An Early Description of Using Oral Route for the Management of Cervical Vertebra Fracture by Ibn al-Quff in the Thirteenth Century.

Abstract

This study presents information regarding the treatment of fractures and dislocations of the vertebrae, including the use of the oral route for upper cervical fractures, presented in certain chapters of the book titled Kitāb al-'Umda fī Ṣinā'a al-Jirāḥa (Ibn al-Quff, thirteenth century ad). A printed copy of the second volume of the book was studied. Chapters 22 ("On treatment of vertebral fractures") and 33 ("On treatment of vertebral dislocation") of the seventeenth treatise of this book were translated from Arabic into English. Each section is presented (in full text) in the Results section of this article. The findings were compared with the relevant literature and discussed to determine whether Ibn al-Quff presented novel information compared with that presented by his predecessors. The writings of Ibn al-Quff regarding vertebral dislocations seem to summarize information derived from his predecessors. Moreover, he modified certain approaches, previously described for vertebral dislocations, and used them for correcting vertebral fractures. Ibn al-Quff introduced the most novel use of a bridlelike instrument for anterior cervical fracture through the oral route. By introducing the device in the mouth, he described a pushing maneuver to the cervical vertebrae from the ventral site and a simultaneous pulling maneuver by cupping on the neck from the dorsal site. The use of the oral route introduced by Ibn al-Quff may be one of the earliest examples of novel, practical, and advanced treatment for cervical vertebral fracture.