Paul of Aegina (625-690): His Work and His Contribution to Neurologic Surgery: Trephinations and Laminectomies in the Dark Ages

The purpose of this historical review is to summarize the work of Paul of Aegina, especially his contribution to the treatment of neurosurgical disorders and trauma. Paul performed trephinations for head injuries in the tradition of the Egyptian and the Greek schools of medicine. However, he was an innovator in the treatment of several spine injuries, as his choice to perform laminectomies and his description of them as safe and successful is unprecedented in the history of the recorded medicine and surgery. Our search of the literature shows that Paul was the first to include in his practice such a surgical technique, and, in this way, he is an innovator, since Hippocrates described the results of spine surgery as disastrous for the patient. Thus, he may be considered the historic father of spine surgery for his pioneering surgical innovations. This shows clearly that innovation in science and medicine was significantly increased through the rise of Islam and the Arabic conquest of the Middle East. The so-called “Dark Ages” were not so dark after all.