Reflections on the History of Nerve Repair – Sir Sydney Sunderland's Final Presentation to the Neurosurgical Society of Australasia

Abstract Sir Sydney Sunderland (1910-1993) was an eminent physician and anatomist who identified the fascicular structure of nerves, and developed the eponymous 5-tiered classification of nerve injuries. Not long before his death, he presented a keynote address to the Annual Scientific Meeting of the Neurosurgical Society of Australasia. Recently, the videotape of his presentation was discovered. In the presentation, Sir Sydney included discussion on the history of nerve repair, commencing with Herophilus and Galen, and progressing through the Middle Ages, including Leonardo of Bertapaglia, and he further noted the discoveries during the 1800s of the microscope, the axon, and nerve histology (including Remak, Schwann, Nissl, and Golgi), Waller's findings on nerve degeneration, and nerve injury (His, Cajal, Forsmann, and Harrison). Sir Sydney discussed nerve injuries sustained during World War I, with the deleterious effects of infection, and following the many nerve injuries sustained during World War II, he discussed his own discoveries of internal topography of nerve fascicles, and the anatomical substrate of nerve fascicles that limit surgery for nerve repair, nerve grafts, and the basic science of spinal cord repair. This paper presents a transcript of Sunderland's presentation and includes many of his original images used to illustrate this tour de force of nerve repair.