Origins of eponymous instruments in spine surgery

Abstract

<jats:p>Every day, spine surgeons call for instruments named after surgical pioneers. Few know the designers or the histories behind their instruments. In this paper the authors provide a historical perspective on the Penfield dissector, Leksell rongeur, Hibbs retractor, Woodson elevator, Kerrison rongeur, McCulloch retractor, Caspar pin retractor system, and Cloward handheld retractor, and a biographical review of their inventors. Historical data were obtained by searching the HathiTrust Digital Library, PubMed, Google Scholar, Google Books, and Google, and personal communications with relatives, colleagues, and foundations of the surgeon-designers. The authors found that the Penfield dissectors filled a need for delicate tools for manipulating the brain and that the Leksell rongeur increased surgical efficiency during war-related laminectomies. Hibbs’ retractor facilitated his spine fusion technique. Woodson was both a dentist and a physician whose instrument was adopted by spine surgeons. Kerrison rongeurs were developed in otology to decompress bone near the facial nerve. The McCulloch, Caspar, and Cloward retractors helped improve exposure during the emergence of new techniques, i.e., microdiscectomy and anterior cervical discectomy and fusion. The histories behind these eponymous instruments remind us that innovation sometimes begins in other specialties and demonstrate the role of innovation in improving patient care.</jats:p>

Comparative Study between Caspar Cervical Retractor System and Traditional S Retractor in Application on Anterior Cervical Decompression and Fixation

“…It is easily to lead to edema of adjacent tissues and organs upon injury during the operative exposing, resulting in a series of complications, including dysphagia, dyspnea, pharyngeal discomfort, even bleeding, shock and death. The Caspar pins and vertebral distractor was invented in 1979 and remains regarded as key instruments for disc space preparation during ACDF 10 . As standardized tools are lacking in three fundamental parts like wound exposure, decompression and fusion, fixation, a Caspar‐based vertebral distractor was tailored.…”

“…The Caspar pins and vertebral distractor was invented in 1979 and remains regarded as key instruments for disc space preparation during ACDF. 10 As standardized tools are lacking in three fundamental parts like wound exposure, decompression and fusion, fixation, a Caspar‐based vertebral distractor was tailored. After application of the Caspar retractor, problems with poor screw placement and loosening as well as associated surgical complications were reduced.…”

Radiographic Analysis of Pedicle Screw Retractor‐Assisted Transforaminal Lumbar Interbody Fusion for Single‐Segment Spondylolisthesis in Adults: A Retrospective Study and Technical Note

“…In our series, we used a screw retractor to expand the intervertebral space properly, thereby stretching the folded ligamentum flavum, and also made the abnormally positioned nerve roots leave the posterior edge of the disc (Figure 2B ), thus the spinal canal and nerve root could be fully seen at any time during decompression and reduction. The screw retractor is inspired by the Caspar pin retractor, 31 which not only enables the combination of the two technologies, but also provides adequate visual field exposure and neuroprotection. We changed the sleeves into two L‐shaped connecting rods in opposite directions, which offered following advantages: (i) a wide range of applications that can be applied to almost all screw‐rod systems without additional customized locking nuts or sleeves; (ii) convenient installation and removal without additional surgical exposure; and (iii) gradual, effective, and stable distraction from the check ratchet.…”

Manual Instruments as an Alternative to Drilling for Bony Exposure in Skull Base Surgery: Concept and Technique

“…This allows one to gradually remove the bone to expose the sigmoid sinus safely. [38][39][40] Authors have been using manual instruments for exposing part transverse/sigmoid sinus for retromastoid approaches for more 6 years with no difference in complications related to sinus injury or postoperative thrombosis. 41 Posterior lip of internal auditory meatus has an acute angle (less than 90 degrees) and can always be removed using thin foot plate of the kerrison punch.…”