Rengachary Setti S, Pelle Dominic, Guthikonda Murali
Department of Neurosurgery, Wayne State University School of Medicine and Detroit Medical Center, Detroit, Michigan, USA.
Neurosurgery. 2008 Jun;62(6):1370-3; discussion 1373-4. doi: 10.1227/01.neu.0000333310.87554.d5.
From prehistoric times, man has been aware that injury to the spine may result in paralysis of the limbs; this is reflected in bas-relief figures found at Nineweh in ancient Mesopotamia, in a hunting scene that depicts a lioness wounded by King Ashurbanipal. The Edwin Smith papyrus gives many case illustrations of spinal cord injury resulting in paralysis, yet early physicians were unaware of the anatomy of the spinal cord. Galen performed prospective studies in animals by sectioning the spinal cord at varying levels and observing the commensurate paralysis and sensory loss. Real advances in the understanding of spinal cord anatomy did not occur until human cadaveric dissections were undertaken; even then, the knowledge of the anatomy of the spinal cord lagged behind that of other body structures. Johann Jacob Huber appears to be the first anatomist to focus on the spinal cord almost exclusively. His descriptions, and especially his illustrations that depict spinal cord surface anatomy, are impressive with regard to their accuracy and their sense of photorealism. Indeed, his illustrations seem to compare well with the anatomic drawings in contemporary anatomic texts. Yet, we were unable to find a single article in the entire English-language literature depicting his illustrations. We conclude that the description and anatomic illustrations by Johann Jacob Huber remain a hidden gem in the history of human spinal anatomy.
从史前时代起,人类就已经意识到脊柱损伤可能导致肢体瘫痪;这一点在古代美索不达米亚尼尼微发现的浅浮雕人物中有所体现,在一幅狩猎场景中描绘了被亚述巴尼拔王打伤的母狮。《埃德温·史密斯纸草书》给出了许多脊髓损伤导致瘫痪的病例插图,但早期的医生并不了解脊髓的解剖结构。盖伦通过在不同水平切断动物的脊髓并观察相应的瘫痪和感觉丧失,对动物进行了前瞻性研究。直到进行人体尸体解剖,对脊髓解剖学的真正认识才取得进展;即便如此,对脊髓解剖学的了解仍落后于对其他身体结构的了解。约翰·雅各布·胡贝尔似乎是第一位几乎专门关注脊髓的解剖学家。他的描述,尤其是描绘脊髓表面解剖结构的插图,在准确性和逼真感方面令人印象深刻。事实上,他的插图似乎与当代解剖学文本中的解剖图不相上下。然而,在整个英文文献中,我们找不到一篇描绘他的插图的文章。我们得出结论,约翰·雅各布·胡贝尔的描述和解剖学插图仍然是人类脊柱解剖学历史上一颗被埋没的明珠。