards, which causes him to poke the chin forwards. If the spine be ta pped pretty firmly in the dorsal region he says that it gives him pain in the cervical region. Tapping in the cervical region itself is, however, not painful; nor is there any tenderness in the lumbar region. When he stoops forwards to the utmost extent, the knees being straight, he can only carry the tips of his fingers to about 4 inches below the knees. The fiexion of the spine in doing this appears to be almost entirely confined to the lower lumbar region, all the rest being held quite rigid. The cervical part of the spinal column is very stiff. Flexion of the head forwards is ajjparently only performed by a slight movement of the upper two or three cervical vertebrae. It is sufficient to relax the skin beneath the chin, but falls very far short of bringing the chin down to the sternum. The movement of the head backwards can be performed in about a corresponding degree; but lateral movement towards the shoulders is almost nil. Rotation of the head can be effected with greater ease than these other movements, but even this is very deficient. In rotating to