Spine Surgery. Techniques, Complication Avoidance, and Management

SPINE SURGERY. TECHNIQUES, COMPLICATION AVOIDANCE, AND MANAGEMENT. Volumes I and II. Edited by Edward C. Benzel. 1538 pp. Illust. Churchill Livingstone, Philadelphia; Harcourt Brace & Co. Canada, Ltd., Toronto. 1999. Can$488. ISBN 0-443-07540-9, vol. I part no. 9997631668, vol. II part no. 9997631676

This comprehensive 2-volume textbook is directed at individuals with a primary interest in spinal surgery. It aims to provide a complete summary of pertinent aspects of the surgical management of spinal disease. The editor and authors come from a neurosurgical background, but with the confluence of knowledge related to the surgical management of spinal disease this textbook will be useful to all individuals with a focus on surgery of the spinal column.

The volumes are arranged in 5 sections, although functionally there are 3 major divisions within the text. The introductory chapters and sections can be grouped into the “background” section of embryology, anatomy, biomaterials and bioengineering concepts. A further section on surgical approaches and specific surgical procedures are arranged anatomically from cervical to lumbosacral spine. There are large sections devoted to spinal implants and fixation devices and their application and use. The final major section deals with adjuncts to surgery such as surgical positioning, imaging, stereotaxis, evoked potential monitoring and a complete section on nonsurgical management of the patient with spinal disease.

This is not a textbook one would read from cover to cover. It provides a comprehensive view of the majority of spinal surgery. As a result of multiple authorship there is significant repetition of detail related to surgical indications, and surgical approaches are detailed in a number of the chapters. Also, I had to look in many areas of the book to gain a complete understanding of one specific area of the spine. For instance, instrumentation of the cervical spine is in a different volume from the chapters describing decompression of the cervical spine. Some disorganization and fragmentation of topics also occurs because some chapters address minor issues and contain only 2 or 3 pages and other chapters contain up to 40 pages. Areas of spinal surgery such as scoliosis and pediatric deformity, which could occupy entire texts of their own, are covered in varying depths. It is clear that a general text like this could not do justice to all topics or to all individuals’ tastes.

Nevertheless, the book provides a “one-stop shop” for the interested practitioner. I particularly liked the final portion, in which specific controversies are debated. This provides a refreshing point–counterpoint argument that allows readers to draw their own conclusions.

This 2-volume set would be welcome on the shelves of surgeons with an interest in spinal disease and will be valuable to the senior resident or fellow who plans to gain further training in spinal surgery. The trainee who is reading up on a topic or preparing for a surgical procedure would find this a convenient reference that provides sufficient information in one location. There is little material on the epidemiology, conservative management and assessment of the patient with mechanical back symptoms; however, as illustrated by the title, rational information to guide the surgical management of spinal disease is the primary goal of this text. I believe that this goal has been met.