Backache, 2d ed.

The stated purpose of this book is to describe the various conditions afflicting the lumbar spine in a clear and concise fashion that is readable by orthopedists, neurosurgeons, family practitioners, physical therapists, and other professionals who desire an understanding of the basic principles of lumbar disorders. The major section rewritten in this second edition emphasizes the importance of magnetic resonance imaging (MRI) and computed tomography (CT) in improving clinical medicine.

For practitioners involved with the surgical treatment of low back pain, this could be a valuable text. The book is well-written and well-referenced. Copious, clear illustrations complement and enhance the content. The authors demonstrate discernment and extensive clinical expertise in analyzing and describing the various lumbar disorders and the use of MRI and CT to supplement conventional radiography and physical examination. The chapter on the failure of spinal surgery is especially good and should be required reading for all spine surgeons.

The order of the contents is unusual. Chapters on history and physical examination are located in the middle of the text; the chapter on psychogenic back pain is located near the beginning of the text.

The chapter on the sacroiliac joints reiterates traditional orthopedic dogma on the basic nonexistence of sacroiliac sprains. Information on the structure, function, and pathomechanics of the sacroiliac joints is not appropriate in this type of book and therefore should not have been included in the chapters on history and physical examination.

The information provided on conservative treatment is sound but traditional; it lacks specificity and probably would be of scant value to physical therapists. The value of this text depends on the requirements of the reader, but the book probably would be much more useful to spine surgeons or radiologists than to therapists.