Born in Russia in 1917, he dedicated his life’s work to the people of that country. But life is full of paradoxes. After becoming the most respected and famous scientist in his specialty in Russia as the creator and leader of the new clinical discipline and chief of Russian National Center of Vertebroneurology, Popelyanskiy witnessed a collapse of the country’s economy, medical services and research funding. He immigrated to the United States in 2000, with the intention of reporting the content of his fundamental work and making it a part of American medicine. He wished to report the content of his fundamental work, and to publish it in the United States. The last 2 years of his life he was working harder than ever, trying to translate into English his Manual on Vertebroneurology and preparing new books. He died unexpectedly of a heart attack after nephrectomy.

    We are witnesses to a rare phenomenon in medical science -- the posthumous publication (all in Russia) of three major works in a single year, including the Manual of Peripheral Nervous System Diseases, demonstrating the dedication of Popelyanskiy’s followers. His new book on eye-movements and gaze paralysis, which tackles several controversial issues in classical neurology, was published at the end of last year. Still, none of these works have been translated into English. There were numerous reasons for the isolation of Soviet science: many Russian scientists were prohibited from traveling to international conferences and publishing abroad. At the same time, due to a language barrier, foreign scientists had limited access to Russian scientific literature.

    One may be surprised how high quality research could be performed in the economically underdeveloped Soviet Union. However, disease-prevention, along with defense and space research, was well funded, which is how Popelyanskiy could establish the National Center of Vertebroneurology. The accomplishments of this remarkable scientist deserve and need to be disseminated to the international community.

   Yakov Popelyanskiy graduated from First Moscow Medical Institute in 1940 and entered the professional field during World War II, when he was chief physician of a Soviet Air Force regiment. He was wounded during the war and, after the victory, continued his education in Central Neurology Research Institute in Moscow, where he completed his candidate dissertation. In that exploration, Yakov Popelyanskiy examined the involvement of the third neuron of vestibular nerve, described the oculogyric crisis, and was one of the first scientists to discover the activating ascendant influence of the brain stem on the cortex. A Noble Prize later acknowledged similar studies in the West, but the Iron Curtain made the discovery of Yakov Popelyanskiy totally unknown outside the Soviet Union.

   Yakov always declined calls to become a member of the Communist Party, which was a mandatory condition for professional advancement. Owing to his political untrustworthiness and his Jewish heritage, which was a particular blemish in the atmosphere of the “Conspiracy of Jewish Doctors” in the last years of Stalin’s reign, Yakov was exiled first close to the Siberian region, and then to a very poor (at that time) Moldova Republic. Despite the isolation and continued harassment on the part of “apparatchiks,” his talent was well known and he became a sought-after professional. He was able to return to Moscow in 1955 to resume his work in an inconspicuous outpatient clinic. The conditions for scientific exploration there were inadequate, but his talent and energy inspired those who worked with him, and that clinic became well known for its success in treating patients with sciatica, back and neck pain, as well as studies that related the genesis of those diseases to “Intervertebral Osteochondrosis”. This term over years became widely used in Eastern European countries, then spread to the West, and has been accepted in the US almost 50 years later as a major part of degenerative disc diseases specter.

   The clinical evidence gathered during those years later formed the basis of Yakov Popelyanskiy’s doctoral dissertation. However, further expansion of his studies demanded a new venue. In 1957, he returned to Siberia, this time on his own will, to join the Advanced Medical Training Institute in the city of Novokuznetsk. While working there as professor-in-chief of the neurological department, he created a new direction in medicine. He put his research at the intersection of neurology, orthopedics, neurosurgery, osteopathy and physical therapy. Under his leadership, much research and multiple dissertations were completed and this provincial Institute became famous throughout the former Soviet Union. Overall, those were the happiest years of his life.

