=Morbid Anatomy.=—The vertebræ in the region involved are rotated so
that their spinous processes point toward the concavity of the lateral
curve. The bodies of the vertebræ on the side next to the concavity
are thinner, due to absorption; the intervertebral discs are made thin
on the same side by pressure and absorption. The ribs are considerably
distorted, depressed on the concave side and prominent on the convex
side. The ligaments on the concave side are contracted, and stretched
on the convex side. The muscles on the concave side are more or less
contracted, and on the convex side they are stretched, causing atrophy
and fatty infiltration of their tissues.
=Kyphosis.=—This may be a slight posterior curve really amounting to
nothing, or it may be a very grave pathological condition as in Pott’s
disease. Therefore it is very necessary that one should make a most
careful diagnosis (see Pott’s disease).
The most common =causes= of kyphosis are Pott’s disease, rachitis,
occupation, general weakness, rheumatism and old age.
In Pott’s disease, the posterior curve is characterized by a sharp
angle, and by the spine being very rigid. This, taken in conjunction
with the history and other symptoms should be sufficient to enable one
to make a diagnosis. Radiographic examination should be made.
The condition of round shoulders, which in time produces marked
kyphosis, is rarely a habit as it is usually termed. In nearly every
case it indicates either a weakness of the back muscles or, what is
more apt to be the cause, a strained posterior condition of the dorsal
vertebræ, commonly of the lower dorsal region.
=Morbid Anatomy.=—In mild cases there is simply a relaxation of the
ligaments of the vertebræ and a separation of the laminæ and spinous
processes. In severe forms there may be absorption of the anterior
portion of the intervertebral discs and the bodies of the vertebræ
(Pott’s disease).
=Lordosis.=—This may be a congenital condition, especially when
occurring in the lumbar region. Anterior curves of the spine are
generally found in the lumbar or cervical regions, but occasionally
occur in the dorsal region, causing the spinal column to be more
or less straight, and thus weakening the individual. This curve is
commonly compensatory to kyphosis, hip-joint disease and congenital
dislocations of the hip.
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