Human Cadaveric Dissection Research Articles

Medical students' reactions to anatomic dissection and the phenomenon of cadaver naming

The teaching of gross anatomy has, for centuries, relied on the dissection of human cadavers, and this formative experience is known to evoke strong emotional responses. The authors hypothesized that the phenomenon of cadaver naming is a coping mechanism used by medical students and that it correlates with other attitudes about dissection and body donation. The authors developed a 33-question electronic survey to which 1,156 medical students at 12 medical schools in the United States voluntarily responded (November 2011-March 2012). They also surveyed course directors from each institution regarding their curricula and their observations of students' coping mechanisms. The majority of students (574, 67.8%) named their cadaver. Students most commonly cited the cadaver's age as the reason they chose a particular name for the cadaver. A minority of the students who did not name the cadaver reported finding the practice of naming disrespectful. Almost all students indicated that they would have liked to know more about their donor, particularly his or her medical history. Finally, students who knew the birth name of the donor used it less frequently than predicted. The authors found that the practice of naming cadavers is extremely prevalent among medical students and that inventive naming serves as a beneficial coping mechanism. The authors suggest that developing a method of providing students with more information about their cadaver while protecting the anonymity of the donor and family would be useful.

English

BACKGROUND: Dissection of human cadaver forms an integral part of anatomy pedagogy. 'Willed body donation' is a must to maintain a constant supply of cadavers for anatomy teaching. To encourage the public towards body donation we must first develop a positive attitude in medical professionals towards the same. AIMS: The present study aims to evaluate the awareness, attitudes, beliefs of doctors towards willed body donation. METHOD: A questionnaire was administered to 250 consenting doctors (divided into two groups- male doctors and female doctors) practicing Delhi and NCR India. RESULTS: It was observed that though doctors unanimously agree to the importance of dissection in anatomy teaching and understanding they are themselves not keen on donating their bodies. The number of female doctors (29%) consenting to donation is significantly less than the number of male doctors (52%) (p<.0001). INTERPRETATION AND CONCLUSION: Dissection does modulate the attitudes of doctors towards donation. Whether it is the disrespectful behavior they see being observed towards the cadaver in the dissection hall or the detachment and depersonalization they feel bound to develop towards the cadaver in order to dissect it, the outcome remains - they are not eager to consider such fate for their own dead corpse. As the success of willed body donor programs lies in the trust the health care professionals develop with the public, it is imperative to first address and allay their fears - psychological and spiritual. Only when the doctors support this idea in all its entirety can we hope to address and preach the society of the importance of body donation. Inclusion of literature in the curriculum, seminars conducted in medical conferences and media such as television and print media are some of the suggested platform to address this issue. A positive change in society's attitude towards body donation is

Development of a Resource for Training Anatomy Lab Dissection Techniques

Human cadaver dissection is a well‐established tool for teaching medical gross anatomy. Often students formally learn the subject matter, but learn the technique of dissection and tissue manipulation informally during their first labs. Previous classes have indicated the desire for more formal training in dissection techniques to reduce their uncertainty and nervousness. In response, we developed a formal curriculum and resources to help students more quickly become comfortable with dissection tools and techniques. The curriculum involved training Teaching Assistants (TAs) about a range of dissection techniques and uses for the tools. The TAs then taught lessons in tool use to the medical students during the first 3 labs of our course. Both TAs and students valued the techniques incorporated into this curriculum. We are also developing a website that will highlight the same lessons, which will be made freely available. Feedback indicates that using a formal framework to teach dissection techniques helped students become more comfortable with dissection and ultimately dissect more efficiently. Both students and teachers benefitted from the module and recommend it for future classes.Grant Funding Source: Boston University

Integrative physiology and systems biology: reductionism, emergence and causality

Integrative physiology and systems biology: reductionism, emergence and causality

The anatomical and histological features of the area between the upper and lower lateral nasal cartilages: a pilot study

