Harvey Cushing 1), in 1905, attempted to remove an intramedullary spinal cord tumor but aborted the procedure after a dorsal column myelotomy.
Harvey Cushing's paper, “The special field of neurological surgery,” published in the Bulletin of The Johns Hopkins Hospital in 1905, constitutes a recognized milestone in the establishment of neurological surgery as a separate surgical specialty in the United States 2).
The unilateral suboccipital approach was popularized by Woolsey (1903) and with great contributions by Fedor Krause (1905).
After several refinements and modifications through different dedicated neurosurgeons (Fish, House and Seiffert , Dandy's suboccipital approach (1917) with an ipsilateral suboccipital flap evolved to the retrosigmoid transmeatal approach.