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Surgical Management of Low Back Pain,
The Spine Journal 1 (2001) 232–233
Information Resource Reviews Surgical Management of Low Back Pain Surgical Management of Low Back Pain, Edited by Daniel K. Resnick and Regis W. Haid, Jr., American Association of Neurological Surgeons Press, 2001. In 14 chapters, averaging less 12 than pages each, 20 authors (17 of whom are neurosurgeons and 10 of whom are from Emory or the University of Wisconsin) explore certain aspects of the surgical management of low back pain. The goal of the book, as stated in the Foreword, is to present “an overview of new techniques for the diagnosis and management of medically refractory low back pain.” Although there are excellent discussions of pathophysiology, imaging and mechanics, the techniques discussed are, for the most part, surgical techniques and the book is written primarily for spine surgeons. Although some chapters do not contain references after 1998, many cite works in 2000, and, in general, within the scope of the presentation, the text is as upto-date as hardback copy can be. Because this is an effort backed by the American Association of Neurological Surgeons (AANS), one would expect mainstream, even-handed presentations, with minimal bias. For the most part (although one can find scattered nods to manufacturers, they are generally not gratuitous), these expectations are admirably rewarded. Enthusiasms of authors who are expert enough about a technique to have been asked to write a chapter are appropriately tempered with caveats of restraint. The title suggests a full spectrum of concern for surgery for low back pain, but this text focuses mostly on arthrodesis for degenerative disease. Deformity is discussed as it relates to pain of degenerative origin. Acute trauma is not within the scope of this text. Surgical treatments of uncomplicated disc herniation and all the contemporary minimally invasive permutations of such are, somewhat disappointingly, not included. The first chapter discusses pathophysiology. The second gets to the focus of the text: patient selection for arthrodesis. Following are good chapters on imaging, mechanics and, perhaps a little out of the flow, “facet syndrome.” The following chapters get to the meat of this book: the various technical means of achieving arthrodesis. The coverage of anterior and posterior approaches is excellent, although dividing discussion of posterior lumbar interbody fusion (PLIF) into two chapters seems unnecessary. The chapter on transforaminal (or transfacet, if you wish) arthrodesis is good, but its title, “Circumferential Fusion Techniques: The TLIF” is obscure to the uninitiated, leaving the reader of the two chapters on PLIF wondering if this approach was left out. A long chapter, entitled “Failed Back Surgery Syndrome,” reprises much of what was said in the introductory
chapters and previews some of what follows. Although the repetition makes it a little out of synch with the flow of the text, the chapter works well as a stand-alone and does bring a needed overall perspective. “Failed Back Surgery Syndrome” is, of course, not a diagnosis at all, an opinion that the author of the chapter shares, stating, “The FBSS diagnosis is too broad to be meaningful and should be eliminated.” Unfortunately, his excellent coverage of refractory low back pain under this title, and the fact that the AANS Press includes it as a chapter head, does serve to perpetuate the term. Similarly of concern for the power of publication by AANS (although a disclaimer at the front says not to construe AANS endorsement) is an entire chapter devoted to intradiscal electrothermal annuloplasty. The author of the chapter thoroughly examines and discusses the uncertain status of this therapy. Although it is a topic of current interest and not to be ignored, the devotion of a chapter, in a brief text, supports the value of the treatment in a way that the author seems discomforted by. Perhaps it would have been better to have folded the discussion of electrothermal annuloplasty into a broad chapter dealing with various percutaneous techniques, some of which this text ignores (eg, epidural steroid, chemonucleolysis) and some of which are admirably covered (viz., spinal cord stimulation). Although this is a hardback text, the quality of the backing, the paper and the print are less than what one would want for a valuable permanent addition to a personal library. This is a practical concern only in the poor presentation of some of the photographs of radiographic images. Such reflects the dilemma of having to publish, quickly and at reasonable expense, information that may be obsolete in a short time. One gives up some quality features for the advantage of being current. This book does not skimp on the quality of the writing or on the even-handed authority of its authors, so is to be recommended for spine surgeons wanting a contemporary, well-referenced text with an emphasis on treatment of lumbar pain related to degenerative disease.
David Fardon, MD Knoxville, TN PII: S1529-9430(01)00093-6
Musculoskeletal Imaging: A Concise Multi-Modality Approach, First Edition, K. Bohndorf, H. Imhof, and Thomas Lee Pope, Jr., Thieme, 2001. Musculoskeletal radiology is a rapidly expanding radiologic subspecialty, with cross-sectional imaging becoming
1529-9430/01/$ – see front matter © 2001 Elsevier Science Inc. All rights reserved.
