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December 2021

Historian Corner

Jay Shapiro
Historian

This year marks the 110th anniversary of Dr Russell Hibbs’s performing his first surgical fusion for spinal deformity.  On January 91911 Dr Hibbs performed a T12-L3 fusion under general anesthesia for Pott’s disease in a nine-year-old male. 
 

Tuberculosis and poliomyelitis were endemic at this time particularly in urban areas often causing significant morbidity and spinal deformities. Surgical procedures to fuse the spine date back to Dr Berthold Hadra in 1891, but at the turn of the 20th century, treatment of spine deformity was dominated by long term casting or bracing

Dr Hibbs modified a technique he had used to fuse knees in polio patients by morselizing the patella into the knee joint to create a bony bridge between the femur and tibia. After experimenting on the spines of animals and cadavers he developed a technique that included subperiosteal exposure of the involved spinous processes and detaching them at their base and transposing them to longitudinally bridge the inter-spinous space. He then closed the periosteum and skin. The patient remained in bed for one month and then a cast for two more months till bony fusion on radiographs. 

On May 27, 1911 the first three patients were reported in The New York Medical Journal titled “An Operation for Progressive Spinal Deformities” and he talked of the possible use for treatment of idiopathic and neuromuscular scoliosis.  As with most surgical advancements, the technique relied on meticulous animal and cadaver experimentation and modifying and building on previous knowledge. This process is what we do today to advance surgical treatments. We need to not only remember these historical achievements, but understand they are the basis for what we do today and hopefully continue to improve upon in the future.

Historical Committee: George H. Thompson, Past Historian, Matthew J. Mermer, Behrooz A. Akbarnia, Richard M. Schwend