This year marks the 100th anniversary of the Neurological Institute (NI). The Institute was founded in 1909 as the first hospital in the U.S. dedicated exclusively to the study and treatment of Neurological disorders. This anniversary inspires us to look back and see how far the field has come. A good place to do this is by looking at the work of three NI surgeons in their time; Charles A Elsberg in 1925, J. Lawrence Pool in 1959, and Paul McCormick in 2009, all three pioneers in the diagnosis and treatment of spinal tumors.

Dr. Charles A. Elsberg was one of the NI founders and their first Chair of Neurosurgery. He held this position until retirement in 1937. Elsberg has been called the “father of spinal surgery.” In his paper, Some Aspects of the Diagnosis and Surgical Treatment of Tumors of the Spinal Cord, published in 1925, he commented on the progress in the field, “we are now able, in many instances, to say with certainty that an individual has a spinal cord tumor, and it is possible to diagnosticate not only the level at which the spinal cord is compressed, but also the side of the cord… upon which the expanding lesion is exerting its pressure.” This was a remarkable achievement in his day especially since X-rays were the only imaging techniques and, as they were, didn’t actually pick up these tumors.

In his article, Elsberg, also details the surgical procedure of tumor removal. He says, “The attempt should always be made to do as wide a laminectomy as possible to reduce to a minimum the amount of handling of the cord.” This meant making as large an incision and removing as much bone as possible. In fact, because the damage was too great, Elsberg recommended not removing the entire tumor if the cord was involved. The problem was, he had to rely only on what he could see with his naked eye. This was a challenge to be tackled by the next generation of surgeons.

Enter Dr. J. Lawrence Pool. Pool was chairman of the Department of Neurological Surgery from 1949 to 1972. In 1937, he made strides in diagnosis when he first performed an exam using a myeloscope. In 1959, he presented A look Ahead at Technical and Training Developments in Neurosurgey in which he details advancement of other diagnostic techniques such as radioactive scanning and enzyme studies of the cerebrospinal fluid. But it was his introduction of the use of the microscope during surgery that lead to the development of the microsurgical techniques used today.

The torch was then passed to Dr. Paul McCormick, current director of the Spine Center at NI. He has dedicated his research to the study of the spine, and largely to the microsurgical management of spinal tumors. Microsurgery involves the use of microscopes and tiny instruments that can remove more of the tumor, more safely than ever before. Highly focused beams of radiation can also be used to target any remaining tumor. This together with advances in diagnostics such as MRIs and CAT scans have greatly improved patient outcomes. More information on Dr. McCormick’s and the Spine Centers’ work can be found here: Spinal Tumors and Spinal Tumor Resection Procedure.

Finally, in the words of Dr. J. Lawrence Pool, “Technical developments along these and other lines rest entirely on the ability and imagination of future neurosurgeons. Their predecessors have already demonstrated a remarkable degree of ingenuity in this regard,”

Learn more about the History of the Neurological Institute