Spina bifida historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

## Overview

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Spina bifida has existed as long as history of humanity. Evidence of children with characteristic features of spina bifida has been found in the archeological findings and a large number of anthropological figures from early civilizations. Spina bifida was first discovered by Hippocrates, (born c. 460 bce, island of Cos, Greece—died c. 375 bce, Larissa, Thessaly). The first definitive description of spina bifida was made by the Dutch clinician Pieter van Foreest (1522–1597) in the late 1500s. In 1614, Nicolaas Tulp (whose real name was Claes Piereszoon) was the first who coined the term spina bifida. Ligation or amputation of the dural sac was the surgical treatment of spina bifida for centuries. The outcome of this procedure was almost always fatal because of central spinal fluid leakage and infection or the secondary progressive untreated hydrocephalus. In 1918, Charles H. Frazier started better surgical concepts of repair of spina bifida, with multilayer closures using dura, fascia, muscles, and skin advocated. In 1967, a study by Sharrard, confirmed that better results were obtained by performing the surgery of spina bifida in the perinatal period. Now, the surgery of spina bifida in the perinatal period, is the preferred treatment.

## Historical Perspective

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### Discovery

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* Spina bifida has existed as long as history of humanity. Evidence of children with characteristic features of spina bifida has been found in the archeological findings and a large number of anthropological figures from early civilizations.[1]

* Spina bifida was first discovered by Hippocrates, (born c. 460 bce, island of Cos, Greece—died c. 375 bce, Larissa, Thessaly).[1]

* The first definitive description of spina bifida was made by the Dutch clinician Pieter van Foreest (1522–1597) in the late 1500s.
* In 1614, Nicolaas Tulp (whose real name was Claes Piereszoon) was the first who coined the term spina bifida.[1]

### Landmark Events in the Development of Treatment Strategies

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* Ligation or amputation of the dural sac was the surgical treatment of spina bifida for centuries. The outcome of this procedure was almost always fatal because of central spinal fluid leakage and infection or the secondary progressive untreated hydrocephalus.[1]

* In 1918, Charles H. Frazier started better surgical concepts of repair of spina bifida, with multilayer closures using dura, fascia, muscles, and skin advocated.[1]
* In 1967, a study by Sharrard, confirmed that better results were obtained by performing the surgery of spina bifida in the perinatal period.[1][2]
* Now, the surgery of spina bifida in the perinatal period, is the preferred treatment.[1]

## References

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1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Liakakos D, Karpouzas J, Agathopoulos A. Missing or empty `|title=` (help)
2. ↑ Sharrard WJ, Zachary RB, Lorber J (1967). "The long-term evaluation of a trial of immediate and delayed closure of spina bifida cystica". Clin. Orthop. Relat. Res. 50: 197–201. PMID 5339471.

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