Paralytic deformities of the lower extremities : the principles of their surgical treatment / by E. Noble Smith.

  • Smith, E. Noble (Eldred Noble), 1847-1906.
Date:
1900
Catalogue details

Licence: In copyright

Credit: Paralytic deformities of the lower extremities : the principles of their surgical treatment / by E. Noble Smith. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    upwards to about the eleventh rib. At the back of the thighs the area of duhiesH did not extend so far downwards. There was hyperiesthesia of the buttocks. Operation.—On May 24, 1894, with the assistance of Mr. Ernest Lane, I performed laminectomy by removal of the neural arches of the eighth, ninth, and tenth dorsal vertebrre. There was no fat over the dura mater, which was congested, and in the upper part of the opening, in the position beneath the removed arch of the eighth vertebra, was found a spongy material like granulation tissue. This was producing some pressure on the cord and was removed. It covered the dura mater as far as it was exposed transversely, being rather thicker on the right than on the left side. The amount removed was about equal to the contents of an ordinary hazel nut; but as it could only be taken away in small pieces the amount was rather difficult to estimate. The patient made a rapid recovery from the laminectomy. The wound appeared quite healed upon the third day after the opera- tion, except at the lower part, where a drainage tube had been left in for twenty-four hours. The day following the operation the . patient remarked upon the great difference in her sensations, having lost the feeling of coldness in the lower extremities, which she had suffered from for several years. She gradually recovered strength, and with a supporting apparatus to the spine began to walk about three weeks after the operation. A letter from her, dated November 7, 1894, five months after the operation, describes her condition at that time in com- parison with what it had been formerly. She referred to the coldness, which had existed for years, in her lower limbs, as deadlv coldness.' She had been obliged to have hot bottles at night, summer and winter, and these had only given her relief during their use. She stated : ' Almost directly after the operation I felt