ARTICLE IN PRESS

Available at wwwsciencedirectcom

journal homepage wwwelseviercomlocatecuor

Current Orthopaedics (2007) 21 83ndash84

BOOK REVIEWS

Emerging Spine Surgery Technologies Evidence andFramework for Evaluating New Technology TPCorbin PJ Connolly HA Yuan Q-B Bao SDBoden Quality Medical Publishing (2005) 611pp$225 ISBN0756707641

In recent years there has been an explosion in spinaltechnologies The editors of this book recognise theimportance of evidence-based medicine and the need fortraining in the evaluation of that evidence

The book is arranged in four parts with chapters groupedtogether in related themes Throughout this book the text iswell illustrated and extensively referenced

Part I Basic Considerations looks at basic science theFood and Drug Administration regulations and the issue ofclinician reimbursement from the perspective of the UnitedStates There is a useful insight into the difficulties ofgetting a product to market and hence the marketingpressure that is generated to promote the use of a deviceAll surgeons treating low back pain should read chapter 2 byCarragee and Cheng

Part II is focussed on biological and tissue engineeringThe biological basis of bone graft fusion is followed logicallyby the technologies to enhance and stimulate fusion the useof allograft bone demineralised bone matrix growthfactors and gene therapy to promote spinal fusion Thechapters have an introduction to each topic that can beunderstood by a clinician without demanding detailed basicscience expertise in each particular field of knowledgeSeveral chapters cover the basic science of disc degenera-tion and strategies for repair as well as potential futuredevelopments A slim chapter 13 on spinal cord regenerationand repair outlines several potential treatment regimens

but it rather pulls its punches with respect to the NASCIStrials in view of recent guidelines that have criticised thelevel of evidence supporting the use of methylprednisolonein acute spinal cord injury

Part III is a short collection of three chapters on therelated theme of surgical navigation as applied to the spineEach chapter is concise and discusses the pitfalls as well asthe potential advantages of this technology

The remaining half of the book is contained in Part IV andis dedicated to surgical techniques Chapters are arrangedinto sections on minimally invasive and endoscopicallyassisted techniques vertebral augmentation and cagesanterior spinal fixation dynamic neutralisation and endingin seven chapters on disc replacement Surprisingly thereare no chapters dedicated to open placement of pediclescrew and rod constructs for the treatment of spine traumaand deformity Perhaps this is seen to be no longer anemerging technology but more an established practice Theimplant companies still seem to find their own screws to betechnologically advanced

Overall this is an outstanding reference book for thespecialist spinal surgeon or even for the non-specialist whowishes to have a deeper understanding of new developmentsin spinal surgery General orthopaedic trainees will finduseful chapters in the first three parts of this book anddedicated spinal specialists will find educational value fromthe whole volume Surgeons will find it helpful to have somany different innovations described in a single text and tohave a foundation for understanding the science supportingthese developments

Crispin Wigfield

doi 101016jcuor200610008

lsquolsquoWhorsquos Whorsquorsquo of North American arthroplastysurgeons R Barrack R Booth Jr JH Lonneret al (Eds) Orthopaedic Knowledge Update Hipand Knee Reconstruction Vol 3 American Academyof Orthopaedic Surgeons (2006) 450pp pound9795ISBN 0-89203-348-7

The previous hip and knee edition in 2000 was anlsquolsquoupdatersquorsquo whereas this text is a stand alone edition on all

aspects of managing the degenerative hip and knee Thiscombined with the excellent annotated bibliography atthe end of most of the chapters will be very appealing totrainees

Written in 2005 this edition should be all that a traineeneeds to know about arthroplasty surgery and joint preser-ving procedures for the FRCS (orth) or board exams

The UK trainee needs to be aware that this is a NorthAmerican tome and should carry a warning when applied toUK practice and exams Hip resurfacing is covered but with

