Atlas of Minimal Access Spine Surgery, ed 2.

Atlas of Minimal Access Spine Surgery, ed 2 Regan JJ, Lieberman IH, eds. St Louis, MO 63146, Quality Medical Publishing Inc, 2004, hardcover, 563 pp, illus, ISBN: 1-57626-100-X, $275.

Minimal access spine surgery has gained popularity as a result of the decreased paraspinal muscle trauma, decreased postoperative pain, and earlier hospital discharge that may be associated with this procedure compared with open surgical approaches. The stated goal of this text is to provide a step-by-step guide to performing minimal access spinal procedures. The target audience for this book is spinal surgeons. The editors have brought together 46 expert authors who provide comprehensive coverage of the topic.

The book is divided into 4 parts. Part I discusses collaboration between spinal and endoscopic surgeons, anatomy, equipment, surgical approaches, surgeon training and credentialing, complications, and anesthesia. Part II provides the surgeon with decision-making tools for treatment of the lumbar and thoracic spine and spinal deformities. Part III describes in detail various techniques for minimal access surgery to the lumbar and thoracic spine and to correct spinal deformity. Part IV describes new technologies, including vertebral body augmentation, intradiscal electrothermal therapy, microendoscopic and percutaneous discectomy, nucleus pulposus and total disc replacement, and extreme lateral interbody fusion.

An outstanding feature of this book is its wealth of illustrations--500 line drawings, imaging studies, and intra-operative photographs--that augment the well-written chapters. Decision flow charts clarify the decision-making process. Case reports, literature reviews, and some original case series complement the technical descriptions of the various surgical approaches. All chapters are well referenced, and some provide suggested reading and annotated reference lists. Most references are less than 10 years old, illustrating the recent advent of minimal access spine surgery. There is some duplication Of information in the different chapters on anatomy, surgical approaches, and technique, but this allows the separate chapters to be read as stand-alone instructional guides.

This book most certainly serves its stated purpose. Its relevance to physical therapists, however, is limited. Physical therapy is only mentioned a handful of times throughout the book and only the chapter on intradiscal electrothermal therapy provides some summary guidelines for physical therapy treatment. This is not surprising--outcomes research for these relatively new techniques is limited, and research data on the associated rehabilitation is nonexistent. This book, therefore, may be of interest to those physical therapists who work closely with minimal access spine surgeons and who need to develop rehabilitation protocols for these patients that are based on an anatomical-physiological rationale rather than an evidence-based rationale.

Peter A Huijbregts, PT, DPT, OCS 

University of St Augustine for Health

Sciences

St Augustine, Fla

Dr Huijbregts is Assistant Professor of Online Education teaching courses in orthopedic basic science and spinal instability. He also is a consultant and OMPT residency coordinator at Shelbourne Physiotherapy in Victoria, BC, where he mainly treats patients with spine-related conditions.