Heary RF, Albert TJ, eds. Spinal Deformities: The Essentials. 2nd ed. Thieme; 2014; 261 pp; 496 ill; $129.99
Spinal Deformities: The Essentials by Drs. Heary and Albert is a comprehensive review of the pathophysiology, diagnosis (with both clinical and radiographic emphasis), and treatment of spinal deformity. This book provides the reader with a thorough understanding of the management of spinal deformity, regardless of the reader’s medical background.
The book begins with a good general overview of spinal deformity, including a historical perspective on the treatment of deformity. The introductory section is comprehensive and intended for a wide range of audiences. It provides a good infrastructure for the remainder of the book. Subsequently, there is a valuable discussion on the economics of spinal deformity care.
The intended audience of this book is clearly surgical, and there are sections on topics such as intraoperative neuroimaging that will not prove as useful to radiologists as some of the imaging-oriented sections. There is are also several sections dedicated to different approaches to spinal surgery, including the anterior, lateral, and posterior approaches to scoliosis surgery. While interesting and informative, these sections may prove less useful to radiologists.
There is, however, a significant emphasis on the imaging of scoliosis, and it is these segments that would provide most benefit to the radiologist. Specifically, there is an introduction to the concepts of coronal and sagittal balance, and there are entire chapters dedicated to the understanding of the basic principles of sagittal and coronal plane deformity, with thorough description of relevant radiographic parameters, including coronal plane decompensation (for the coronal plane) and spinal vertical alignment (for the sagittal plane). Equally important is an introduction and thorough discussion of the role that the sacrum and pelvis play in maintenance of normal sagittal and coronal balance. There is a comprehensive discussion on pelvic radiographic parameters, including pelvic tilt, pelvic incidence, and sacral slope, and the role that these parameters play in the maintenance of normal balance. Finally, there is an introduction to the concept of compensation and how imaging can be used to identify those patients with pelvic compensation as a means by which to restore neutral sagittal and/or coronal balance.
For the radiologist seeking a more thorough understanding of the pathophysiology of scoliosis there are sections on the genetics, evaluation, and treatment of congenital scoliosis, early-onset scoliosis, neuromuscular scoliosis, and Scheurmann kyphosis. There is also a section dedicated to the understanding of the Lenke Classification System for adolescent idiopathic scoliosis.
In summary, this book is intended for a surgical audience, and there are several segments of this book that will probably not as useful to the large majority of radiologists. There is, however, an excellent overview of the concept of coronal and sagittal balance, relevant imaging paramaters in the evaluation of balance, the significant role that the pelvis plays in maintenance of balance, and how to identify those patients with pelvic compensation. This book would be particularly useful for those radiologists working in tertiary or academic centers with a large volume of surgery dedicated to spinal deformity.
