Hartl R, Korge A. Minimally Invasive Spine Surgery. Thieme; 2013; 508 pgs.; 711 illustrations; $159.99.
This text is a comprehensive review of the latest minimally invasive surgical spine techniques. It is edited by Hartl and Korge, two accomplished spine surgeons, and its authors include some of the pre-eminent neurosurgical and orthopedic spine surgeons of our time, who have pioneered many of the minimally invasive techniques covered in the text. The book is 5 chapters and 490 pages long, includes 711 illustrations and images and 35 cases reviews. The images include diagnostic films, intraoperative photos, and illustrations that are clear, with legends that are descriptive and easy to read.
The content is clearly geared toward spine surgeons. The first chapter is largely introductory and presents the basic principles and goals of minimally invasive spine surgery. It also discusses some key controversial issues that surround these techniques, including radiation exposure and cost effectiveness. Finally, it gives a general overview of the adjuncts vital to minimally invasive spine techniques, including scopes, instrumentation, biologics, and image-guidance technology.
Chapters 2 through 4 discuss specific minimally invasive procedures used in the cervical, thoracic, and lumbar spines, respectively. Some of the techniques covered include posterior cervical foraminotomy, extreme lateral mini-thoracotomy, and minimally invasive anterior midline approach to the lumbar spine. These chapters are very well-organized. Each procedure is covered thoroughly, including historical background, pros and cons, patient selection, detailed descriptions of surgical technique, and complication avoidance. The evidence-based results for each procedure are also summarized, and the key articles from the literature pertinent to each procedure are emphasized in table format at the end of each corresponding section. The articles reviewed are current and represent some of the best evidence in the literature on the topics. Each section uses images effectively to emphasize issues vital to minimally invasive spine techniques, such as pictures of patient positioning, illustrations of operating room layout, preoperative and intraoperative imaging studies, and intraoperative pictures of surgical techniques. The sections also include specific case reviews that highlight the critical points raised during the discussion of a particular procedure.
The final chapter is entitled “Critical Overview and Outlook.” It is a recapitulation of some of the key concepts surrounding minimally invasive spine surgery. Its main point of emphasis is that these techniques must be heavily scrutinized in their early stages in order to ensure their safety and effectiveness.
This text, although comprehensive, concise, and current, is surgically oriented. It is, however, so well-written that it can effectively acquaint neuroradiologists with the spectrum of common minimally invasive cervical, thoracic, and lumbar procedures. Familiarity with the surgical principles used to treat both simple and complex spine disorders will give neuroradiologists a stronger clinical and biomechanical understanding of the common spine pathology they would encounter frequently. Finally, this text also effectively describes how evolving image-guidance technology is being used in the operating room to make these procedures safer and more efficient. For the neuroradiologist looking for an accurate, complete, easy-to-read, and up-to-date source on minimally invasive spine techniques, this text would make a nice addition to their collection.
