Lumbar Spinal Imaging in Radicular Pain and Related Conditions: Understanding Diagnostic Images in a Clinical Context. Jan T. Wilmink (author). Springer 2010, 161 pages, 75 illustrations, $129.00.
In a well illustrated, short (161 pages), single subject book Jan Wilmink takes the reader through all aspects of lumber degenerative disc disease. The chapters are “The Nature of Radicular Pain and Related Conditions,” “Imaging Techniques,” “Normal Anatomy,” “Pathologic Anatomy and Mechanisms of Nerve Root Compression,” and “Spinal Imaging/Surgical Therapy—Pre and Post Operative.”
A brief explanation of radical pain, neurogenic claudication, and the cauda equina syndrome introduces the reader to the remainder of the contents of this monograph. The techniques from a CT and MR standpoint are well known to the readership of the AJNR; nonetheless, the review of the protocols and the pertinent anatomy (along with Modic changes in the vertebral body narrow) are succinct and well imaged. The strongest part of this book is the detailed topographic anatomy both with clinical images and with artist’s rendition of the lumbar roots related to bone structures. One can quickly review issues of clinical importance such as the effect of central, paracentral, foraminal and far lateral disc and degenerative osteophytes on the lumbar nerve roots. Other structures such as venous plexus, ligaments, fat, root sleeves, effects of flexion/extension (often misinterpreted/misunderstood) are described in imaging and drawing detail. Concepts in a tight/stenotic canal along with foraminal structure are seen as multi-factorial.
The postoperative imaging deals with only the most basic of surgical procedures. There is no information on the consequences of various instrumentation on root irritation or failure of adequate stabilization. The book ends with brief sections on postoperative complications: spondylodiscitis, hematomas, pseudomeningocoele, arachnoiditis.
For an overview of lumbar spine imaging directed to degenerative disc disease and its attendant changes (pre- and postoperative), the book has value.
