Arthroscopic and endoscopic Spinal Surgery: text and atlas, ed 2.

Kambin P, ed. Totowa, NJ 07512, Humana Press Inc, 2005, hardcover (with DVD), 383 pp, illus, ISBN: 1-58829-522-2 $157.50.

The phrase "minimally invasive spine surgery" and the establishment of 2 related international societies closely followed publication of the first edition of this book (Arthroscopic Microdiscectomy: Minimal Intervention in Spinal Surgery) in 1990. In the 15 years since, this relatively young subspecialty has witnessed the evolution of endoscopic fragmentectomy, decompression of lateral recess stenosis, forminoplasty, and spinal stabilization, to name a few procedures. The purposes of this second edition are to (1) describe and illustrate the current minimally invasive surgical techniques and approaches that may be able to prevent the development of postsurgical "failed back" syndrome and (2) discuss evidence regarding treatment effectiveness.

The text is organized into 19 chapters, the first 7 of which were written by the editor, who appears to have been one of the founding fathers of this subspecialty. Kambin provides a history of microsurgical management of herniated lumbar disks. He then describes the arthroscopic and endoscopic anatomy of the lumbar spine, instrumentation, step-by-step surgical approaches, and current management of herniated lumbar disks, diskogenic pain and spinal instability, and lateral recess stenosis.

The remaining 12 chapters, written by a group of experts from the United States, Greece, and Scotland, cover a range of topics: the role of the epidural and radicular veins in chronic back pain and radiculopathy; diagnostic and therapeutic percutaneous transpedicular approaches; use of the Atavi internal fixation technique; vertebral augmentation; principles of transthoracic, transperitoneal, and retroperitoneal endoscopic techniques in the thoracic and lumbar spine; laser; pain management; nucleus replacement; interspinous process implants; stereotactic imaging techniques; chemonucleolysis; and lumbar microendoscopic diskectomy. The text is supplemented with a DVD that contains selected video segments showing arthroscopic and endoscopic approaches.

This book's intended audience is primarily physicians or physicians in-training, and, for this audience, the material appears to be accurate comprehensive and presented in a well-organized and usable fashion. For example, there are numerous photographs, images (arthroscopic as well as computed tomographic and magnetic resonance images), line drawings, and tables that illustrate normal and abnormal anatomy, patient positioning, instrument insertion options, and implanted devices. Many of the black-andwhite arthroscopic/endoscopic figures, however, have poor resolution, making it difficult to delineate anatomical structures. In some instances, the editor places line drawings beside the photo images to help the reader identify structures. In addition, 39 high-resolution color plates of black-and-white illustrations provide improved visual representation of arthroscopic/ endoscopic anatomy. Each chapter concludes with an ample list of up-to-date references.

As a physical therapist, I admit that I cannot provide the most expert critical review of the methods and outcomes described in this text; however, I was impressed with the unbiased presentation by at least 2 of the surgeon authors. Kambin, in his chapter on the herniated lumbar disk (chapter 4), concluded that the indication for arthroscopic and endoscopic management of herniated lumbar disks was primarily "[the] failure to respond to a well-designed and executed non-operative management" program, as well as correlation of history, physical examination, and imaging data. In addition, in chapter 11 on vertebral augmentation for osteoporotic vertebral compression fractures (VCF), the authors stated that two thirds of patients respond to no treatment or conservative management, implying that surgical treatment is not the "end-all, be-all" approach for VCF.

This text could serve as the starting point for a resident in orthopedic surgery or neurosurgery who might be considering expanding their surgical expertise. Because this book is quite readable and its content is both general and specific, it should be in the medical libraries that serve students in chiropractic, medicine, nursing, and physical therapy. Furthermore, this text would augment the reference shelves of practitioners with patients who have spinal pathology.

GJ Alderink, PT, PhD, is Associate Professor, Physical Therapy Department, Grand Valley State University Grand Rapids, Mich.

[DOI: 10.2522/ptj.2007.87.2.230]