As an orthopaedic-educated, spine-fellowship-trained surgeon
whose practice is totally spine-based and strongly integrated with
the resident teaching program, I am constantly looking for good
teaching texts. This text covers the breadth of spine surgery, from
patient evaluation, pathology, and treatment decisions to surgical
techniques, associated complications, and long-term care. Nonoperative
care, biomechanics, and medical economics also are given thorough
consideration. The authors are primarily neurosurgically oriented,
but the text and bibliographies have large contributions from both
the orthopaedic and neurosurgical disciplines.
The chapters are well organized, easy to read, and well illustrated.
The discussions are to the point and easily understood. This applies
particularly to the presentations of techniques, which are a strong point
of this work. Chapters on controversial areas clearly show the divergence
among approaches and treatment philosophies. The chapters on medical
practice and economics are very informative and timely.
This text should not be the primary source of education about
spine surgery for residents or fellows. Although the pathology,
anatomy, and treatment of particular disease processes are well
presented, more depth is needed for the spine fellow and better
organization of the material on pathology is needed for the resident.
However, this is in keeping with the authors' intention that the
book be a tool for the spine surgeon and, in many respects, a book
of techniques.
The chapters on scoliosis are good summaries of spine deformities
and their treatment, but I do not consider the coverage to be complete.
(The subject of scoliosis deserves two volumes alone.) To omit a
discussion of the principles of surgery for the treatment of deformity
is to leave out much of the history and philosophy of spine surgery.
I believe that these principles are well represented in this text
even though the coverage of spine deformity and its treatment is
incomplete.
I believe that this text will be of great value to the practicing
spine surgeon, whether neurosurgically or orthopaedically trained.
I strongly recommend it to all practitioners, although I would not
recommend it as a primary text for residents or fellows. The descriptions
of surgical techniques and the discussions of related topics, such
as complications, prognosis, and patient management, are strengths
of this work and make excellent reading for all.