Clinical Anatomy and Management of Cervical Spine Pain.

Clinical Anatomy and Management of Cervical Spine Pain Giles LGF, Singer KP, eds. Newton, MA 02158-1626, Butterworth-Heinemann, 1998, paperback, 214 pp, illus, $65.

This book is a comprehensive reference on the anatomy and biomechanics of the neck, mechanisms of neck injury, and management of neck pain. The renowned contributors to this volume have diverse experiences and backgrounds and other detailed information in their areas of expertise.

The chapters are logically arranged to address the topic from anatomy through medical and surgical management. The first chapter describes the anatomy and the proper posture of the cervical region. This chapter includes a brief description of the consequences of motor vehicle accidents, which chapter 5 addresses in greater detail. The first chapter also describes innervation and the autonomic nervous system, pain mechanisms, and degenerative processes involving the cervical spine. Chapter 2 further depicts anatomy, biomechanics, and head and neck mobility, often using helpful figures as illustration.

The cervicothoracic transition is an area that poses difficulties for clinicians. Chapter 3 describes the distinguishing features of the cervicothoracic junction and should be useful in understanding this less commonly described area of pain. Chapter 4 covers the radiological analysis of the kinematics of the cervical spine. Interestingly, line drawings, rather than photographs or stills from spine films, are used to supplement the text.

The scope, pathophysiology, and sequelae of motor vehicle accidents arc described in chapter 5, and this chapter is a particularly strong portion of the text. Although the radiological analysis chapter did not include films, chapter 6, which addresses diagnostic imaging, more than compensates for this absence. This chapter will prove to be beneficial to physical therapists who have not had extensive radiology training.

In chapter 7, Calliet describes the medical management of neck pain. This chapter is concerned primarily with posture and traction. The ensuing chapter deals with surgical management and, again, should prove useful for physical therapists. The following 3 chapters (9-11) address the management of the cervical spine by chiropractors, osteopaths, and physical therapists, respectively. The similarities and differences among the approaches are interesting and are helpful in increasing the reader's understanding of different schools of thought.

Chapter 12 thoroughly describes the contraindications tar manipulation of the cervical spine. The medico-legal implications and the potential tar disastrous consequences of high velocity thrust in the presence of vertebrobasilar insufficiency and spinal instability make this chapter especially important reading.

The prevalence of neck pain and the increasing use of computers in society warrant special attention regarding the diagnosis and management of cervical spine conditions. This book will prove to be a very useful resource for physical therapists who manage patients with neck pain.

Dr Schenk is Associate Professor inn the physical therapy program and President and owner of Schenk Physical Therapy. His research interests include orthopedic physical therapy and functional outcomes.