tailieunhanh - Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 6

Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 6. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | 22 Section HistoryofSpinalDisorders HenkVerbiest discovered the relevance of a narrow spinal canal the intervertebral foramina and lateral recess for causing sciatica by causing an entrapment of the existing root Fig. 7a 94 . In his article published in The Lancet in 1927 Putti gained international attention and it was a further step in the understanding of the pathomechanism of sciatica in cases which are not caused by a slipped disc 95 . With the Dutch neurosurgeon Henk Verbiest 1909-1997 also known as the pope of spinal stenosis lumbar stenosis became a well-defined pathological entity Fig. 7b 4 . He introduced the concept of developmental stenosis which is caused by an abnormally short midsagittal diameter of the spinal canal 114 115 . Spinal Infections Despite the advent of chemotherapy and improved surgical techniques spinal infections are still a potentially life threatening disease even in the industrialized world. In the past tuberculosis has played an important role as a cause of spinal deformities and was one of the most common orthopedic diseases all over the world. Spinal tuberculosis is older than written history Pott recognized the link between tuberculosis kyphosis and paraplegia Dalechamps first described the association of paraplegia and kyphotic deformity Egyptian Mummies and Sir Percival Pott Spinal tuberculosis is older than written history because the first evidence of spinal tuberculosis was found in a skeleton from about 5000 . 51 . Further evidence of spinal infection most likely caused by tuberculosis was found in Egyptian mummies dating from the Predynastic time 3000 . and earlier. A very good example of spinal tuberculosis was found in Neshparenhan from the cache of 44 priests of Amun 21st Dynasty 1100 . reported by Ruffer in 1910. The mummy reveals the typical features of Pott s disease with an acute angulation of the spine caused by the collapsed thoracic vertebral bodies and a psoas abscess Fig. 8a 103 . In the Hippocratic .