Harvey cushing, the spine surgeon: The surgical treatment of pott disease

Ali Bydon, Hormuzdiyar H. Dasenbrock, Courtney Pendleton, Matthew J. McGirt, Ziya L. Gokaslan, Alfredo Quinones-Hinojosa

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Study Design. Review of historical archival records. Objective. Describe Harvey Cushings patients with spinal pathology. Summary of Background Data. Harvey Cushing was a pioneer of modern surgery but his work on spine remains largely unknown. Methods. Review of the Chesney Medical Archives of the Johns Hopkins Hospital from 1896 to 1912. Results. This is the first time that Cushings spinal cases while he was at the Johns Hopkins Hospital, including those with Pott disease, have been described.Cushing treated three young men with psoas abscesses secondary to Pott disease during his residency: he drained the abscesses, debrided any accompanying necrotic vertebral bodies, irrigated the cavity with salt, and left the incision open to close by secondary intention. Although Cushing used Kochs "tuberculin therapy" (of intravenous administration of isolated tubercular bacilli) in one patient, he did not do so in the other two, likely because of the poor response of this first patient. Later in his tenure, Cushing performed a laminectomy on a patient with kyphosis and paraplegia secondary to Pott disease. Conclusion. These cases provide a view of Cushing early in his career, pointing to the extraordinary degree of independence that he had during his residency under William Steward Halsted; these cases may have been important in the surgical upbringing both of Cushing and his coresident, William Stevenson Baer, who became the first professor of Orthopedics at Johns Hopkins Hospital. At the turn of the last century, Pott disease was primarily treated by immobilization with bed rest, braces, and plaster-of-paris jackets; some surgeons also employed gradual correction of the deformity by hyperextension. Patients who failed a trial of conservative therapy (of months to years) were treated with a laminectomy. However, the limitations of these strategies led to the development of techniques that form the basis of contemporary spine surgery-instrumentation and fusion.

Original languageEnglish (US)
Pages (from-to)1420-1425
Number of pages6
JournalSpine
Volume36
Issue number17
DOIs
StatePublished - Aug 1 2011
Externally publishedYes

Fingerprint

Spinal Tuberculosis
Spine
Laminectomy
Internship and Residency
Psoas Abscess
Therapeutics
Calcium Sulfate
Bed Rest
Braces
Kyphosis
Paraplegia
Tuberculin
Immobilization
Intravenous Administration
Abscess
Bacillus
Orthopedics
Salts
Surgeons
Pathology

Keywords

  • Harvey Cushing
  • history of spinal surgery
  • Pott disease
  • psoas abscess
  • spinal deformity
  • tuberculosis spondylitis

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Bydon, A., Dasenbrock, H. H., Pendleton, C., McGirt, M. J., Gokaslan, Z. L., & Quinones-Hinojosa, A. (2011). Harvey cushing, the spine surgeon: The surgical treatment of pott disease. Spine, 36(17), 1420-1425. https://doi.org/10.1097/BRS.0b013e3181f2a2c6

Harvey cushing, the spine surgeon : The surgical treatment of pott disease. / Bydon, Ali; Dasenbrock, Hormuzdiyar H.; Pendleton, Courtney; McGirt, Matthew J.; Gokaslan, Ziya L.; Quinones-Hinojosa, Alfredo.

In: Spine, Vol. 36, No. 17, 01.08.2011, p. 1420-1425.

Research output: Contribution to journalReview article

Bydon, A, Dasenbrock, HH, Pendleton, C, McGirt, MJ, Gokaslan, ZL & Quinones-Hinojosa, A 2011, 'Harvey cushing, the spine surgeon: The surgical treatment of pott disease', Spine, vol. 36, no. 17, pp. 1420-1425. https://doi.org/10.1097/BRS.0b013e3181f2a2c6
Bydon, Ali ; Dasenbrock, Hormuzdiyar H. ; Pendleton, Courtney ; McGirt, Matthew J. ; Gokaslan, Ziya L. ; Quinones-Hinojosa, Alfredo. / Harvey cushing, the spine surgeon : The surgical treatment of pott disease. In: Spine. 2011 ; Vol. 36, No. 17. pp. 1420-1425.
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