   In 1967, the already eminent professor was invited to join Kazan State Medical Institute, where he managed the neurological department and the Russian National Center of Vertebroneurology until 2000. A highly successful school of Vertebroneurology was formed during those years, and a uniquely detailed manual on original clinical discipline was written. Yakov Popelyanskiy brought European ideas of manual therapy to Vertebroneurology, reciprocally upgraded and partly united them. He considered that neurosurgeons and spinal surgeons from one side, and osteopaths, chiropractors, physical and manual therapists from another side, treat the same disease from opposite ends but leave the main important neuropathological essence unattended. By his estimation, less than 1% of patients needed the help of neurosurgeons. Yakov Popelyanskiy was one of the first neurologists, who in 1960-s brought attention to the fact, that pain radiating from the spine to extremities very often has nothing to do with nerve root compression, but may be referred pain from degenerated disks, facet joints, ligaments, sympathetic nerves etc. In such cases the spinal surgery directed to remove incidental herniated disc will fail. He believed that the trained neurologist/vertebroneurologist has to screen and select the patients for spinal surgery and thus to stop the epidemic of diskectomies.

    Popelyanskiy established the reflex and adaptive pathogenesis of the cardinal vertebrogenic syndromes that explained the interrelationship and feedback between spine, spinal cord and myofascial structures. Describing and discovering the new entrapment syndromes, he was one of the first to show that the majority of vertebrogenic back and neck pains, muscular dystonic, dystrophic and autonomic vascular manifestations are the result of the reflex reaction to the irritation of the receptors of the afferent sinuvertebral recurrent nerve. Yakov Popelyanskiy recognized that vertebrogenic reflex muscular fixation (stabilization) is a major counter-pathogenic (“sanogenic”) process that determines primary relief and following re-compensation of the clinical crisis. The timing of improvement is stipulated by the perfection of newly developed locomotive patterns that alleviate muscular imbalance due to abnormal discharge of intervertebral disks as well as connective, articular, and cartilaginous structures of the afflicted vertebral mobile segment. Yakov pointed out the ponderability of pathological afferent internal and external stimuli, and proprioreception in the forming of clinical picture of degenerative disk disease.

   Yakov Popelyanskiy and his disciples studied multiple original locomotive patterns including those relating to mechanical pathology of neural and vascular pathways. The most known patterns include scalenus syndrome with brachial plexus neuropathy and pyriformis syndrome with sciatic neuropathy. Among the pathologies of the spinal cord that Yakov Popelyanskiy discovered and explained was the Vertebrogenic Ischemic Dorsal Column Syndrome.
Yakov’s interests and skills were not restricted by the neurology of the spine. Every day he participated in clinical examinations of patients with ailments of central and peripheral nervous system. He was the editor of Russian translation of Travell and Simons’ classic Myofacial Pain. Among more than 200 of his publications, there are many books with topics of peripheral nervous system diseases, problems of the eye, pathogenesis and clinical manifestation of botulism, organization of medical work, and history of medicine. In his book on anti-Semitism, he examined its paranoia from the standpoint of a neurologist. Quite a few of his manuscripts have not yet been printed.

   His personal achievements and those of his scientific school have now been widely acknowledged in Russia and worldwide. There are several Vertebroneurological Centers around the country. There exists the World Vertebroneurological Association. Many conventions, conferences and international congresses have been devoted to problems of vertebroneurology. His disciples work around the world. Overall, Yakov Popelyanskiy’s life work has contributed to a notable expansion of the field of theoretical and practical neurology. His more than 40 year research of Intervertebral Osteochondrosis as the main cause of the back and neck pain, is being acknowledged in the U.S. now. It can only be expected that soon his ideas will continue to gain support and be further developed in our country. However, only a small portion of his work has been translated into English. His most valuable life work, the second edition of Manual of Vertebroneurology with the majority of his original ideas, practical results, and achievements is currently awaiting its English translator, editor, and publisher in the U.S. There has been a fund established to create an opportunity for his most essential work to come to life here in the United State (“Orthopedic Neurology Research Fund “, 16716 68 Ave NE Suite #B1, Kenmore WA, 98028 , call 425-486-8025, 206-407-7642).

    A true man of science, Yakov Popelyanskiy was a genuine teacher, completely dedicated to his students and his work. The creativity of his thought was enhanced by an absolute scrupulousness in his research and practical work. Despite his commitment to science, he was a loving husband, caring father, and an adored grandfather, a man of great respect and wisdom. His family, friends and colleagues will forever feel the lack of the warmth of his soul, and the generosity of his beautiful mind and spirit.
Yan Lupyan, MD, PhD, D. Sc, ,  Marina Sobol, MD, PhD, Igor Sobol, MD, PhD, New Jersey, AAN Members; Alex Popelyanskiy, MD, PhD Russia, Gregory Korshin, PhD