Piek J, Lidke G, Terberger T, von Smekal U, Gaab M R
Neurochirugische Klinik, Ernst-Moritz-Arndt-Universität, Greifswald, Germany.
Neurosurgery. 1999 Jul;45(1):147-51; discussion 151. doi: 10.1097/00006123-199907000-00033.
Trephination of the cranial vault is the oldest known surgical procedure and has often been reported in the literature. The present study was performed to study the incidence, the techniques used, and possible indications for trephinations in the region of Mecklenburg-Vorpommern, the most northeastern German state.
One hundred thirteen of a total of 115 Neolithic (c. 2000-3500 BC) skulls and eight smaller skull fragments found in the region of Mecklenburg-Vorpommern were examined. Defects and abrasions were detected in 31 of these skulls and underwent further examination (careful microscopic and/or endoscopic examination, three-dimensional computed tomography, and x-rays).
Six skulls showed defects resulting from trephination, mainly located along the midline or in the left parieto-occipital region. There was good osteological evidence that at least five of these operations had been survived. Two different techniques for trephination (circular cuts and scraping) had been used.
From the present study, we conclude that the incidence of trephination in Neolithic skulls in our region is at least 5% and that these operations had been survived in singular cases. There is increasing evidence that these procedures were intended to be curative.
颅骨环锯术是已知最古老的外科手术，文献中常有报道。本研究旨在探讨德国最东北部的梅克伦堡-前波美拉尼亚地区颅骨环锯术的发生率、所采用的技术以及可能的适应证。
对在梅克伦堡-前波美拉尼亚地区发现的115具新石器时代（约公元前2000 - 3500年）颅骨中的113具以及8块较小的颅骨碎片进行了检查。在其中31具颅骨中检测到缺损和擦伤，并进行了进一步检查（仔细的显微镜和/或内镜检查、三维计算机断层扫描和X射线检查）。
6具颅骨显示有环锯术造成的缺损，主要位于中线或左顶枕区域。有充分的骨学证据表明，这些手术中至少有5例患者存活了下来。采用了两种不同的环锯术技术（环切和刮除）。
从本研究中，我们得出结论，我们地区新石器时代颅骨中环锯术的发生率至少为5%，并且在个别病例中这些手术的患者存活了下来。越来越多的证据表明，这些手术旨在治疗疾病。
