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James W. Watts and Walter Freeman

the pursuit of her graduate studies. Case 2 . Mr. H.D., a teacher and tool-designer aged 54, was neurotic all of his life, and complained of a peculiar clicking in the ear and of pressure in his head that made it impossible for him to continue work. For a year and a half his only task was to run errands for his wife. He suffered from nervous tension, anxiety, fear of going insane, depression of spirits and an exhausted feeling. At about the age of 40, he began experiencing twitching of the facial muscles, with actual subluxation of the jaw which was also

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George S. Baker and Farrington Daniels Jr.

cauda equina. J. Neuropath. exp. Neurol. , 1944, 3: 172–183. 8. Kennedy , F. , Denker , P. G. , and Osborne , R. Early laminectomy for spinal cord injury not due to subluxation. Amer. J. Surg. , 1943 , n.s. 60 : 13 – 21 . Kennedy , F., Denker , P. G., and Osborne , R. Early laminectomy for spinal cord injury not due to subluxation. Amer. J. Surg. , 1943, n.s. 60: 13–21. 9. Knight , G. War injuries of the spine and spinal cord. In: War wounds and injuries. E. Fletcher and R. W

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Non-Traumatic Atlanto-Axial Dislocation

Report of Case with Recovery after Quadriplegia

Leonard A. Titrud, C. A. McKinlay, Walter E. Camp and Hewitt B. Hannah

. Arch. Orthop. Mech-Ther. , 1905, 3: 97–100. 4. Ely , L. W. Subluxation of the atlas. Report of two cases . Ann. Surg. , 1911 , 54 : 20 – 29 . Ely , L. W. Subluxation of the atlas. Report of two cases. Ann. Surg. , 1911, 54: 20–29. 5. Englander , O. Non-traumatic occipito-atlanto-axial dislocation. A contribution to the radiology of the atlas. Brit. J. Radiol. , 1942 , 15 : 341 – 345 . Englander , O. Non-traumatic occipito-atlanto-axial dislocation. A contribution to the radiology of the

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Glen O. Cross, James R. Reavis and William W. Saunders

was 1111100000. Roentgen Examination . Roentgenograms of the spine ( Figs. 3 and 4 ) demonstrated a soft-tissue lesion expanding the thoracic and upper lumbar neural arches and intervertebral foramina. It was most prominent at T10 and T8. Here the pedicles were disrupted, allowing displacement of the bodies of the vertebrae from the neural arches to form a short anterior arc. The dorsa of the bodies were deformed, apparently by pressure erosion. They were smoothly arched between the intervertebral discs, which were much less involved. Subluxation with

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Intervertebral Foramen Studies

I. Foramen Encroachment Associated with Disc Herniation

Lee A. Hadley

. The most common cause of foramen constriction is disc degeneration and its secondary changes. These include: herniation of disc substance into the foramen, thinning of the disc with approximation of the pedicles, subluxation of the upper vertebra forward or backward upon the one beneath, hyperplasia of the ligamentum flavum, bony spur formation projecting backward from the disc or forward from the posterior joint, and lastly, subluxation of the articular process from below upward and forward into the foramen. Some of these are illustrated in Fig. 2 . A and B are

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Frederic Schreiber and Herbert Rosenthal

. Surg., Chicago , 1933, 27: 859–867. 5. Kennedy , F. , Denker , P. G. , and Osborne , R. Early laminectomy for spinal cord injury not due to subluxation. Amer. J. Surg. , 1943 , n.s. 60 : 13 – 21 . Kennedy , F., Denker , P. G., and Osborne , R. Early laminectomy for spinal cord injury not due to subluxation. Amer. J. Surg. , 1943, n.s. 60: 13–21. 6. Luck J. V. : Bone and joint diseases. Pathology correlated with roentgenological and clinical features. Springfield, Ill

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Ralph B. Cloward

subluxation of the articulate facets following collapse and narrowing of the intervertebral space. (c) Proliferation of bone along the margins of the body of the vertebrae posteriorly, (osteophytes) encroaching upon the intervertebral foramen. (d) Hypertrophy of the ligamentum flavum which, with the facet, forms the posterior boundary of the intervertebral foramen. This latter condition, however, is questioned by some writers. In the medical literature of the past 15 years on the treatment of ruptured intervertebral disc, most emphasis has been placed upon the relief of

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Robert Dean Woolsey

leg helped somewhat. He had been able to work, was told that he had a ruptured disc, and operation was advised. He had refused the operation. Examination . He was a somewhat obese white male. He had marked tenderness over the lower lumbar spine. There was limitation of straight leg raising bilaterally, particularly on the left. There was limitation of forward bending. There was a hypesthesia of L4 and 5 on the left. The ankle jerks were bilaterally absent. The knee jerks were equal and active. X-rays of the lumbar spine showed no subluxation at L5 on S1, but there

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Eben Alexander Jr. and Blaine S. Nashold Jr.

45 cases and reported 8 cases (18 per cent) in which the hips were dislocated; club feet were present in over half of the cases. Bony abnormalities of the spine can occur from the cervical to the sacral region. These may consist of hemivertebra, abnormal fusions, failure of development of the neural arches, sacralized and wedged 5th lumbar vertebra and congenital aplasia. Congenital synostosis of several ribs, genu recurvatum, and congenital subluxation of the knees also have been described. The relation of the dural sac to the vertebral canal may be altered, as

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Henry W. Dodge Jr., J. Grafton Love and Cornelius M. Gottlieb

on many of these patients before they were examined at the clinic, was multiple sclerosis syringomyelia, amyotrophic lateral sclerosis, chronic encephalomyelitis or primary lateral sclerosis. An additional group of diagnoses attached to patients afflicted with benign neoplasms of the foramen magnum, but less common, were: subluxation of the upper cervical vertebrae, brachial plexus neuritis, platybasia, protrusion of an upper cervical disk, cervical cord tumor and posterior fossa tumor. 1, 5 The pitfalls to early diagnosis are many, and at times it is difficult