Vialle LR, ed. Bellabarba C, Kandziora F, guest eds. Thoracolumbar Spine Trauma. AOSpine Masters Series. Vol. 6. Thieme; 2015; 190 pp; 207 ill; $115.81
This book on spine trauma is a publication from AOSpine, which is a specialty group under the umbrella of the AO (Arbeitsgemeinschaft für Osteosynthesefragen) foundation. Founded in 1958 by a group of four Swiss surgeons, AO is a society focused on the treatment of trauma and disorders of the musculoskeletal system. One focus of AO is education, and this is book 6 in a series of 10 volumes dedicated to the spine. Further information can be found at https://aospine.aofoundation.org/.
The first chapter is a presentation of a new classification system for spine trauma, the “AOSpine Thoracolumbar Injury Classification.” Injury is divided into three types. Type A are compression fractures with further subclassification (minor, wedge, pincer, etc). Type B are tension band injuries, referring to injury to the anterior or posterior bony-ligamentous complexes, again with further subtyping. Type C are translation/displacement injuries with failure of all elements in the spine. Neurologic involvement further classifies the trauma and is a factor in clinical algorithims. One of the consistent features of this book is that all subsequent chapters refer to this classification system in regards to clinical decisions. This chapters includes radiographic examples of most of the subtyped injuries.
The second chapter is “Radiographic Assessment of Thoracolumbar Fractures,” with emphasis on applying this new classification system. The chapter includes all pertinent modalities (x-ray, CT, MRI); however, at 23 pages, it can only provide a general overview.
The remaining 11 chapters include:
- Posteriorly Minimally Invasive Surgery in Thoracolumbar Fractures
- Anteriorly Minimally Invasive Surgery in Thoraclumbar Fractures
- Cervicothoracic Spine Injuries
- Transpedicular and Costotransversectomy Approaches for Trauma
- Short or Long Posterior Fusion: Determining Extent of Fixation
- Brust Fracture Treatment
- Differentiating Lumbar Fractures from Thoracolumbar Fractures
- Thoracolumbar Fracture Fixation in the Osteoporotic Patient
- Correction of Possttraumatic Deformity
- Fractures in Ankylosing Conditions
- Spinopelvic Fixation
In these chapters, the focus is primarily clinical, with extensive discussions on surgical approach, technique, and complications. Imaging is referred to regarding the initial classification of injury as well postoperative evaluation and complications. Images and figures are of good quality, though many are somewhat small, making it hard to discern detail. There are plenty of useful tables in the chapters, and a “pearls and pitfalls” section at the end nicely summarizes important points.
References in general are somewhat anemic; however, a nice feature is that authors highlight the 5 most important references. For those interested in reading about the new spine classification system, a couple of published references include: Vaccaro et al, Spine 2013 Nov 1;38(23):2028-37 and Reinhold et al. Eur Spine J. 2013 Oct; 22(10): 2184–2201.
Overall, the book is more clinically oriented than may be useful for a radiologist. As a neuroradiologist, the book breaks no new ground on imaging techniques but provides some insight on the clinical decision models and algorithms that surgeons utilize. For those interested in surgical approaches to topics besides trauma, other volumes in this series focus on primary/metastatic tumors, degenerative changes, and spinal deformities, with upcoming volumes on spinal infection and spinal cord injury.
