The three great needs to be recognized in the treatment of tuberculosis of the spine are: first, support of the superincumbent weight, namely, that of the head, shoulders and arms, away from the carious and softened vertebral bodies; second, some form of posterior leverage to throw the weight of the upper part of the body on the posterior and lateral aspects of the spine, and third, some form of fixation until ankylosis has occurred so that arrest of the disease and healing may ensue.
The aim of curative measures is to secure ankylosis, for in its absence there is no certainty that relapse may not occur. The choice of method today lies between nonoperative measures (external splinting) and operative procedures (internal splinting).
While it is true that under favorable conditions by the use of conservative measures, such as the convex frame for the recumbent patient, or the plaster-of-paris jacket, the
KURTZ AD, HORWITZ MT. AN INVESTIGATION INTO WIRING OF THE SPINOUS PROCESSES AS A MEANS OF INTERNAL SPINAL FIXATION. Arch Surg. 1936;33(4):630-648. doi:10.1001/archsurg.1936.01190040088006