Albin Lambotte: Pioneer of Osteosynthesis (Bone Fixation).

Stamp Vignettes focus on biographical details and accomplishments related to science and medicine, and not individual views and prejudices except when they had a major impact on the subject's life. The authors of Stamp Vignettes do not intend to imply any endorsement of such views when discussing a Stamp Vignette on Medical Science.

Evolution of Design of Interbody Cages for Anterior Lumbar Interbody Fusion.

Anterior lumbar interbody fusion (ALIF) is one of the surgical procedures for the relief of chronic back pain, radiculopathy and neurogenic claudication in patients with degenerative lumbar spine disease that is refractory to conservative therapy, low-grade spondylolisthesis and pseudo arthrosis. Over the past half century, both the surgical techniques and instrumentation required for ALIF have changed significantly. In particular, the designs of ALIF cage and the materials used have evolved dramatically, the common goal being to improve fusion rates and optimize clinical outcomes. The increasing popularity of ALIF is reflected by the increasing abundance of published studies reporting clinical outcomes, surgical techniques and grafting options for ALIF. Developments in cage designs include cylindrical Bagby and Kuslich, cylindrical ray, cylindrical mesh, lumbar-tapered, polyethyl-etherketone cage and integral fixation cages. Biologic implants include bone dowels and femoral ring allografts. Methods for optimization of cage design have included cage dimensions, use of novel composite cage materials and integral fixation technologies. However, the historical development and evolution of cages used for ALIF has not been extensively documented. This article therefore aims to provide an overview of the historical basis for the anterior approach, evolution in design of ALIF cage implants and potential future research directions.

[History of internal fixators. The subsequent importance for spinal surgery]. / Geschichte des Fixateur interne. Seine spätere Bedeutung für die Wirbelsäulenchirurgie.

BACKGROUND: This article presents a retrospective look at spinal implants of the 1970s and 1980s. OBJECTIVE: The historical development of internal fixators as the successor to external fixators. MECHANICAL PRINCIPLE: Pedicled screws are stably anchored in vertebral bodies of the thoracic or lumbar spine or the sacrum using a dorsal approach. They are joined by a rod as a longitudinal support, separated by freely selectable distances and in any desirable and initially modifiable angle. After locking this results in an angular and rotationally stable completely sunken bilateral construction for fixing two or more vertebrae together and the position can be manually adjusted using long lever arms on the pedicled screws. RESULTS: The first in vivo application in humans was on 22 December 1982 in Basel. The initial indications were unstable spinal fractures. The expectations placed on the new working principle of internal fixation and its realization were confirmed and short stretch fixation exclusively of the neighboring vertebra and immediate mobilization of patients could be routinely achieved. The indications were extended to include instability of the spine for conditions outside the field of traumatology. Further developments of implants and other technical solutions in the coupling system using the same basic principle in the direction of multisegmental applications, ease of operation and titanium-based materials became internationally established and were developed into universal spinal stabilization systems for spinal degeneration, deformities, tumors and olisthesis. CONCLUSION: The basic principle of spinal fixators (internal and external) is contained in the complete product range of dorsal stabilizing implants from practically all manufacturers worldwide and has become taken for granted.

The "tract" of history in the treatment of lumbar degenerative disc disease.

In this paper past, present, and future treatments of degenerative disc disease (DDD) of the lumbar spine are outlined in a straight forward manner. This is done to review previous knowledge of the disease, define current treatment procedures, and discuss future perspectives. An analysis of a subject of this magnitude dictates that one describes as accurate a history as possible: an anatomical/historical "tract" with emphasis on all possible deviations. Although spinal disorders have been recognized for a long time, the view of DDD as a particular disease entity is a more recent development. In this paper, the authors attempt to outline the history of DDD of the lumbar spine in an unbiased and scientific fashion. Physiological, diagnostic, and therapeutic implications will all be addressed in this study.

History of surgery for the correction of spinal deformity.

During the last century the technological advances in the field of spinal surgery had a dramatic impact on the treatment of spinal deformity in children and adults. Before the advent of medications and vaccines to treat and/or prevent tuberculosis and poliomyelitis, patients suffering from these disorders often became incapacitated by the resulting kyphoscoliosis. In the early 1900s Lange began to address this problem mechanically by using foreign materials to stabilize the spine internally. In the 1950s and 1960s, owing to the efforts of Harrington and others, the process evolved to create the first generation of modern spinal instrumentation. The Harrington rod was able to correct a spinal deformity primarily through distraction. In the next wave of advances, some of the shortcomings of Harrington rods were addressed. Segmental fixation involving sublaminar wires was introduced in the 1970s by Luque. Anterior approaches and instrumentation-related techniques developed by Zielke and colleagues as well as Dywer and coworkers in the late 1960s and mid-1970s allowed for better correction of deformity with immobilization of fewer motion segments compared with posterior surgery. Transpedicular fixation of the spine was popularized by Cotrel and Dubousset in the 1980s; they used the technique to perform segmental stabilization, which better reduces the rotational aspect of a deformity. Finally, in the mid-1990s, thoracoscopic techniques were developed and are currently in use for anterior release and placement of instrumentation. The authors review the major technical developments for the surgical treatment of spinal deformity.