Spinal Deformity and Axial Traction

Abstract

Axial traction to correct spinal deformity is a very old concept. The oldest reference available is in ancient Hindu mythological epics (written between 3500 BC and 1800 BC) where it is mentioned how Lord Krishna corrected the hunchback of one of his devotees. Later, Hippocrates (460 BC to 377 BC) described certain devices. Galen (131 AD to 201 AD), a follower of Hippocrates, used axial traction with direct pressure. Ibn Sena (980 AD to 1037 AD) in the Middle East also used similar methods. Osteopaths of Turkey also used axial traction to correct spinal deformities. But gradually mechanical methods for the correction of the spinal deformity went into disrepute due to the invariable production of paraplegia. In the past few decades, interest in the correction of spinal deformity has been rejuvenated due to better understanding of anatomy, physiology, and pathomechanics of spinal deformity. Controlled axial traction has been the keystone of several modern procedures such as Cotrel traction, Halo traction, and Harrington Outrigger instrumentation, etc. It appears that the primitive ways of application of axial traction by crude methods did not totally vanish but have been modified. In Indian tribal areas, bone setters still practice it in modified form.

First detailed description of axial traction techniques by serefeddin sabuncuoglu in the 15th century

“…Axial traction to correct spinal deformities was known first in ancient Hindu epics (3500-1800 BC) [13]. Hippocrates was the first to arrange devices (Fig.…”

Scoliosis surgery with the posterior approach from the past till present

“…u. 129-99) 56 nevéhez fûzõdik és a σχολιοσ (=ka-nyargós) görög szóra vezethetõ vissza. Nyilvánvaló, hogy ekkor még csak a legkirívóbb esetek felismerésérõl és konzervatív kezelési kísérleteirõl lehetett szó.…”

The treatment of spine deformities before Nicolas Andry

“…Sokféleképpen magyarázzák a fennmaradt rajzokat. Egyik magyarázat az 1. ábrára az, hogy Krishna mechanikusan -álló helyzetben, szemben a beteggel, lábbal fi xálva a beteg egyik lábát és őt az állánál felhúzva -egyenesítette ki a deformitást 9 .…”