Hangman's fracture: a historical and biomechanical perspective.

The execution technique of hanging, introduced by the Angle, Saxon, and Jute Germanic tribes during their invasions of the Roman Empire and Britain in the 5th century, has remained largely unchanged over time. The earliest form of a gallows was a tree on which prisoners were hanged. Despite the introduction of several modifications such as a trap door, the main mechanism of death remained asphyxiation.

Safety of instrumentation in patients with spinal infection.

Object: Treatment of spine infection remains a challenge for spine surgeons, with the most effective method still being a matter of debate. Most surgeons agree that in early stages of infection, antibiotic treatment should be pursued; under certain circumstances, however, surgery is recommended. The goals of surgery include radical debridement of the infective focus.

Thoracolumbar spinal deformity: Part I. A historical passage to 1990: historical vignette.

Seven millennia of anthropological artifacts and historical tales reference human spinal deformity, its diagnosis, and treatment-many of the latter of which turned out to be worse than the deformity itself. From Hippocrates to Harrington to the 21st century, the literature base has expanded in exponential fashion to yield an imperfect but constantly improving body of evidence, experience, and understanding of this challenging disease phenomenon. This review details the pre-1990 innovations, whose failures and successes have equally contributed to the advancement and dissemination of the increasingly evidence-based field of spinal deformity.

Development of anatomic science in the late middle ages: the roles played by Mondino de Liuzzi and Guido da Vigevano.

Medical historians generally consider anatomic science, as we know it today, to have been established through the pioneering work of Vesalius during the Renaissance. Although this is largely true, detailed assessment of the scientific advances made in the late Middle Ages, though not as spectacular as those made during the Renaissance period, did pave the way and form a foundation for subsequent progress. During the two centuries of AD 1300 to 1500, several worthwhile advances occurred.

The departmental chair in Western medicine: tale of the first and foremost. Historical vignette.

The use of the term "chair" in medical literature probably started in the Late Middle Ages with the Italian anatomist Mondino de Liuzzi. History reveals the term's origin at Bologna, one of the oldest degree-granting universities in Europe. Nobody has been shown in documented literature before Mondino to have reached the level of chair, the zenith of hierarchy in Western scholastic medicine.

Albert Wojciech Adamkiewicz (1850-1921): unsung hero behind the eponymic artery.

The artery of Adamkiewicz is an important radiculomedullary artery supplying the spinal cord, especially the lumbar enlargement. Anatomical knowledge of this artery is important for avoiding serious neurological complications during surgery performed in this region--for neurosurgeons and interventional radiologists treating intramedullary tumors and spinal arteriovenous malformations, traumatologists performing spinal fusions, thoracic surgeons treating aortic aneurysms, and urologists and pediatric surgeons conducting retroperitoneal dissections. However, the biography of the talented Polish pathologist Albert Adamkiewicz, after whom the landmark artery is named, has not been described adequately in the existing neurosurgical literature.

The legendary contributions of Thomas Willis (1621-1675): the arterial circle and beyond.

Thomas Willis established neurology as a distinct discipline and made significant original contributions to many related fields including anatomy, pathology, cardiology, endocrinology, and gastroenterology. He is most remembered for his work in elucidating the function and anatomy of the circle of Willis. Willis' accomplishments and research methods can be credited in large part to his unconventional medical education which did not include traditional teachings, but rather emphasized learning through clinical practice.

Contributions of Johann jacob Huber to the surface anatomy of the spinal cord and meninges.

From prehistoric times, man has been aware that injury to the spine may result in paralysis of the limbs; this is reflected in bas-relief figures found at Nineweh in ancient Mesopotamia, in a hunting scene that depicts a lioness wounded by King Ashurbanipal. The Edwin Smith papyrus gives many case illustrations of spinal cord injury resulting in paralysis, yet early physicians were unaware of the anatomy of the spinal cord. Galen performed prospective studies in animals by sectioning the spinal cord at varying levels and observing the commensurate paralysis and sensory loss.

Medicosocial problems engendered with the discovery of the Bell-Magendie Law.

