The Classic

Abstract

While the specter of poliomyelitis and its associated legacy of musculoskeletal disabilities is now confined largely to the Third World, the ingenuity, innovations, and skills developed in dealing with these patients have had a significant impact upon present-day orthopedic practice. Nowhere is this more apparent than in the field of spinal surgery. It should not be forgotten that the first rodding procedures pioneered by Harrington were devised to stabilize the spine in patients with paralytic scoliosis and that the halo brace was developed to aid in the treatment of some of these paralyzed patients. During the era dominated by the poliomyelitis epidemics, the facility supported by Los Angeles County, Rancho Los Amigos Hospital, became a center for the treatment and rehabilitation of those patients. It is not surprising therefore that a device such as this should be developed there. Vernon L. Nickel (Fig. I) was the chief of the surgical services at Rancho Los Amigos Hospital from 1953 to 1978. A native of western Canada, he obtained his medical degree at Loma Linda University in California and had postgraduate training in orthopedic surgery at the Campbell Clinic in Memphis, Tennessee. During his career he has held appointments as a professor of orthopedic surgery at several of the medical schools in the Los Angeles area and is presently professor of surgery (in residence) for orthopedics and rehabilitation in the University of California, San Diego, School of Medicine. He has had a continuing interest in rehabilitation of disabled patients throughout his career and in 1977–1980 served as director of rehabilitative engineering research and development service for the Central Office of the Veterans Administration, Washington, D.C. His colleague, Jacquelin Perry (Fig. 2), began her career as a physical therapist at Walter Reed Army Medical Center. She obtained her medical degree and postgraduate orthopedic training at the University of California, San Francisco. She began her service to the patients at Rancho Los Amigos Hospital in 1955. She has been a professor of orthopedics at the University of Southern California since 1965. The Halo: A Spinal Skeletal Traction Fixation Device, written by Dr. Nickel, Chief of the Spinal Injury Service, Dr. Peny, Chief of the Scoliosis Program, Dr. Garrett, Head of the Children's Clinic, and Dr. Heppenstall, Senior Resident, has been chosen as the Classic article for this Symposium because it represents a major contribution to the technical armamentarium of the spinal surgeon. It has broad application in all types of spinal injuries and diseases and, indeed, can serve effectively in many cases as the only modality of treatment required.