Little-known Swiss contributions to the description, diagnosis, and surgery of lumbar disc disease before the Mixter and Barr era

Abstract

<jats:p>The understanding of lumbar spine pathologies made substantial progress at the turn of the twentieth century. The authors review the original publication of Otto Veraguth in 1929 reporting on the successful resection of a herniated lumbar disc, published exclusively in the German language. His early report is put into the historical context, and its impact on the understanding of pathologies of the intervertebral disc (IVD) is estimated. The Swiss surgeon and Nobel Prize laureate Emil Theodor Kocher was among the first physicians to describe the traumatic rupture of the IVD in 1896. As early as 1909 Oppenheim and Krause published 2 case reports on surgery for a herniated lumbar disc. Goldthwait was the first physician to delineate the etiopathogenes is between annulus rupture, symptoms of sciatica, and neurological signs in his publication of 1911. Further publications by Middleton and Teacher in 1911 and Schmorl in 1929 added to the understanding of lumbar spinal pathologies. In 1929, the Swiss neurologist Veraguth (surgery performed by Hans Brun) and the American neurosurgeon Walter Edward Dandy both published their early experiences with the surgical therapy of a herniated lumbar disc. Veraguth's contribution, however, has not been appreciated internationally to date. The causal relationship between lumbar disc pathology and sciatica remained uncertain for some years to come. The causal relationship was not confirmed until Mixter and Barr's landmark paper in 1934 describing the association of sciatica and lumbar disc herniation, after which the surgical treatment became increasingly popular. Veraguth was among the first physicians to report on the clinical course of a patient with successful resection of a herniated lumbar disc. His observations should be acknowledged in view of the limited experience and literature on this ailment at that time.</jats:p>

Letter to the Editor: Early achievements of Hans Brun in the surgery of intramedullary tumors

“…We agree with Prof. Hildebrandt that Brun and Veraguth's work is not well documented and that they should be remembered as an early and successful team of surgeon and neurologist who removed some of the few first intramedullary spinal cord tuberculomas in history. 23,24 We are happy that Prof. Hildebrandt and colleagues feature Dr. Brun's work in 2 of their recent papers, 14,22 and we are indeed pleased that our work has promoted an open discussion in which other influential figures in the field whom we may have missed in our paper, such as Hans Brun, have been remembered. As Prof. Hildebrandt details in his comment, Hans Brun and his colleague the neurologist Otto Veraguth from Zurich were pioneers in the field of spine surgery, including some of the first cases of herniated lumbar discs and intramedullary spinal cord lesions.…”

UniversitätsSpital Zürich: 80 years of neurosurgical patient care in Switzerland

“…Despite being commonly perceived as a centre specialising in cranial procedures, the department of neurosurgery at the USZ has a long-standing tradition in the surgical care of spinal pathologies. USZ neurologist Otto Veraguth played an important role in one of the first surgeries ever performed for a herniated lumbar disc (see above) [ 38 , 86 ]. Moreover, the method of laminectomy was introduced at the USZ on 31 January 1938, to remove a spinal meningioma.…”

“…[ 38 ]}. This happened well before Dandy, or Mixter and Barr’s so-called landmark paper of 1934 [ 86 ]. Both Veraguth and Brun proved to be pioneers in regards to the surgical treatment of intramedullary spinal lesions: in 1910, Hans Brun became the third surgeon (after Anton von Eiselsberg in Vienna and Charles Elsberg in New York) to successfully remove an intramedullary lesion in a patient [ 38 , 85 ].…”

Definitions of traumatic conus medullaris and cauda equina syndrome: a systematic literature review

“…18 Veraguth was the first author to describe the diagnosis and surgical treatment of a patient with a conus-cauda syndrome. 19 In 1944, French and Payne described clinical symptoms that were caused by compression of the CE and named this as 'cauda equina compression syndrome'. 20 From 1982, CMS and CES were included in the International Standard for Neurological and functional Classification of Spinal Cord Injury (ISNCSCI) by the American Spinal Injury Association (ASIA), but were recently omitted because of the absence of a clear definition.…”