Objective: Nasal alar retraction deformities occasionally require both soft tissue release and large cartilage grafts. The structure between the upper lateral cartilage and the lateral crus of the lower lateral cartilage has been described as fibrous tissue, intercartilaginous ligament, ligament-like arrangement or connective tissue. Despite its importance, no anatomical and histological examination has been conducted on this structure. Therefore, the present study aimed to identify the area between the upper and lower lateral cartilages by histological examination. Methods: Eleven hemi-facial human cadaver dissections were performed. Initially, the gross dissection of all specimens was conducted. The cutaneous-subcutaneous division of the skin was elevated and was removed. The upper and lower lateral cartilages were removed en bloc together with the area among these cartilages from six specimens and were divided from its midline. The obtained twelve specimens were fixed in formalin, processed and embedded in paraffin. 4 μm sections were obtained. Other five specimens were examined to outline under a stereomicroscope. This approach allowed free access to the structure extending from the area between the upper and lower lateral cartilages to the skin. The full-thickness biopsy was taken from the structure extending from the area between the upper and lower lateral cartilages to the skin. All specimens were fixed in formalin, processed and embedded in paraffin. 4 μm sections were obtained and prepared for microscopic examination. All the sections were stained with hematoxylin & eosin, Mowry’s colloidal iron, Verhoff’s elastic stain, and Masson’s trichrome stain for histological examination. The contents were determined. Results: A single dense longitudinal collagenous bundle between the cartilages and a structure extending from the area between the cartilages to the skin were found. Conclusion: The knowledge of this area in terms of anatomical and histological features will provide additional data for surgeons. © 2012 GESDAV

A historical perspective: Infection from cadaveric dissection from the 18th to 20th centuries

Today, the study of human anatomy utilizing the ultimate study guide, the cadaver, is relatively safe. In the past, however, human dissection was dangerous. Prior to the germ theory, antibiotics, and the use of gloves, cadavers were often life threatening to dissectors including both the teacher and the student. Medical students who graduated in the United States before 1880 were unlikely to practice antisepsis in the dissecting room. In the present article, we review human cadaveric dissection in Europe and the United States primarily from the 1700s to the early 1900s in regard to its potential for transmission of infection to the dissector. A brief account of the infectious hazards of human cadavers in general and those of cadavers used for dissection in particular is given.

The safety and feasibility of a less invasive distal femur closing wedge osteotomy technique: a cadaveric dissection study of the medial aspect of the distal femur

To investigate the feasibility and safety of a less invasive surgical approach to the distal medial aspect of the femur in supracondylar medial closing wedge osteotomy for the treatment of lateral compartment osteoarthritis of the knee. The aim of a less invasive approach is to minimize soft tissue disruption, reduce damage to neurovascular structures and thereby prevent muscle atrophy and optimize bone healing potential. A human cadaver dissection study on the vascular and neural structures of the medial side of the distal femur was conducted. Surgical dissection (n=4), cryomicrotomy and subsequent 3D reconstruction of the anatomy (n=1), and surgical dissection after performance of a supracondylar osteotomy through a less invasive approach (n=1) were performed in 6 legs in total. The surgical dissection and 3D reconstruction showed that a branch of the femoral artery, the distal genicular artery, supplies the distal area of the vastus medialis (VM) muscle. This artery has several branching patterns; crucial in the presented less invasive approach is its musculo-articular branch, which has an oblique course through the VM to the superomedial pole of the patella. The femoral nerve and saphenous nerve innervate the VM. These structures are at risk in the traditional subvastus approach, whereas no major damage was observed in the leg in which a less invasive approach was performed. In this cadaveric dissection study, a less invasive approach to the medial side of the distal femur proved to be feasible and safe. Damage to the VM and its neurovascular structures is minimized as compared to the traditional subvastus approach.

Unilateral variations in the branching pattern of right external carotid artery- a case report

