Spine Surgery: Tricks of the Trade

AR Vaccaro TJ Albert (eds) Thieme, New York, Stuttgart. 2009; 321 pages. ISBN: 13-987-1-58890-519-2

This is a very practical technical book regarding spine surgery. It has a staggering number of 81 chapters written by 130 world-recognized spine surgeons. Of them, 126 are from North America, whereas the other four are from Japan, Australia and Italy. It is so concise that a colossal amount of information is compacted in only 321 pages. Owing to the compactness, a full understanding of the rationale behind the described procedures requires earlier basic knowledge, experience and skills. Therefore, it is a good book for those who are not beginners and who want to extend and enhance their knowledge and skills. It is the second edition published 6 years after the first in 2003. It is probably an oversight that, on the publisher's information page, the year of the first edition is not available.

It is worth noting that both editors are orthopaedic surgeons and at the same time neurosurgeons. In the modern era of spine surgery, traditional orthopaedic surgeons cross their border to deal with not only orthopaedic consequences of nervous lesions but also some lesions proper. The latter mostly involve spinal cord and nervous tissues of the occipito–cervical junction. This subspecialty is recent and known as Neuro-orthopaedics, a trade that the Department of Orthopaedics of the University of Pennsylvania, wherein the editors are from, is leading. The dual qualification of the editors itself sends a message to the orthopaedic community that neurology should be an integral part of their education and training programme.

Every chapter is written in a standard and uniform manner and consists of nine sections.

• 1) Description

• 2) Expectations

• 3) Indications

• 4) Contraindications

• 5) Special Considerations

• 6) Special Instructions, Position and Anaesthesia

• 7) Tips, Pearls and Lessons Learned

• 8) Key Procedural Steps (well illustrated with artistic line drawings)

• 9) Bailout, Rescue and Salvage Procedure

Preservation of motion is a relatively recent issue in spine surgery. Section XVII, entitled ‘Spinal Arthroplasty/Motion-Sparing Procedures’, is especially devoted to this issue.

It is impossible in a book review to comment on specific contents of individual chapters. That said, I would like to suggest that a new edition include the following:

• 1) A brief introduction to general guidelines and trend of development of spine surgery to allow readers to obtain a broad view before digging deep into specific techniques. It is advisable that this include a balance between patient care and technology.¹

• 2) A chapter on TB spine, which is extremely common in the developing world.