Book Review

Atlas of Spinal Surgery

N Engl J Med 1993; 328:590February 25, 1993

Article

Atlas of Spinal Surgery
By Donlin M. Long and Paul C. McAfee. 431 pp., illustrated. Baltimore, Williams and Wilkins, 1992. $175. ISBN: 0-683-05149-0

In the past several years, there has been a great deal of interest among surgeons in the spine and in new operative techniques for dealing with diseases of the spinal cord and vertebral column. We have also seen the emergence of spinal surgery as a separate discipline and the blurring of traditional lines of responsibility between neurologic and orthopedic spinal surgeons. Thus, many contemporary neurosurgeons address problems of instability, and orthopedic surgeons frequently operate to perform neural decompression. Increasingly, spinal surgery entails a team approach, with contributions from both specialties. Because of this convergence of interests, textbooks of spinal surgery must address the needs of specialists in both areas.

Atlas of Spinal Surgery has been edited by a neurosurgeon and an orthopedic surgeon, and its stated goal is to present a “fundamental collection of what have been traditional neurosurgical and orthopedic procedures that should now be mastered by any spinal surgeon.” This is an ambitious goal, but one that I think has largely been met.

The book is divided into 10 sections dealing with various aspects of spinal surgery. It is not all-inclusive, but in general it covers most of the operations that would be performed on a busy spinal-surgery service.

There were two things that I particularly liked about this book. The first was the quality of the drawings, which I felt were excellent representations of surgical exposures. Surgical atlases frequently contain simplified drawings that make the operation appear easier than it really is; in this book, the neural and bony structures are shown realistically, as the surgeon actually sees them. Second, I thought the descriptions of the operations were quite good and contained a great deal of useful advice for both novices and experienced surgeons.

There were also one or two things that I did not like. First, the text did not consistently refer to specific illustrations, a deficiency that sometimes made it hard to follow the description of an operation. Second, certain operations were mentioned in passing that should have been described in greater detail. In particular, I thought the retroperitoneal approach to the lumbar spine should have been described completely and additional space should have been devoted to the transoral approach to the craniovertebral border.

These criticisms aside, I liked this book very much and think that it would be a worthwhile investment for spinal surgeons from either discipline and at any level of experience.

Russell W. Hardy, Jr., M.D.
University Hospitals of Cleveland, Cleveland, OH 44106