AbstractA case report of anomalous origin and branching pattern of right external carotid artery found during the dissection of human cadavers is reported here. Knowledge of anatomical variations of external carotid artery is especially important in head &amp; neck surgeries. This knowledge is also important for radiologists in the image interpretation. In the case reported here, the right external carotid artery gave direct origin of one of dorsal lingual artery, two stylomastoid arteries, muscular artery and lymph nodal artery along with its normal eight branches. Generally the dorsal lingual arteries are two arising from lingual artery. Contrary to that, in this case the dorsal lingual arteries were found arising one from front of external carotid artery and other from lingual artery, and both these arteries communicated at 4mm beyond their origin. The two stylomastoid arteries arising directly from the front of external carotid artery 4mm above the facial artery were found arising with a gap of 2mm distance from one another. Muscular artery arose directly from the posterior aspect of external carotid artery opposite the anomalous dorsal lingual artery and descended downwards and forwards in its course giving small twigs to surrounding muscles . Lymph nodal artery arising just beside the muscular artery opposite to facial artery passed downwards and laterally and divided into two small twigs to supply a pair of lymph nodes. These lymph nodes are deep cervical nodes measuring about 5x5 mm in size hard in consistency on histopathological examination, found to be nonmalignant.

The Gracilis Myocutaneous Free Flap: A Quantitative Analysis of the Fasciocutaneous Blood Supply and Implications for Autologous Breast Reconstruction

BackgroundMastectomies are one of the most common surgical procedures in women of the developed world. The gracilis myocutaneous flap is favoured by many reconstructive surgeons due to the donor site profile and speed of dissection. The distal component of the longitudinal skin paddle of the gracilis myocutaneous flap is unreliable. This study quantifies the fasciocutaneous vascular territories of the gracilis flap and offers the potential to reconstruct breasts of all sizes.MethodsTwenty-seven human cadaver dissections were performed and injected using lead oxide into the gracilis vascular pedicles, followed by radiographic studies to identify the muscular and fasciocutaneous perforator patterns. The vascular territories and choke zones were characterized quantitatively using the ‘Lymphatic Vessel Analysis Protocol’ (LVAP) plug-in for Image J® software.ResultsWe found a step-wise decrease in the average vessel density from the upper to middle and lower thirds of both the gracilis muscle and the overlying skin paddle with a significantly higher average vessel density in the skin compared to the muscle. The average vessel width was greater in the muscle. Distal to the main pedicle, there were either one (7/27 cases), two (14/27 cases) or three (6/27 cases) minor pedicles. The gracilis angiosome was T-shaped and the maximum cutaneous vascular territory for the main and first minor pedicle was 35×19 cm and 34×10 cm, respectively.ConclusionOur findings support the concept that small volume breast reconstructions can be performed on suitable patients, based on septocutaneous perforators from the minor pedicle without the need to harvest any muscle, further reducing donor site morbidity. For large reconstructions, if a ‘T’ or tri-lobed flap with an extended vertical component is needed, it is important to establish if three territories are present. Flap reliability and size may be optimized following computed tomographic angiography and surgical delay.

Unilateral variations in the branching pattern of right external carotid artery - a case report

A case report of anomalous origin and branching pattern of right external carotid artery found during the dissection of human cadavers is reported here. Knowledge of anatomical variations of external carotid artery is especially important in head & neck surgeries. This knowledge is also important for radiologists in the image interpretation. In the case reported here, the right external carotid artery gave direct origin of one of dorsal lingual artery , two stylomastoid arteries ,muscular artery and lymph nodal artery along with its normal eight branches. Generally the dorsal lingual arteries are two arising from lingual artery. Contrary to that, in this case the dorsal lingual arteries were found arising one from front of external carotid artery and other from lingual artery, and both these arteries communicated at 4mm beyond their origin .The two stylomastoid arteries arising directly from the front of external carotid artery 4mm above the facial artery were found arising with a gap of 2mm distance from one another. Muscular artery arose directly from the posterior aspect of external carotid artery opposite the anomalous dorsal lingual artery and descended downwards and forwards in its course giving small twigs to surrounding muscles . Lymph nodal artery arising just beside the muscular artery opposite to facial artery passed downwards and laterally and divided into two small twigs to supply a pair of lymph nodes. These lymph nodes are deep cervical nodes measuring about 5x5 mm in size hard in consistency on histopathological examination, found to be nonmalignant.

