1. =METHODS OF EXAMINATION.= The spinal cord may be opened anteriorly
or posteriorly. The choice of method is largely a matter of
convenience or of individual skill in using certain instruments,
such as the Brunetti chisels. The method of opening posteriorly is
more commonly used in this country, as it requires less skill. It
necessitates, however, an additional long skin incision that must
be tightly stitched together to prevent leakage of blood and fluids
after the restoration of the body. For this reason it is not as
clean a method as the anterior opening, which requires only the one
main skin-incision. In private practice the latter method is often
advisable, as by it an examination of the cord can often be secured
when the relatives would not consent to its removal posteriorly, on
the ground of undue mutilation of the body. The anterior examination
also permits a better inspection and an easier removal of the spinal
ganglia and nerves.
=Examination of Cord Posteriorly.= For the _opening of the spinal
cord posteriorly_ the cartilage-knife, bone-forceps, bone-nippers and
rhachiotome are necessary; in place of the latter the single saw,
double chisel, Brunetti chisels or single chisel may be employed. The
posterior examination of the cord should take place at the beginning
of the autopsy, after the external inspection of the cadaver, before
the thorax and abdomen are examined. The removal of the sternum
gives a loss of resistance to the manipulations upon the back of the
cadaver, and the turning-over of the body after it has been opened
anteriorly is usually an unpleasant procedure because of the dripping
of blood and other fluids. When it is found necessary to examine the
cord posteriorly after the opening of thorax and abdomen it is better
to fill these cavities with tow or excelsior, replace the sternum and
sew up the anterior skin-incision before turning the body over.
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