The Hindu epic Srimad Bhagwat Mahapuranam, which dates from 3500 to 1800 BC, involves a myth in which Lord Krishna straightens the spine of Kubja, one of his devotees. Kubja, who was hunchbacked, had spinal deformities in three places. By pressing het feet down and pulling her chin upwards, Lord Krishna managed to straighten her spine. This is the first reference to axial traction methods.
The Gospel of Luke describes how on a Sabbath, Jesus was teaching in one of the synagogues, when he spotted a woman whose spine had been bent for 18 years. When he laid his hands on her, her back immediately straightened.
It was the great Greek physician Hippocrates (460-375 BC) who first described abnormal curvatures of the spine in “de Articulaciones” of the Corpus Hippocraticum. Though he recognized that the curvatures in healthy spines may vary widely, he talked about old age, pain, falls and bad posture as causes of abnormal curvatures., He also mentioned lateral curves of the spine, which he felt were caused by the positions his patients would lie in. Hippocrates designed two different types of traction devices, one called the Hippocratic Ladder, and a traction table named the Scamnum. In “De Articulaciones” he mentioned that great damage could be done if this traction table were to be used by those wanting to cause mischief. Less well meaning people indeed used the table in later times as a torture device called the Rack.
The foundations of modern Scoliosis management
Six centuries later, Galien (AD 130-200) coined the terms Scoliosis, Kyphosis and Lordosis to describe specific deformities in the spine. He was also the first physician to describe back pain. He did extensive research on the stucture and the function of the spinal cord and kidneys. By his statement that observation and investigation are the basis for medical research Galien laid the foundation of modern medical research methods
Ambroise Pare (1510-1590). the “father of French surgery”, was a barber-surgeon whose work on the battle fields made him realise that a physician’s job should be to ease a patient’s suffering. This concept was unheard of in his day… Pare developed a brace for Scoliosis, meant to “hide and correct defects”. These early braces were actually metal corsets with holes in them to diminish their weight, which were fitted and padded, and changed as the patient outgrew them. He only used them for young patients, as he felt they would not be effective for patients whose skeleton had reached maturity. Braces are still used in the treatment of Scolios to stop the curves from progressing.
The French paediatrician Nicholas Andry (1510-1590), author of “Orthopaedia“, believed Scoliosis was caused by asymetric muscle thightness, and used corsets made from whalebone with padding at the place of the protuberances, suspension, and postural approaches, in its treatment.
Other names mentioned in the history of Scoliosis are this of Jacques Delpech, a French surgeon, who used traction and exercise in the treatment of Scoliosis, rather than surgical methods, and this of Jules Guerin, a French orthopedic surgion who used to treat Scoliosis patients by controversial subcutaneous surgery. Other techniques used included a plaster body cast which was applied while the patient was being suspended.
The man who changed the face of Scoliosis treatment forever,was an American named Russel Hibbs (1860-1932), the first surgeon ever to perform a spinal fusion. In 1911, Hibbs performed surgery to prevent the progression of curvature of the spine in a patient with spinal tuberculosis. Three years later, he applied spinal fusion to patients with Scoliosis in order to halt the progression of their curvatures. After surgery, his patients were put on extended bed rest and had to wear plaster casting for sometimes up to one year.
The basis for modern surgery of Scoliosis was laid by Dr. Paul Harrington, who in the 1950’s performed for the first time surgery using the so called Harrington Rod. Dr. Harrington later chose to combine use of the rod with spinal fusion.
Viviane De Doncker / Chloe Pieters