Uncommon Variation in Musculature of the Chest wall

Occasionally a vertical strip of muscle is seen at the lateral border of sternum, which is named as ‘Rectus sternalis (sternalis) muscle’. This muscle is considered as part of the vertical strip of muscles (strap muscles present from chin to pubis). A rare case of unilateral right sided sternalis muscle was found during routine dissection of human male cadaver at Kamineni Institute of Medical Sciences, Narketpally. The early detection of this variant muscle is necessary for assessing in radiological examination. Here by we report a case of right unilateral rectus sternalis muscle. Knowledge of variations occurring in the muscular system is of great importance to the surgeons and professionals who works with imaging. An unusual variation in chest wall rectus sternalis, it can be confused for a mass on mammography, but confusion revolved by computerised tomography/magnatic resonance imaging. It has unclear embryonic origin, perhaps a remnant of the panniculus carnosus. It is an unusal muscle found occasionally in the anterior part of the thorax. This variation was found in a male cadaver during routine dissection, it belongs to a muscle of pectoral group. It was found in 8% of population. This muscle is called as rectus sternalis, rectus means straight; it lies parallel to the lateral border of sternum on right side, absent in left side. It is an accessory muscle of the chest wall; it is useful for reconstruction of the neck, chest, abdomen, and perhaps even other places. At last, sternalis may be nothing more than misplaced developed muscle tissue, arising from variable sources in a localised region at the anterior thorax, and serving no apparent function but to be fuddle diagnosticians. Therefore, familiarity of the sternalis only broadens the surgeon’s knowledge of variations of chest wall anatomy but also provides reconstructive operations (when present) for wounds in the chest wall as well as adjacent regions. It may be bilateral (or) unilateral. It is a rare variation.

Feasibility of Robot-Assisted Neck Dissections via a Transaxillary and Retroauricular (“TARA”) Approach in Head and Neck Cancer: Preliminary Results

Recently, robot-assisted neck dissection in thyroid cancer patients with lateral neck node metastasis has been demonstrated to be feasible. We realized the necessity of technical modification in order to apply robotic system to comprehensive neck dissection for head and neck squamous cell carcinoma. This study examined the feasibility and safety of transaxillary and retroauricular ("TARA") approach for robotic neck dissection in patients with head and neck squamous cell cancer. Four human cadaveric dissections were followed by robotic neck dissections in seven patients with oral cavity or laryngopharyngeal cancer through TARA incision. In all cases, vital structures including major vessels and nerves were preserved. The numbers of retrieved lymph nodes in robotic neck dissections were comparable with those in conventional neck dissections. Robotic neck dissection via TARA approach is a feasible and useful method with excellent cosmetic results for treating nodal metastasis in selected cases of head and neck squamous cell cancer.

Medical students' attitudes toward the anatomy dissection room in relation to personality

Assessment of the personalities of medical students could enable medical educators to formulate strategies for the best development of academic and clinical competencies. In this article, we focus on the experience of students in the anatomy dissecting room. While there have been many attempts to evaluate the emotional responses of medical students to human cadaveric dissection, there has been no investigation into how different personality traits affect the responses. The main hypothesis tested was that there is a relationship between personality traits and attitudes toward the dissection room. For the present study, a group of French medical students (n = 403; mean age 21.3 ± 1.6; 65.3% female) completed a "Big Five" personality inventory and a questionnaire to assess their attitudes in regard to human dissection. The findings are consistent with our hypothesis, in that we found a relationship between reporting anxiety and four of the "Big Five" dimensions (all except openness). The rated level of anxiety was positively correlated with negative affectivity, more strongly at the beginning than at the end of the course. There were significant gender differences in attitudes toward dissection. The findings are discussed in relation to the possibility of preparing students for the dissecting room experience and also in relation to the students' understanding of mortality issues.

Divided and reunited maxillary artery: developmental and clinical considerations

We describe an anatomical variation of the right maxillary artery, discovered during dissection of a male human cadaver. The right maxillary artery bifurcates into unequal superficial (larger) and deep (smaller) divisions. Each division gives off several branches that distribute to the muscles of mastication, facial structures, and teeth. The superficial and deep divisions then reunite to form a complete loop, before giving off terminal branches in the pterygopalatine fossa. The entire arterial loop lies superficial to the branches of the mandibular nerve. This case provides further evidence for a network of vascular rings that surround soft tissue structures in the developing infratemporal fossa. Persistence of all or part of these rings determines adult anatomy. Extreme anatomical variations such as this one may complicate major procedures such as radical maxillectomy, as well as simple procedures such as inferior alveolar nerve blocks.

