Treatment of Gunshot Wounds to Spine During Late 19th Century.

BACKGROUND: The demand for neurosurgical procedures increased drastically in the late 19th century owing to advances in ballistics during the American Civil War and Crimean War. METHODS AND RESULTS: Surgical care for a gunshot wound to the spine relied on skilled identification and removal of the fractured bone. Hemorrhage control and infection prevention were also imperative for improving survival rates. CONCLUSIONS: Although new techniques were implemented, the mortality rate from spinal injuries during this period was staggering. Nevertheless, those 19th century procedural methods provided the basis for present-day treatment for spinal injury patients.

Spinal Traumas and their Treatments According to Avicenna's Canon of Medicine.

Spinal Traumas have been categorized as disabling diseases that cause irretrievable personal and social problems. Having conducted a rather comprehensive diagnosis of the anatomy of the backbone and spinal cord as well as their functions, Avicenna (Ibn Sina, 980-1037) stated the levels and kinds of spinal impairments that are caused by spinal traumas in his great masterpiece Al-Qanun fi al-Tibb (The Canon of Medicine). He also based his treatment process on his etiological diagnosis of such impairments. Avicenna had used the following methods to treat spinal traumas: food and drug therapy and regimental therapies such as massage, phlebotomy, cupping, dry sauna, and surgery. The authors of the present article review the bases of Avicenna's viewpoints regarding spinal traumas and their treatment.

[The future and the past of surgery for the complicated spine trauma].

The state of art of the spine and spinal cord trauma is highlighted. The thorough literature review was performed. Main trends of the spine surgery, both adopted long ago, and new experimental theories were represented. Problems of medical help organization were also stressed.

Ambroise Paré and 16th century neurosurgery.

The luminousness of Ambroise Paré, the surgeon-statesman, has withstood the ravages of time as the mark of a man, a hero, a surgeon-par-excellence, and above all, a benevolent philosopher. A self-made individual, his tryst with the art of surgery emanated from the literally non-stop battlefields of 16th century feudal Europe. Although a maverick in the medical world of his times; he rose from the humblest origins to the highest echelons solely as a result of his own genius and diligence. Among his mammoth contributions to the renaissance of surgery, Paré did perform many procedures which we see as neurosurgical, especially in the realms of neurotrauma and paediatric neurosurgery; the present vignette is an attempt to elucidate the same.

Pediatric neurosurgical techniques in the 15th century.

The renowned Turkish surgeon Serefeddin Sabuncuoglu (1385--1468 AD), delineates management of various pediatric neurosurgical diseases such as head trauma, spinal trauma, and intrauterine and infantile hydrocephalus, as well as basic surgical principles in his textbook Cerrahiyyetü'l Haniyye, which consists of three chapters dealing with a variety of surgical specialities. The sections on neurosurgery are still relevant to modern medicine. The book combines previous knowledge of Greek, Roman, Arabic, and Turkish surgery. Today, Sabuncuoglu is recognized as a pioneer of pediatric neurosurgery.

History of spine surgery in the ancient and medieval worlds.

There is a paucity of surviving texts from ancient and medieval times that can shed light on the early development of spine surgery. Nevertheless, the author reviews many of the available books and fragments and discusses early developments in the field of spine surgery from the point of view of physicians' personalities, general themes, and actual surgical practices. For purposes of an overview and to highlight changing trends in spine surgery, he divides the paper into four eras of medicine: 1) Egyptian and Babylonian; 2) Greek and early Byzantine; 3) Arabic; and 4) medieval.

Medieval management of spinal injuries: parallels between Theodoric of Bologna and contemporary spine surgeons.

In recent decades there have been revolutionary technological advances in the management of traumatic spinal column injuries. Despite these advances, the basic principles of reduction and stabilization of vertebral fractures and dislocations remain similar to those proposed by ancient and medieval physicians. Theodoric of Bologna, in his text Chiurgica de Theodoric (ca. AD 1267), described an extracorporeal approach to the management of traumatic spinal column misalignments. Surprisingly, his techniques are still used in many instances by contemporary spine surgeons, despite the availability of a more advanced technological armamentarium than that existent in medieval times.

History of thoracolumbar decompression and stabilization.

This article organizes the history of thoracolumbar spine surgery around its two major purposes: spinal decompression and spinal stabilization. Only select turning points of this history are addressed. Emphasis is given to important surgical obstacles and perioperative and anesthetic problems, as they have influenced the development of thoracolumbar spine surgery.

Diseases of the spine in South American mummies.

OBJECTIVE: The skulls and spinal columns of people from ancient civilizations, which frequently are found in a preserved state at archeological sites, can provide a large amount of information about these individuals' physical condition through paleopathological investigation. METHODS: This study represents the examination of more than 700 human remains dating back more than 8000 years that were recovered from archaeological excavations in the Andean region of southern Peru and northern Chile. RESULTS: Examples of congenital malformations, degenerative processes, infectious diseases, neoplasias, and traumatic diseases were discovered. Congenital anomalies such as spina bifida occulta were relatively common in these populations. No cases of meningomyelocele were discovered. The most common pathological findings were degenerative changes of the vertebral bodies. Large cervical and lumbar osteophytes were identified in some remains. Several cases of cervical spondylosis were determined to be the result of an occupational disease resulting from carrying heavy loads on the back. These heavy loads were supported by wearing around the forehead a tumpline, known as a capacho. The most common infectious disease process in the spine was due to tuberculosis. The diagnosis was made by radiological and histopathological studies, and in several cases the organism Mycobacterium tuberculosis was identified in the soft tissues. Metastatic lesions on the vertebral bodies were identified in a single case. Examples of traumatic spinal injury were rare. Compression fractures were noted infrequently. CONCLUSION: Diseases of the spinal column in the ancient inhabitants of the Andean region of South America were similar to those that affect the present-day population of that area.

Al-Zahrawi and Arabian neurosurgery, 936-1013 AD.

The authors highlight the neurosurgical contributions of an Arabic surgeon by the name of Abul-Qasim Al-Zahrawi, known in Western literature as Abulcasis. This man lived during the Middle Ages from 936 to 1013 AD and wrote a 30-volume treatise on medicine. A significant part of his work on surgery consists of early descriptions of neurosurgical diagnosis and treatment, including the surgical treatment of head injuries and skull fractures, spinal injuries and dislocations, hydrocephalus and subdural effusions, headache, and many other medical afflictions. He described neurosurgical instruments such as cranial drills that avoided puncture of the dura mater. Abulcasis is known for his concepts of pain as a symptom and his emphasis on anatomy of the skull and brain in relation to the neurosurgical operations of that period. Because his works were translated from Arabic to Latin, Hebrew, and Turkish with only recent or limited translation into the modern occidental languages, the historic role played by this man has been largely unknown by neurosurgeons who are not fluent in these languages.