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INJURY TO INTERVERTEBRAL DISCS DURING SPINAL PUNCTURE
MOSES GELLMAN
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Surgical Department (Orthopaedic Division) of the Sinai Hospital, Baltimore
1940 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1940; 22:980-985 
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Abstract

Herewith is presented the case of a syphilitic girl, aged fourteen, whose spine was first punctured on June 20, 1936, without any untoward effects. On September 4, 1937, she was subjected to several unsuccessful spinal taps. These were followed by immediate clinical manifestations of Some local disturbance at the site of these taps. Lumbar hyperextension and severe pain were replaced within five weeks by lumbar flexion and prominence of the spinous processes of the second and fourth lumbar vertebrae. Roentgenograms on September 8, 1937, were read as negative for bone pathology, but, as time went on, subsequent plates from October 1937, until the final date of observation in April 1939, gave evidence of narrowing of the affected joint spaces, compensatory widening of the adjacent joint spaces, and the development of the characteristic interarticular, intra-osseous Schmorl's nodules which are generally regarded as pathognomonic of intervertebral-disc disturbance. The entire succession of events in this case is so direct and clear that it is difficult to escape the conclusion that the described end results followed the misadventurous spinal puncture.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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