A Novel Technique for Repositioning Lower Eyelid Fat via the Transoral Approach in Association with Midface Lift

BackgroundOrbital fat repositioning in association with subperiosteal midface elevation has been variably described via both the transconjunctival and skin muscle flap approaches. Poor visualization, middle and posterior lamellar cicatricial fibrosis, technical difficulty, and incomplete release are disadvantages commonly ascribed to the transconjunctival approach. Lower eyelid malposition and retraction also are commonly seen in association with skin muscle flap approaches. A simple technique using the intraoral approach to release the orbital septum and postseptal fat is described in this report. This procedure avoids complications associated with the violation of key lower eyelid anatomic structures and markedly improves visualization through an incision allowing a much larger access.MethodsA retrospective review of six patients who underwent endoscopically assisted midface elevation in combination with lower eyelid fat repositioning via a transoral approach since 2009 and were followed up for at least 1 year is presented. A pre- and postoperative assessment of tear trough depth, lower eyelid fat herniation, and midface descent is made. Four of the six patients presented also underwent concurrent additional facial rejuvenation procedures including endoscopically assisted brow-lift, genioplasty, structural fat grafting to the nasolabial folds, and lower eyelid “pinch” blepharoplasty. Standard upper buccal sulcus access incisions were used for subperiosteal midface elevation and exposure of the lower orbital septum. Fat redraped over the orbital rim was not secured with fixation sutures as is commonly performed using lower eyelid approaches. Human cadaveric dissection with endoscopic visualization also was performed to demonstrate the reported technique.ResultsDuring this study, one complication developed for a single patient who experienced a temporary dense right zygomatic and frontal branch nerve palsy lasting 8 weeks. No evidence of lower eyelid malposition, ectropion, entropion, incomplete release, or asymmetry was otherwise encountered. Improvement in tear trough appearance, lower eyelid herniation, and midface descent was noted in all six patients.ConclusionA novel approach for lower eyelid fat transposition in combination with midface lift using the intraoral approach is presented. Excellent visualization, decreased operative times, technical ease, and improved outcomes all are potential advantages of this technique over standard approaches in which access to lower eyelid fat is achieved through the conjunctiva or a skin muscle flap.

Combined approach for extensive maxillectomy: technique and cadaveric dissection

Background Currently described endoscopic techniques for subtotal resections of the maxilla include endoscopic medial maxillectomy and extended endoscopic medial maxillectomy; however, a complete resection of the maxilla is sometimes warranted. We describe a combined transoral and endoscopic technique for total and subtotal maxillectomy in an attempt to decrease the morbidity of traditional approaches. Methods Technical note, Feasibility, Human cadaveric dissection. Results Ten total and subtotal maxillectomies were performed in human specimens without the need of facial incisions or transfixion of the nasal septum. The pterygopalatine and infratemporal fossas were accessed and dissected in all cases. Conclusions A combined transoral and endoscopic approach is feasible and can be used in selected patients when other minimally endoscopic techniques are not indicated. The benefits of no facial incisions and/or transfixion of the nasal septum, potential improvement in hemostasis, and visual magnification may help to decrease the morbidity of traditional open approaches.

