This name was proposed by Gibney for what seems to be an infectious periostitis involving the vertebral column, of a character similar to that which has been described in a previous chapter. It is characterized by excessive pain, tenderness, and later stiffness. It may occur during or after mild as well as severe cases of typhoid.
TRAUMATIC SPONDYLITIS.
Kümmel has shown that a traumatic and non-tuberculous ostitis of the vertebræ occurs, with succeeding kyphosis resembling that of Pott’s disease, but not so angular, usually without associated abscesses, but with occasional paralyses. This may occur without necessary reference to that curvature which may follow a healed or healing spinal curvature. Inasmuch as the condition occurs only after the lapse of considerable time after injury, it is questionable whether it represents any distinct form of disease.
CANCER OF THE SPINE.
Malignant disease of the spine may assume a type either of sarcoma when primary or carcinoma when secondary. The latter type is much the more common, and is not so infrequent as an expression of metastasis from cancer in various other parts of the body, even the more distant. It is most common in the lower spinal region. Pain occurs early and is usually severe. It is as often referred as localized. It may lead to curvature of the spine with some of the grosser signs of spinal caries, but the prominence, if any occurs, will be rounded rather than angular. When paralyses occur they usually assume that type described by Charcot as paraplegia dolorosa. (See [Plate XXXVIII].)
When symptoms of a general type like those produced by spinal caries occur in adults who are known to have had previous or present malignant disease the inference will be that they are to be interpreted as local expressions of the same character. Under these circumstances treatment can only be palliative. There is no hope of cure.
SPONDYLOLISTHESIS.
The term spondylolisthesis implies a partial displacement forward of the body of the last lower or next to the last lower lumbar vertebra, usually the former, which slips forward on top of the sacrum with very little perceptible displacement of arches. The condition may be slight or well marked, and may or may not be followed by secondary changes. There appears to be a real fragmentation or separation of the body from the arch, which may be traumatic, congenital, pathological, or the sole result of pressure from above; later exostoses or osteophytes appear about the separation, thus forming a new fixation and preventing further displacement.
The condition is more common in females and in the young, and most cases give a traumatic history. In those which do, deformity may follow accident or it may be long postponed, perhaps until pregnancy.