A new contribution to the history and etiology of spondyl-olisthesis / by Franz Ludwig Neugebauer ; translated by Fancourt Barnes.

  • Neugebauer, Franz Ludwig, 1856-1914.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: A new contribution to the history and etiology of spondyl-olisthesis / by Franz Ludwig Neugebauer ; translated by Fancourt Barnes. Source: Wellcome Collection.

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    tion of the vertébral column cannot take place witliout an accom- panying condition of irritability in the surrounding soft parts. Quite apart, however, from this, and from the history of the case, several other points corroborate the diagnosis. As has been stated, the angle of dislocation was on oue occasion felt below the level of the anterior superior raargin of the os sacrum, while in a case of lumbo-sacral spondylizematic kvpliosis the apex of the angle of flexion is situated exactly at this margin, and there- fore the finger tip passing outwards on either side from this angle of flexion must hit upon the anterior edges of the latéral masses of the sacrum. Moreover, the thickness of the posterior pelvic wall in a médian plane at the level of the plane of the pelvic inlet is evideutly too great ; the posterior pelvic wall now consists at this place of the body of the fiftli lumbar vertebra + the body of the first sacral vertebra, the posterior arch, and the spine of the fiftk lumbar vertebra, a diagnostic mark on the value and mensuration of wliich, by means of subtracting the direct thickness of the posterior pelvic wall at this part from the length of the external conjugate diameter, and so getting the length of the false conjugate, I bave already written in my earliest work and elsewhere.* We bave, fiually, the assistance of the ckaracteristic condition of the solid angle of Breisky, as well as the circumstance tliat to reach the latéral parts of the anterior superior margin of the base of the sacrum one must on each side pass one’s finger upwards along the posterior pelvic wall above the depressed body of the fiftli lumbar vertebra. The history of the case, its course and symptoms, the progress of the development of the existing deformity, tlie attitude of the body, &c., ail give additional support to the clinical presumptive diagnosis, every objection to which may in the face of thèse circumstances be considered removed, as indeed Herr Scliroder himself considered. Mrs. F. had stated tliat slie found relief if she supported * Zur Enlwickelungeschichte des Spondt/loUslhelischen Becken'.i u.s.io. S. 88, ff. “A further peculiarity of the spondyl-olistlietic pelvis is found theoretically and practically in the position of the lumbar vertebræ (especially of the fifth lumbar vertebra) in front of the first sacral vertebra. The increase in the direct thickness of the posterior pelvic wall at the level of the base of the sacrum which this causes, leaves a striking différence between Baudeloque’a diameter and the conj agate pseudo- vera <fcc.” ; and S. 37, “ If in certain cases we were able to measure with instru- ments the thickness of the posterior pelvic wall, the estimation of the conjugate spuria from Baudeloqne’s diameter would (sic) be possible,” et sequent.