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A NEW RADICAL OPERATION FOR POTT'S DISEASE: Report of Ten Cases.

ITO, HIROMU; TSUCHIYA, JUNICHI; ASAMI, GOICHI
The Journal of Bone & Joint Surgery: July 1934
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1. Disinfection of the field of operation must be most thorough.

2. For Pott's disease involving the lumbar vertebrae below and including the second, our pararectal incision with extraperitoneal approach is advantageous, in that the resection of the body is comparatively easy and danger of contamination of the peritoneum is obviated.

3. For resection of the body of the twelfth dorsal or first lumbar vertebra, an oblique incision, similar to that of Bergmann's for nephrectomy, is accompanied by least hemorrhage.

4. A preliminary costotransversectomy enabled us to resect the body of a dorsal vertebra.

5. In performing a radical operation, it is not only necessary to be thorough in curettage, but the eburnated bony tissue of the immediate vicinity must also be chiselled off, as this manoeuver definitely favors the subsequent regeneration of bone.

6. A complicating cold abscess heals by mere aspiration of its contents and obliteration of its communication with the original focus.

7. In a series of experiments on the rabbits we have proved that when autotransplantation of bone is made into the place of a resected body of vertebra, a new bone is formed on the line of contact between the healthy vertebra and the transplant; the transplant itself grows by proliferation of its own tissue; and a weight of twenty kilograms is easily withstood by the transplanted segment of the spine.

8. A defect in the body of the vertebra caused by resection may be repaired either by an operation after the method of Albee or by a direct transplantation of a piece of the patient's own tibia or rib, without subsequent disturbance of weight-bearing function, as shown by the fact that a kyphosis does not develop, nor does any increase of a preexisting kyphosis occur.

(C) 1934 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.

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