Szpalski M, Gunzburg R, Rydevik BL, Le Huec JC, Mayer HM, eds. Surgery for Low Back Pain. Springer 2010, 285 pages, 80 illustrations, $139.00.
As all those radiologists who work closely with spine surgeons (neurosurgeons and orthopedic surgeons) know full well, the surgical options for treating low back pain are numerous and the approaches/devices are seemingly growing at a bewildering rate. Everyday we see new cages, spacers, interpinous implants, sponge filled growth factors, plates, and screws to say nothing of the varying approaches to interbody fusions (anterior, lateral, posterior, transforamenal). The list of options is, in fact, so long that one wonders how one procedure is chosen over another. While this book does not attempt to analyze the outcomes inherent in all operative procedures or to show consequences and complications of all these procedures it does serve to inform as to the relatively current status of spine surgery for LBP.
Edited by five European surgeons with contributions from 61 authors, this 285-page, (37 chapters) hardcover book covers the basic concepts in LBP, diagnostic considerations, conservative treatment, surgical treatment both fusion and other emerging technologies, and outcomes (cost and medical evidence). Chapters which a neuroradiologist might find interesting are those which deal with the end plate changes and diffusion in degenerative disease, disease (evidence to show that end plate alterations precipitate DDD), dynamic (or kinetic) MR of the spine (surprisingly, no images are shown and the technical factors are sparse; both are certainly a limitation of these chapters), indication for spinal fusion (some indications are clear like a posttraumatic instability, but other indications are controversial), the 4 chapters on common fusion procedures, (such as disc arthrophasty, rigid/semi rigid/ non rigid stabilization of the spine), and interspinous process implants. While all these chapters are short and do not touch on all aspects of the procedure under consideration, the material allows one to gain on appreciation of where the field stands in mid 2010. One interesting chapter (non exhaustive and lacking images) is entitled “Adjacent Level Disease: Myth or Fact”; it sets forth the consideration that perhaps non fusion technology might alter present assumptions concerning adjacent level disease.
As a general overview of this field, this book might be worth a glance, but from an imaging point of view in terms of how exactly to analyze images arising from these procedures and what complications may be secondary to these operative interventions, the book is too superficial.