Information Resource Reviews Surgical Management of Low Back Pain Surgical Management of Low Back Pain, Edited by Daniel K. Resnick and Regis W. Haid, Jr., American Association of Neurological Surgeons Press, 2001. In 14 chapters, averaging less 12 than pages each, 20 authors (17 of whom are neurosurgeons and 10 of whom are from Emory or the University of Wisconsin) explore certain aspects of the surgical management of low back pain. The goal of the book, as stated in the Foreword, is to present “an overview of new techniques for the diagnosis and management of medically refractory low back pain.” Although there are excellent discussions of pathophysiology, imaging and mechanics, the techniques discussed are, for the most part, surgical techniques and the book is written primarily for spine surgeons. Although some chapters do not contain references after 1998, many cite works in 2000, and, in general, within the scope of the presentation, the text is as upto-date as hardback copy can be. Because this is an effort backed by the American Association of Neurological Surgeons (AANS), one would expect mainstream, even-handed presentations, with minimal bias. For the most part (although one can find scattered nods to manufacturers, they are generally not gratuitous), these expectations are admirably rewarded. Enthusiasms of authors who are expert enough about a technique to have been asked to write a chapter are appropriately tempered with caveats of restraint. The title suggests a full spectrum of concern for surgery for low back pain, but this text focuses mostly on arthrodesis for degenerative disease. Deformity is discussed as it relates to pain of degenerative origin. Acute trauma is not within the scope of this text. Surgical treatments of uncomplicated disc herniation and all the contemporary minimally invasive permutations of such are, somewhat disappointingly, not included. The first chapter discusses pathophysiology. The second gets to the focus of the text: patient selection for arthrodesis. Following are good chapters on imaging, mechanics and, perhaps a little out of the flow, “facet syndrome.” The following chapters get to the meat of this book: the various technical means of achieving arthrodesis. The coverage of anterior and posterior approaches is excellent, although dividing discussion of posterior lumbar interbody fusion (PLIF) into two chapters seems unnecessary. The chapter on transforaminal (or transfacet, if you wish) arthrodesis is good, but its title, “Circumferential Fusion Techniques: The TLIF” is obscure to the uninitiated, leaving the reader of the two chapters on PLIF wondering if this approach was left out. A long chapter, entitled “Failed Back Surgery Syndrome,” reprises much of what was said in the introductory
chapters and previews some of what follows. Although the repetition makes it a little out of synch with the flow of the text, the chapter works well as a stand-alone and does bring a needed overall perspective. “Failed Back Surgery Syndrome” is, of course, not a diagnosis at all, an opinion that the author of the chapter shares, stating, “The FBSS diagnosis is too broad to be meaningful and should be eliminated.” Unfortunately, his excellent coverage of refractory low back pain under this title, and the fact that the AANS Press includes it as a chapter head, does serve to perpetuate the term. Similarly of concern for the power of publication by AANS (although a disclaimer at the front says not to construe AANS endorsement) is an entire chapter devoted to intradiscal electrothermal annuloplasty. The author of the chapter thoroughly examines and discusses the uncertain status of this therapy. Although it is a topic of current interest and not to be ignored, the devotion of a chapter, in a brief text, supports the value of the treatment in a way that the author seems discomforted by. Perhaps it would have been better to have folded the discussion of electrothermal annuloplasty into a broad chapter dealing with various percutaneous techniques, some of which this text ignores (eg, epidural steroid, chemonucleolysis) and some of which are admirably covered (viz., spinal cord stimulation). Although this is a hardback text, the quality of the backing, the paper and the print are less than what one would want for a valuable permanent addition to a personal library. This is a practical concern only in the poor presentation of some of the photographs of radiographic images. Such reflects the dilemma of having to publish, quickly and at reasonable expense, information that may be obsolete in a short time. One gives up some quality features for the advantage of being current. This book does not skimp on the quality of the writing or on the even-handed authority of its authors, so is to be recommended for spine surgeons wanting a contemporary, well-referenced text with an emphasis on treatment of lumbar pain related to degenerative disease.
David Fardon, MD Knoxville, TN PII: S1529-9430(01)00093-6
Musculoskeletal Imaging: A Concise Multi-Modality Approach, First Edition, K. Bohndorf, H. Imhof, and Thomas Lee Pope, Jr., Thieme, 2001. Musculoskeletal radiology is a rapidly expanding radiologic subspecialty, with cross-sectional imaging becoming
1529-9430/01/$ – see front matter © 2001 Elsevier Science Inc. All rights reserved.