ARTICLE IN PRESS

Book Reviews84

only one UK reference uncemented arthroplasty is givenfive times the space as cemented arthroplasty and impactiongrafting in hip revision surgery is dismissed in a singleparagraph Most of the major differences in practice relateto hip surgery There seems to be better cross Atlanticconcordance in knee surgery though many will disagree on

their views on venous thromboembolic disease and prophy-laxis

Despite these criticisms I can wholeheartedly recom-mend this edition to all trainees and departmental libraries

David Macdonald

doi 101016jcuor200606005

Endoscopic Spine Surgery amp InstrumentationmdashPer-cutaneous Procedures Kim DH Fessler RGRegan JJ editors Thieme New York Stuttgart(2005) (404pp $ 16995 ISBN 1-58890-225-0)

This is a multi-author text with contributors drawn largelyfrom North America All are acknowledged experts in theirrespective procedures

It is a technique focused tome with seven chaptersarranged according to anatomical region (cervical thoraciclumbar) percutaneous procedures (nucleoplasty kypho-plasty) and image-guided and robotic-assisted surgery

Its aims include lsquoyproviding the fundamentals for acomplete understanding of the minimally invasive approa-chy[and] a useful tool and educational resource forintegrating these operative methods into practicersquo

This book only partially achieves the stated aimsThe text is generously illustrated but in common with

previous books on this subject the endoscopic intra-operative figures do not allow the surgical anatomy to befully appreciated by the surgical tyro

Several of the procedures are repeated under eponymoustitles with the variation based on the type of implant used Isuspect that these techniques will have limited longevity asthe technology evolves still further Furthermore some ofthe operations described are based on very limited clinicalexperience (cf four patients in the section on microscopiclaminoplasty)

The broad range of procedures disguises the fact thatmany have only very limited uptake (laser-based ablativetechniques) by the spinal surgical community or evenoutdated (eg stand-alone laparascopic anterior lumbarinterbody fusion with cylindrical cages)

In conclusion this book is for the specialist spine surgeonexperienced in the traditional lsquoopenrsquo techniques who islooking to update knowledge of less-invasive approachesWhilst it does provide a valuable overview of the lsquostate ofthe artrsquo I suspect the general orthopaedic trainee orresident will not benefit from reading it

Michael Grevitt

doi101016jcuor200610001

Raymond T Morrissy Stuart L Weinstein Atlas ofPediatric Surgery Lippincott Williams and WilkinsISBN 07817 57894 2006 (954pp pound215)

Surgical atlases are usually a popular frame of reference forthe individual surgeon although it is difficult to ensure thatthey remain both up-to-date and comprehensive Ray Morrissyand Stuart Weinstein have now produced a fourth edition oftheir popular atlas attempting to cover orthopaedic proce-dures for all the relevant anatomical regions including thespine They have brought in four other contributing authors

Much of the text and references is admirable The black andwhite illustrations are rendered accurately although colourwould enhance the portrayal of the anatomy The incisionsdescribed for certain operations are open to criticism such asthe extensile one for trigger thumb the obliquity of the Salterosteotomy incision and the inadequate length of the incision togive proper access for a displaced lateral humeral condylarfracture and fixation The medial approach for the openreduction of the dislocated hip remains contentious

More should have been made of the three-dimensionalcorrection required for supracondylar fracture malunion andduring Pauwelrsquos procedure Compression screw fixation ofthe Chiari osteotomy aids more rapid functional recoveryand full-threaded screws should be used in operations tosecure the slipped upper femoral epiphysis The periace-tabular osteotomy example shown on page 323 appears tohave been carried out for minimal acetabular dysplasia withan os acetabuli that has yet to fuse The radiographs inprocedure 45 are of poor quality Mention of the Dunnprocedure for SUFE and the Metazieau operation for radialneck angulated fracture would have been welcome and theindication for transiliac lengthening is surely unusual

Overall this edition of the atlas has succeeded in addingsome current orthopaedic procedures As a general refer-ence book it is commendably wide-ranging I recommend itto those intent upon a career in orthopaedic surgeryparticularly for those who are specialising in paediatric care

Malcolm Macnicol

doi101016jcuor200701002