In the course of more than sixty spinal operations I have had occasion to observe a number of lesions within the substance of the cord which seemed amenable to surgical treatment. This led me to investigate the subject in order to determine the frequency of localized intramedullary disease, and the part of the cord into which an incision can be made with a minimum amount of injury to the delicate cord tissue. In addition, I have attempted to develop a special technic for intramedullary spinal surgery, and have made use of this technic in a number of spinal operations in which the cord itself was invaded during the operative manipulations.
The results of my investigations have convinced me that under the proper conditions and with the proper technic it is perfectly feasible and safe to incise the cord substance in order to allow of the extrusion of localized intramedullary growths,
ELSBERG CA. SURGERY OF INTRAMEDULLARY AFFECTIONS OF THE SPINAL CORD: ANATOMIC BASIS AND TECHNICWITH REPORTS OF CASES. JAMA. 1912;LIX(17):1532–1536. doi:10.1001/jama.1912.04270100300013
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