Tubbs RS, Loukas M, Hanna AS, et al. Surgical Anatomy of the Lumbar Plexus; Thieme; 2018; 220 pp; 130 ill; $99.99.
Surgical Anatomy of the Lumbar Plexus, edited by a chief science officer, a chair of a department of anatomical sciences, and 2 neurosurgeons provides a nice mix of editors for a book on this topic. There are a variety of disciplines represented by 43 contributors — the overwhelming majority of whom are in anatomical departments comprised of both PhDs and MDs. There are also contributions from neurosurgeons, neurologists, internists, a molecular medicine specialist, anesthesiologists, general surgeons, oral maxillofacial surgeons, and 4 radiologists; there is also 1 short chapter dedicated to diagnostic imaging.
This book is organized by 27 chapters:
- An overview of the lumbar plexus
- Subcostal nerve
- Iliohypogastric nerve
- Ilioinguinal nerve
- Lateral femoral cutaneous nerve
- Genitofemoral nerve
- Femoral nerve
- Obturator nerve
- Furcal nerve
- Accessory obturator nerve
- Variations of the lumbar plexus
- High-Resolution magnetic resonance neurography of the lumbar plexus
- Lesions involving the lumbar plexus
- Injury to the lumbar plexus following lateral lumbar spine fusion procedures
- Lumbar plexus anatomy with application to lateral approaches to the lumbar spine
- The subcostal nerve during lateral approaches to the lumbar spine
- Surgical techniques for approaching the lumbar plexus
- Nerve root anomalies with application to the lumbar plexus
- Lumbar dorsal root ganglia
- History of the dermatomes with focus on the contributions from the lumbar plexus
- Dermatomes and the lumbar plexus
- Anesthetic blockade of the femoral nerve
- Anesthetic blockade of the lateral femoral cutaneous nerve
- Anesthetic blockade of the iliohypogastric, ilioinguinal, and genitofemoral nerves
- Microanatomy of the lumbar plexus
- Surgical anatomy of the lumbar plexus with emphasis on landmarks and Comparative anatomy of the lumbar plexus
The sections within each chapter are not arranged in a consistent fashion, even among those that focus on the same general topic, and they do not have the same number of subsections and subsection headings within each chapter. For example, in the 9 chapters dedicated to a specific nerve, all start with an “abstract”, 4 have an introduction and 5 don’t, 5 have “anatomy,” 2 have “anatomy and variations,” 1 has “anatomy and function,” 1 does not have an “anatomy” subsection, 6 have a dedicated “variations” section while 1 does not specifically deal with “variations,” 5 have specific “pathology” sections while 3 do not, and 1 combines “pathology and surgery.” Additionally, 5 chapters have specific surgical sections while 3 do not, and 1 chapter combines surgery with pathology. Lastly, 2 chapters have embryology subsections while 7 do not, and only 2 have an “imaging” subsection.
There is also much repetition of the same information throughout the book. In the overview chapter, the authors include a high-level discussion of the nerves of the lumbar plexus (which is repetitive); however, a discussion of all the nerves was not included. Additionally, some anatomic variations were discussed in the overview chapter even though there is an entire chapter on anatomic variations.
The chapter titled “High-Resolution Magnetic resonance Neurography of the Lumbar Plexus” provides a good overview to both radiologists and to those providers who might order a lumbar plexus. The references are relatively up-to-date and relevant. The subsection that deals with protocols has an overview, but it does not provide enough detail for one to be able to implement disease-specific protocols. There are 8 figures that include only 1 normal coronal IDEAL T2-weighted image with fat suppression. The remaining 7 figures provide 2 examples of nerve entrapment, 2 nerve sheath tumors, 1 malignant nerve sheath tumor, 1 diabetic polyneuropathy and 1 chronic inflammatory demyelinating polyneuropathy.
Although this first edition book can be improved upon, it is a welcome, unique text devoted to the lumbar plexus that can benefit anatomists, those studying anatomy of the lumbar plexus, and providers of all types; including but not limited to neurologists, neurosurgeons, orthopedic surgeons, anesthesiologists, and radiologists.
