By Nathan Lebwohl, MD
Who was first?
Unless you are discussing thoracoplasty, (see Genesis 2,22) it is always dangerous to identify a surgeon as the first to perform an operation. In the March newsletter I discussed Hibbs’ and Albee’s role in the evolution of spinal fusion surgery. I wrote that although “probably not the first surgeon to fuse the spine (Fred Albee claimed to have done his first spinal fusion in 1909, also to treat tuberculosis) Hibbs recognized that the operation could be used to treat spinal deformity due to causes other than tuberculosis, and titled his initial 1911 report “An operation for progressive spinal deformities.”
Berthold Hadra described the use of interspinous wiring for stabilization of the spine and prevention of deformity in the treatment of tuberculosis and fracture in 1891. In his classic article ( Medical Times and Register 1891 22:423) he credits Dr. W. T. Wilkins with being the first to stabilize the spine with interspinous carbolized silk suture. Fusion was not part of these stabilization procedures, and they were done for deformities other than scoliosis.
So we can argue about whether Albee or Hibbs performed the first fusion, who was the first to fuse the spine for scoliosis? I have to thank Robert Winter for pointing me to what is probably the correct answer (and he credits John Hall with making him aware of this.) In a 1914 article in the Journal of Bone and Joint Surgery ( 1914 s2-12: 253-8) Herbert Galloway reports three cases of fusion for paralytic scoliosis using Albee’s technique of splitting the spinous processes, and inserting a tibial graft into the cleft. Reduction of the deformity was accomplished by manual traction. The first of these surgeries was done in July 1913. In the article, Galloway graciously credits Dr. Kidner of Detroit as having done the same operation 10 days earlier, unbeknownst to Galloway. To the best of my knowledge, no other published record of Kidner’s case exists.
Please click on image to enlarge.
Clinical photographs of patient with paralytic scoliosis treated surgically from Albee’s 1915 textbook, Bone Graft Surgery.