The History of Neurosurgical Spinal Oncology: From Inception to Modern-Day Practices.

The neurosurgical management of spinal neoplasms has undergone immense development in parallel with advancements made in general spine surgery. Laminectomies were performed as the first surgical procedures used to treat spinal neoplasms. Since then, neurosurgical spinal oncology has started to incorporate techniques that have developed from recent advances in minimally invasive spine surgery. Neurosurgery has also integrated radiotherapy into the treatment of spine tumors. In this historical vignette, we present a vast timeline spanning from the Byzantine period to the current day and recount the major advancements in the management of spinal neoplasms.

Alfred W. Adson (1887-1951): his contributions to surgery for tumors of the spine and spinal cord in the context of spinal tumor surgery in the late 19th and early 20th centuries.

Alfred W. Adson was a pioneer in the field of neurosurgery. He described operations for a variety of neurosurgical diseases and developed surgical instruments. Under his leadership the Section of Neurological Surgery at the Mayo Clinic was established and he functioned as its first chair. Adson's contributions to the understanding of spinal and spinal cord tumors are less well known. This article reviews related medical records and publications and sets his contributions in the context of the work of other important pioneers in spinal tumor surgery at the time.

Biographical sketch: George L. Walton, MD and Walter E. Paul, MD.

This biographical sketch on George L. Walton and Walter E. Paul corresponds to the historic text, The Classic: Contribution to the Study of Spinal Surgery: One Successful and One Unsuccessful Operation for Removal of Tumor (1905), available at DOI 10.1007/s11999-010-1664-2 .

Palaeopathological diagnosis after 2500 years. The case of Imakhetkherresnet, sister of priest Iufaa.

The aim of palaeopathological studies has been traditionally the determination of a diagnosis of any found pathological change. If based merely on skeletal evidence, most of them proved to be only tentative. Our case of the mature female Imakhetkherresnet, sister of the lector-priest Iufaa, having preserved scraps of soft tissue, enabled a precise diagnosis. Her skeletized mummy was discovered in Iufaa's unmolested tomb dating late 26th Dynasty at Abusir (Egypt) by the Czech Institute of Egyptology in 2001. A large smooth-walled cavity moulded by pressure of a relatively hard, globular and lobulated tissue mass was found inside the sacrum, growing in hour-glass shape outside it. By macroscopic and radiographic examination its diagnosis was suggested, while by histological analysis with histochemical tests and comparison with a recent case, the origin of the hollow could be "clinically" determined. It was caused by a benign tumour, originating in the nerve sheath, called neurilemmoma (schwannoma, neurinoma). This kind of tumour, occurring in the sacrum relatively rarely, was never before described in the palaeopathological literature.

Spinal vascular malformations: an historical perspective.

In this historical perspective, the author identifies three epochs in the development of the concepts and treatment of spinal vascular lesions: 1) early observations (1860s-1912), with the lesions during this time period recognized only at autopsy; 2) the "middle ages" (1912-1960), with surgical intervention sporadic and yielding dismal results; and 3) the modern era (beginning in the 1960s), coincident with parallel dramatic advances in radiology, microsurgical instrumentation, and anesthesiology. These advances resulted in a better understanding of the pathophysiological aspects and angioarchitecture of the lesions. Whereas the nomenclature of the lesions in the past was confusing, a new understanding of these diseases that has emerged during the modern era has permitted refinement of the classification of the lesions as distinct biological entities. Modern diagnostic imaging has enabled identification of patients who may benefit from surgical or embolic occlusion, and treatment has become rationally based. Future progress in the management of spinal vascular lesions may be anticipated, with improvement in noninvasive imaging for early detection of suspected abnormalities. Furthermore, advances in spinal cord neuroprotection may expand the range of future options for surgical or embolic intervention.

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.

[Primary intracranial and intraspinal neoplasms in Denmark 1943-1987]. / Primaere intrakraniale og intraspinale neoplasmer i Danmark 1943-1987.

This is a descriptive study of primary intracranial and intraspinal tumours notified to the national Danish Cancer Registry during the years 1943-1987. A total of 19,317 cases of benign and malignant neoplasms were included over these 45 years with a doubling of the age-standardized incidence rates for both men and women from start till end of the registration period. The trend was mainly explained by markedly increasing rates in the age groups 60 years or above at diagnosis. Approximately some 74% of tumours were derived from the brain tissues and 19% from the intracranial and intraspinal meninges. Meningiomas predominate among women with a male:female ratio of 0.5, while tumours of the brain tissues predominate among men (ratio 1.3). Meningiomas are more frequently encountered as a chance finding at autopsy compared to other types of intracranial and intraspinal tumours. The above-mentioned increase in age-specific incidence is due mainly to improved diagnostic capabilities over the period and a subsequent decrease in the underreporting of these tumour types.