The history of spinal deformity

Abstract

Spinal deformity is the oldest disease known to humankind. The first record of correction of spinal deformity was documented in an Indian religious mythological book written between 3500 BC and 1800 BC. Initially, all spinal deformities were treated with the use of braces, traction, or casts. Hippocrates was the first physician to treat spinal deformities by using axial traction combined with direct pressure. Galen specifically described the anatomy of the spine and spinal nerves. The treatment of spinal deformity was greatly improved by the development of radiographic imaging by Roentgen. After x-rays became available, spinal fusions began to be used to treat scoliotic curves. Hibbs described the first spinal fusion to stabilize a deformed tuberculous spine. Soon enough, other investigators began to report on a variety of surgical techniques used to treat spinal deformity. Surgical approaches from both the posterior and anterior directions were developed and modified in an attempt to achieve durable curve corrections. Harrington's distraction rod system was a major innovation in providing a method to improve coronal plane deformity. Luque introduced segmental instrumentation, which opened up the era of modern surgical techniques for spinal deformity. This concept allowed surgeons to begin to achieve three-dimensional corrections by respecting both the sagittal and coronal curves simultaneously. The introduction of pedicle screws, throughout the thoracolumbar spine, has increased the ability of surgeons to achieve greater degrees of curve correction than had previously been possible. The history of spinal deformity is still maturing as newer procedures continue to be performed on a daily basis.