Ralph Bingham Cloward (September 24, 1908 — November 13, 2000) was an American neurosurgeon, best known for his innovations in spinal neurosurgery. Cloward is known for the development of the Posterior Lumbar Interbody Fusion and Anterior Cervical Discectomy and Fusion. Cloward moved from Chicago to Hawaii in 1938, becoming the state's lone neurosurgeon. He is well known for his work treating victims of brain injuries after the Pearl Harbour attack in 1941. Early life and education Ralph Cloward was born in Salt Lake City, Utah, in 1908. He schooled at McKinley High School, Honolulu before studying at the University of Utah. He completed his medical education at the Rush Medical School in Chicago. He interned at St Luke's Hospital, Chicago, and attended the University of Chicago under Professor Percival Bailey as a resident in 1938. Medical career He began his practice of neurosurgery in the Territory of Hawaii in 1938. He was the only American neurosurgeon in the Pacific theater during World War II. In connection with the attack on Pearl Harbor in 1941, he performed 44 craniotomies in 4 days. His academic accomplishments include visiting professorships at the University of Chicago, University of Oregon, University of Southern California, and Rush Medical School. He was Professor of Neurosurgery at the John A. Burns School of Medicine at the University of Hawaii. He is the author of numerous papers and book chapters and has lectured and operated in many nations. Cloward's pioneering contributions encompass many areas of neurosurgery, but his enduring interest was the spine, where he devised three major operations. He first performed the posterior lumbar interbody fusion successfully in 1943, reporting it in the Hawaiian Territorial Medical Association in 1945 and publishing it in the Journal of Neurosurgery in 1953. His unique approach for treating hyperhydrosis was reported in 1957. Independently, he conceived an anterior approach to the cervical spine, devised instruments for its implementation, and published his classic paper in the Journal of Neurosurgery on anterior cervical discectomy and fusion in 1958. He designed over 100 surgical instruments which continue to be used today by practicing neurosurgeons. Posterior Lumbar Interbody Fusion (PLIF) After William Mixter and Joseph Barr published their famed paper of disk herniation in 1934, discectomy to remove stenosis became the routine procedure. Alternative attempts were to fuse the posterior arch of the spine. In cases of spondylolisthesis, some surgeons had fused the interbody space, but