Jallo J, Vaccaro A. Neurotrauma and Critical Care of the Spine, 2nd Edition;Thieme 2018; 238 pp; 77 ill; $179.99.
In this second edition text, Drs. Jallo and Vaccaro have prepared a clinically practical reference for those involved with the acute management of spine injuries. Drawing on the expertise of over 60 collaborators, this book succeeds in being able to present a wealth of information into a relatively concise, clinically relevant text. Aiding this pursuit, over 75 high quality illustrations are included to help solidify various concepts, particularly in regards to the myriad of vertebral injury classification schema.
This work is spread out over 22 chapters and broadly sectioned into 5 parts:
- Introduction
- Science
- Management
- Critical Care
- Outcome
All chapters are concluded with a generous references section. Following the introduction that touches on the epidemiology of spine injuries, the science section (chapters 2 -7) delves into various topics that are of diagnostic relevance. As a neuroradiologist, I found this section most applicable to my work.
Chapter 4 ambitiously tackles the numerous spinal trauma classification systems. The various types of vertebral column injuries are systematically presented, with a strong emphasis on the ability of each system to predict stability of a fracture. Clear illustrations further serve to clarify these systems.
Chapter 5 is the only chapter specifically devoted to the imaging of the traumatic spine, with a majority of the chapter discussing the imaging features of common vertebral column injury patterns. Both novices and experts will likely solidify their understating of these imaging features. While the chapter benefits from several high quality radiographs, I would have liked to see more cross sectional images, as CT and MRI are the mainstay of spine imaging at our trauma center.
Chapter 6 is an enlightening dive into the biomechanics of the spine, and I personally found this chapter the most interesting. Augmenting the discussion of the injury patterns presented in the preceding chapter, this section clearly explains how particular stresses result in the predictable injuries that we see everyday. This chapter is well suited for those who wish to possess a fundamental understating of etiology of spinal injury patterns.
The third section (chapters 8 -14) presents topics related to the immediate management of spine injuries, including pre-hospital care (chapter 8), clearing the cervical spine (chapter 9), and surgical intervention (chapters 10-12), with a strong emphasis on clinical decision making. Each of these chapters include a short subsection on the role of radiologic studies.
The fourth section (chapters 15 -20) discusses in great detail several topics that are of critical importance to high quality intensive care, such as targeted temperature management in cord injuries, and while fascinating, are not relevant for the radiologist. The fifth and final section (chapters 21-23) closes with discussions on the clinical and socioeconomic outcomes of spine injury.
Overall, this book takes a global look at all aspects of neurotrauma while still managing to go into an admirable level of detail in a relatively small amount of space, no small feat. The second section of the book presents material that is immediately relevant to neuroradiologists and trauma radiologists, and I would recommend this text as a trustworthy reference for both trainees and experts alike, particularly if they are based at a trauma center.
