Our Summary

This research paper focuses on the lesser known contributions of Harvey Cushing to spinal cord surgery. Cushing is well-known for his work in brain tumor surgery, but he also made significant strides in the development of procedures for the spinal cord. The authors of this paper take a close look at Cushing’s unpublished writing “Technique of Laminectomy” and his first three cases of spinal cord tumor surgeries at Johns Hopkins Hospital.

The paper highlights the challenges Cushing faced, such as identifying the type of tumor, diagnosing it before surgery, locating the tumor, and finding the best surgical approach. While his early attempts at removing these types of tumors weren’t always successful, Cushing demonstrated an ability to adjust his techniques based on the challenges he encountered. His work showed a high level of care, resulting in patients avoiding neurological damage, infections, or complications after surgery.

Despite the obstacles faced by Cushing and his fellow early neurosurgeons, they persevered and laid the foundation for modern neurosurgery. Their experiences are important elements in the history of this field.

FAQs

  1. What contributions did Harvey Cushing make to spinal cord surgery?
  2. What challenges did Cushing face in his early attempts at spinal cord tumor surgeries?
  3. How did Cushing’s work lay the foundation for modern neurosurgery?

Doctor’s Tip

A doctor might tell a patient undergoing a spinal laminectomy to follow their post-operative care instructions carefully, including taking prescribed medications, attending physical therapy sessions, and avoiding strenuous activities until cleared by their healthcare provider. Additionally, the doctor may advise the patient to maintain good posture, practice proper body mechanics, and engage in regular exercise to support their spine and prevent future issues.

Suitable For

Spinal laminectomy is typically recommended for patients with conditions such as spinal stenosis, herniated discs, spinal tumors, or other spinal cord abnormalities that are causing compression of the spinal cord or nerve roots. Patients who experience symptoms such as back pain, leg pain, weakness, numbness, or tingling may benefit from a spinal laminectomy to relieve pressure on the spinal cord and nerves.

Additionally, patients who have not had success with non-surgical treatments such as physical therapy, medications, or injections may be candidates for spinal laminectomy. It is important for patients to undergo a thorough evaluation by a neurosurgeon or orthopedic surgeon to determine if spinal laminectomy is the appropriate treatment option for their specific condition.

Overall, spinal laminectomy is a surgical procedure that can help improve symptoms and quality of life for patients with spinal cord compression or other spinal abnormalities. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine the best course of action for their individual needs.

Timeline

Before a spinal laminectomy, a patient may experience symptoms such as back pain, numbness or weakness in the legs, difficulty walking, and loss of bowel or bladder control. These symptoms may worsen over time and can be caused by conditions such as spinal stenosis, herniated discs, or spinal tumors.

After a spinal laminectomy, patients typically experience relief from their pre-surgery symptoms. They may need to stay in the hospital for a few days for monitoring and pain management. Physical therapy and rehabilitation may be recommended to help regain strength and mobility in the affected area. Patients are advised to avoid heavy lifting and strenuous activities for a period of time to allow for proper healing.

Overall, the goal of a spinal laminectomy is to alleviate pressure on the spinal cord or nerves and improve the patient’s quality of life. With advancements in surgical techniques and post-operative care, patients can expect a quicker recovery and better outcomes compared to the early days of spinal cord surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal laminectomy include:

  1. What is the purpose of the spinal laminectomy procedure?
  2. What are the risks and potential complications associated with spinal laminectomy?
  3. How will my recovery process look like after the surgery?
  4. How long will it take for me to return to normal activities after the surgery?
  5. What type of anesthesia will be used during the procedure?
  6. What are the chances of the spinal laminectomy relieving my symptoms?
  7. Are there any alternative treatments or procedures that I should consider?
  8. How many spinal laminectomy procedures have you performed, and what is your success rate?
  9. What can I do to prepare for the spinal laminectomy surgery?
  10. What follow-up care will I need after the surgery?

Reference

Authors: Pendleton C, Rincon-Torroella J, Gokaslan ZL, Jallo GI, Quinones-Hinojosa A. Journal: J Neurosurg Spine. 2015 Oct;23(4):412-8. doi: 10.3171/2014.12.SPINE13427. Epub 2015 Jun 26. PMID: 26115026