Vialle LR, ed. Gokaslan ZL, Fisher CG, Boriani S, guest eds. Primary Spinal Tumors. AOSpine Masters Series. Volume 2. Thieme; 2014; 216 pp; 85 ill; $119.99
Primary Spinal Tumors is Volume 2 of the multivolume (10 in total) series of books AOSpine Masters Series, which deals with various spine conditions. This particular volume (a 200-page hardcover) is authored primarily by orthopedic surgeons, neurosurgeons, and oncologists, with 1 chapter written by a neuroradiologist, on interventional options for primary tumors of the spine.
Just so there is no confusion about the contents of the book, the material deals strictly with bony tumors of the spine. Sixteen chapters serve to describe the most commonly encountered tumors (osteoid ostoma, ABC, giant cell tumor, chordoma, chondrosarcoma, osteogenic sarcoma, and Ewing sarcoma), with separate chapters on radiation therapy, medical oncology, and, as one would expect, 7 separate chapters on the surgical aspects of these tumors. In the latter category are safety considerations, the surgical plans and approaches to these tumors, complications, and structural support following tumor resection (grafting/hardware fusion).
To the neuroradiologist the material of interest will not be the imaging or the description of it. Rather, it is the integration of the clinical and treatment (surgery vs. medical/radiation) aspects that will be informative. Like many books these days each chapter contains at its end “Pearls” (many are not very pearloid), “Pitfalls” (some pitfalls are fairly obvious), and “References” (with key references highlighted).
Taking 1 chapter, “Chordoma”, to illustrate the strengths and weaknesses of the book, the first sentence begins in an awkward manner, viz. “Chordoma are a rare benign tumor”; the English aside, it is difficult to call a tumor benign when the authors, 5 lines later, describe “metastasis to the lungs and other sites”. Then on the same page, they state that “Among all chordomas, sacral chordomas are the most common, followed by lumbar chordomas”. This contradicts what they state earlier on the same page (“These lesions occur most commonly in the clivus and sacrum”, which we know to be true). The following pages do, however, nicely describe the staged operation (first posterior then anterior) of a thoracic chordoma and in sufficient detail to allow an understanding of how and why it was done in that manner. Important points are made concerning the biopsy technique: the concern of tumor seeding, the chordoma subtypes, and the histopathological description (although this is not shown as figures, it would have been nice to include such illustrations). Concerning the pathology, the authors indicate that a differentiated chordoma may transform into various types of sarcomas, which to this reviewer came as a surprise. The challenges with sacral chordomas, their removal, and subsequent stabilization are appreciated in 2 illustrative cases. Adjunctive therapy, radiation and medical, point out the problems, particularly with radiation, of adjacent neural tissue.
Other chapters follow a similar pattern, with some including gross specimens and all discussing surgical options and planning. It is of value to look through this book as a reminder of the imaging findings in tumors that are encountered infrequently, and to see the manner with which they are dealt.
