Kim DH, Vacarro AR, Fessler RG, et al. Spinal Instrumentation: Challenges and Solutions. Thieme; 2017; 448 pp; 244 ill; $169.99
Publications which address what can go wrong, or what mistakes can be made in either diagnosis or in interventions/surgery, are often of greater value than demonstrations of what is done in standard procedures. Enter the newly published (December 2017), 448 page book Spinal Instrumentation: Challenges and Solutions, edited by Drs. Kim, Vaccaro, Fessler and Radcliff. With over 150 contributors, the book takes 60 spinal-instrumentation scenarios (both cervical and thoracolumbar) and describes with written text, drawings, and images what complications do occur.
So for example, in the chapters dealing with complications of anterior cervical fusions, the authors divide the material into introductory comments, followed by specific complications, properly illustrated — such as dysphagia, adjacent segment disease, pseudarthosis, kyphus deformity, and hardware failure. Relevant anatomic considerations, rationale for certain types of instrumentation, surgical techniques along with summaries and references are included. However, in many figures, far greater attention could have been paid to the quality of the radiographic images. Instances of improper grey scale windowing (level and width) distract in places from an adequate demonstration of the points being made.
The chapters take the reader from the top of spine instrumentation (occipital instrumentation complications) segmentally and step wise inferiorly to the sacral area. Specific complications or associated problem are addressed; such as infection, osteoporosis, use of BMP, vertebral cement augmentation. While obviously written for orthopedic spine surgeons in mind, there is material here which should be of interest to any radiologist, particularly those who deal, clinically, with a large volume of image interpretation of previously instrumented spine. Understanding the complications of importance to the spine surgeon, coupled with a large number of images showing those complications and why they may have occurred, would be of value to all neuroradiologists.