The discovery of the Bell-Magendie Law, which states that the ventral spinal roots transmit motor impulses and the posterior roots sensory impulses, established a major landmark in the history of neuroscience. It led to further elucidation of brain function and served as a starting point for virtually all of electrophysiology. During the past two centuries, there has been an intense debate as to which of the two scientists deserves the credit for the discovery itself and the prominent claim to the discovery.

Modern psychosurgery before Egas Moniz: a tribute to Gottlieb Burckhardt.

The history of modern psychosurgery has been written in several ways, weaving around many pioneers in the field during the 19th century. Often neglected in this history is Gottlieb Burckhardt (1836-1907), who performed the first psychosurgical procedures as early as 1888, several decades before the work of Egas Moniz (1874-1955). The unconventional and original case series of Burckhardt, who claimed success in 50% of patients (3 of 6), had met with overt criticism from his contemporary medical colleagues.

Charles-Edouard Brown-Séquard: an eccentric genius.

Brown-Sequard is known eponymously for the syndrome of hemisection of the spinal cord, but most clinicians are not familiar with his colorful, quixotic, and eccentric life history. His contributions to medicine and neuroscience reached much further than his discovery of the spinal hemisection syndrome. He lived in five countries on three continents and crossed the Atlantic 60 times, spending a total of almost 6 years on the sea.

Outcome of brain abscess by Clostridium perfringens.

Objective: Despite the aggressive infection of soft tissue caused by Clostridium perfringens (gas gangrene-necrotizing fasciitis), a brain abscess with this bacteria treated by early surgical excision, debridement of necrotic tissue, and antibiotic coverage may be expected to have a good recovery. Long-term follow-up has not been well established in this group of patients. We report this case to show the outcome at 3 years post surgical and antibiotic treatment for C.

Sir Robert Boyle and his unique case report on depressed cranial fracture.

Sir Robert Boyle is one of the foremost English scientists in history. He received his inspiration from the scientific approaches initiated by Galileo and his disciple, Torricelli. Through rigorous experimentation, Boyle established the fundamental gas laws as we know them today.

Reduction of spondylolisthesis.

In this article the authors discuss the syndrome of isthmic spondylolisthesis occurring at the lumbosacral junction in adults, providing a description of the clinical syndrome, altered biomechanics, and imaging characteristics. The authors pose arguments in favor of reduction and instrument-assisted fusion. Their surgical technique is detailed.

Black disc disease: a commentary.

Internal disc disruption associated with axial back pain but not radicular pain is a disease entity that was recognized about two decades ago as a disorder that could potentially be treated by spinal fusion. In this article the authors describe the clinical syndrome, magnetic resonance imaging and discography findings of pathophysiological pain generation, and the available surgical options. Based on the current understanding of this disease entity, the optimum surgical procedure entails radical discectomy, anterior column support, adequate amounts of auto- or allograft bone, bone extenders and enhancers, and rigid stabilization of the motion segment.

Biomechanical comparison of two stabilization techniques of the atlantoaxial joints: transarticular screw fixation versus screw and rod fixation.

Objective: To compare the biomechanical stability imparted to the C1 and C2 vertebrae by either transarticular screw fixation (TSF) or screw and rod fixation (SRF) techniques in a cadaver model.

Methods: Ten fresh ligamentous human cervical spine specimens were harvested from cadavers. The specimens were tested sequentially in the intact state, after injury and stabilization (unilateral left side and bilateral), and after fatiguing to 5000 cycles (0.

Bone morphogenetic proteins: basic concepts.

The cellular and molecular events governing bone formation in the embryo, healing of a fractured bone, and induced bone fusion follow a similar pattern. Discovery, purification, and recombinant synthesis of bone morphogenetic proteins (BMPs) constitute a major milestone in the understanding of bone physiology. In this review the author discusses the mechanism of action, clinical applications, dosage, and optimum carriers for BMPs.

Bone healing and spinal fusion.

Bone is a tissue that constantly undergoes deposition, resorption of stromal matrix, and remodeling. These processes may be altered by a variety of chemical, mechanical, cellular, and pathological mechanisms. Understanding the physiology of bone healing and the mechanisms affecting this process is important not only when evaluating normal skeletal development but also when initiating fracture repair.