ABSTRACT
I HISTORICAL PERSPECTIVE The general population has had a healthy fear of spinal injuries for many centuries, as they are so often associated with paralysis and death. In 2500 BC, a medical author described a clinical finding in the Edwin Smith papyrus: ‘‘One having a crushed vertebra of his neck he is unconscious of his two arms and legs and he is speechless-an ailment not to be treated’’ (1). This phrase is quoted many times in the literature dealing with fracture dislocation of the cervical spine. This condition presents many difficulties in its treatment. In his treatise On Joint (2,3), Hippocrates described methods for the management of spinal diseases including fractures. The early methods were primitive, the patient being tied upside down to a ladder, which was violently shaken in order to reduce a dislocation. He later used a more rational form of treatment and applied traction to the neck of a supine patient, but these cases were rarely treated successfully until the beginning of this century.
