An immediate immobilization of the tubercular spine is necessary. This accomplished, the normal use of the remainder of the body not only does not interfere with, but favors, the healing process, by raising the resistance of the organism to infection. The implantation of a long autogenous bone splint under the unsplit lumbodorsal fascia, gives immediate support to the weakened spine; obviates the necessity for external splints, braces or casts; and renders immediate movement safe. The tunneling method permits of its emplacement quickly, with least trauma, without the introduction of any foreign material (catgut, kangeroo tendon, etc.). The maximum of correction possible with safety, can be secured at operation, and the spring effect of the graft continues the correction until union of the graft to the amputated posterior processes occurs. Here correction ceases. The tips of the severed processes drop snugly to the dorsal surface of the graft and furnish excellent centers of osteogenesis immediately opposite the stumps, thus surrounding the bone splint with a complete ring of new bone at the point of contact. The persistence of the graft after seven years proves that bony contact continues, and that fusion of the splint with the posterior processes occurs. The retention of the splint in situ is absolute, being held in place by the taut lumbodorsal fascia and the laterally placed lumbodorsal muscles.
The short time required for the implantation; the ease with which it is secured, using the tunneling tool; the small incision; the freedom from postoperative pain, and the freedom from casts or other restraining apparatus should recommend this method.
(C) 1927 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.