Yale University School of Medicine

Yale University School of Medicine

1880 TRIFECTA OF PAIN: ANATOMIC BASIS FOR DENERVATION OF THE SPERMATIC CORD FOR CHRONIC ORCHIALGIA

You have accessJournal of UrologyInfertility: Physiology, Pathophysiology, Basic Research1 Apr 20101880 TRIFECTA OF PAIN: ANATOMIC BASIS FOR DENERVATION OF THE SPERMATIC CORD FOR CHRONIC ORCHIALGIA Sijo Parekattil, Karen Priola, Hany Atalah, Marc Cohen, Johannes Vieweg, and Robert Allen Sijo ParekattilSijo Parekattil More articles by this author , Karen PriolaKaren Priola More articles by this author , Hany AtalahHany Atalah More articles by this author , Marc CohenMarc Cohen More articles by this author , Johannes ViewegJohannes Vieweg More articles by this author , and Robert AllenRobert Allen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1833AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Levine et al. have shown that microsurgical denervation of the spermatic cord is a treatment option for men with chronic orchialgia (CO). Uceyler et al. have shown that patients with neuropathic pain may have Wallerian degeneration in peripheral nerves. This study was aimed at developing an anatomical basis of how the denervation technique may provide pain relief. METHODS A prospective control study was performed. Specimens of tissue transected in a standardized fashion from cross-sections of the spermatic cord during 30 microsurgical denervation procedures and 4 varicocelectomies performed (May to Oct 2009) by a single microsurgeon (SJP) were reviewed. All specimens were reviewed by a single pathologist (RWA), blinded to the tabulated results of total number of nerves, size and any evidence of pathology (hematoxylin-eosin staining). All denervation cases were performed in men with CO that had failed conservative treatment options (negative urologic and neurologic workup). The 4 varicocelectomy cases were the control group (no CO). A human cadaver dissection was performed to confirm localization of the nerve distribution found on pathology. RESULTS There were an average of 20 reproducible small diameter (<1 mm) nerve fibers within the spermatic cord per patient. 83% (25/30) of orchialgia patients were found to have Wallerian degeneration in at least one or more of these nerves. Only 25% (1/4) patients had Wallerian degeneration in the varicocelectomy group. There was a characteristic distribution of nerves within the cord. There were 3 primary locations, listed in decreasing order of nerve density: 1) Cremasteric muscle fibers (8 nerves/patient), 2) Peri-vasal tissues and vasal sheath (7.6 nerves/patient), and 3) Peri-arterial tissues (1.9 nerves/patient). The nerve distribution was anatomically confirmed on the cadaver dissection. CONCLUSIONS There is an anatomical basis to the success of microsurgical denervation of the spermatic cord for men with chronic orchialgia. There appear to be specific distribution patterns of small diameter nerve fibers within the spermatic cord. There appears to be a significant amount of Wallerian degeneration in spermatic cord nerve fibers in men with chronic orchialgia. This study confirms the key components of the denervation procedure: 1) ligation of cremasteric fibers, 2) ligation of the peri-vasal sheath, and 3) ligation of the peri-arterial tissues. The transsection of these nerves may explain the effect of the denervation procedure. Gainesville, FL© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLarsen S, Benson J and Levine L (2012) Microdenervation of the Spermatic Cord for Chronic Scrotal Content Pain: Single Institution Review Analyzing Success Rate After Prior Attempts at Surgical CorrectionJournal of Urology, VOL. 189, NO. 2, (554-558), Online publication date: 1-Feb-2013. Volume 183Issue 4SApril 2010Page: e730-e731 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sijo Parekattil More articles by this author Karen Priola More articles by this author Hany Atalah More articles by this author Marc Cohen More articles by this author Johannes Vieweg More articles by this author Robert Allen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

DEVELOPMENT OF ANATOMIC SCIENCE IN THE LATE MIDDLE AGES

Medical historians generally consider anatomic science, as we know it today, to have been established through the pioneering work of Vesalius during the Renaissance. Although this is largely true, detailed assessment of the scientific advances made in the late Middle Ages, though not as spectacular as those made during the Renaissance period, did pave the way and form a foundation for subsequent progress. During the two centuries of AD 1300 to 1500, several worthwhile advances occurred. Many universities, centers of learning excellence, were established throughout Europe, most notably in Italy. King Frederick II, the Holy Roman Emperor, established guidelines for medical education and practice that seem to parallel current regulations. Human cadaveric dissection was performed, after a hiatus of over 1700 years, as the foundation for the study of anatomy. Observation of human dissection became a requirement for medical students. A manual for anatomic dissection was written, printed, and published for the first time in history by Mondino de Liuzzi. His student, Guido da Vigevano, who also had an engineering background, established two "firsts" of his own: providing illustrations of anatomy and designing the first automobile in history. The authors believe that the contributions of these two key anatomists in the late Middle Ages should not be forgotten.

CONTRIBUTIONS OF JOHANN JACOB HUBER TO THE SURFACE ANATOMY OF THE SPINAL CORD AND MENINGES

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.