Galen: a pioneer of spine research

Galen of Pergamum AD (2nd century), the most eminent Greek physician after Hippocrates, marked the history of medicine for more than 14 centuries. His doctrines, expressed in his voluminous work, combined the medical heritage of the Hippocratic, the Alexandrian, and some of the most important medical schools of antiquity. The strong influence of the Hippocratic tradition can characteristically be traced in orthopaedics and particularly in Galen's presentation of the spine. Based on his observations, derived from dissection and vivisection of animals, Galen established a pioneer model for the study of human spine. His research ended in an accurate description of the vertebral column and the spinal cord. He also described the course and the distribution of the nerves emerging from the spine. In addition, he dealt with the diseases affecting these structures focusing on spinal tuberculosis and the injuries of the spine and the spinal marrow. Galen was the first physician to demonstrate the neurological implications following transection of the spinal cord at several levels. The predominant feature in Galen's reference to spine is its teleological perspective; the great physician tended to attribute the prodigious structure of the spine to nature's providence. Despite the inevitable anatomical errors, Galen's inspired experiments remained the only thorough approach of spinal anatomy and pathology until the recent centuries, when the evolution of sophisticated technical aids opened new pathways to spine research.