Contemporary Conservative Care for Painful Spinal Disorders.

The purpose of this text is twofold: to review all of the major issues in current spine care and to provide an algorithm for conceptualizing modern spine care for the primary care physician and for other health care practitioners.

The list of contributors is a "Who's Who" of individuals who are acclaimed in the spinal field. Among the contributors are Nikolai Bogduk, with a chapter on lumbar spine structure and function; Malcolm Pope, with a chapter on spine physiology and mechanics; Philip Greenman, with a chapter on the osteopathic approach to acute spinal disorders; Robin McKenzie, with a chapter on a physical therapy perspective; and Leonard Matheson, with a chapter on integrated work hardening, just to name a few. The editors have done an excellent job of organizing a truly comprehensive text. The text is comprehensive because, although not discussed in detail, surgical concepts are presented, including a surgical decision-making model in part 6.

The contents are divided into the following eight sections: "Introduction and Overview of Degenerative Spine Problems"; "Anatomy, Physiology, and Biochemistry of Spinal Disorders"; "Psychosocioeconomic Factors Related to Spinal Disorders"; Acute Spinal Care Options: Evaluation and Treatment"; "Subacute Spinal Disorder"; "The Place for Surgical Treatment"; "Rehabilitation of the Patient with Chronic Spinal Disorders"; and "Special Issues in Spinal Care." The special issues section covered such topics as vocational rehabilitation, ergonomic considerations, preemployment screening, and impairment and disability. The spine is literally covered from A to Z in this text, but the parts that I found most enlightening were those on magnetic resonance imaging, research challenges related to the spine, chiropractic view of acute disorders, and legal-disability issues.

This book is well written, with the narrative appropriately complemented by high-quality tables, figures, photographs, and sketches. It is obvious that chapter authors are on the cutting edge of spinal care by the up-to-date lists of works to which they refer.

Through careful selection of the authors and topics, the editors have succeeded in presenting a truly holistic approach to back care. This text is paradigmatic of the sports medicine approach to back care and values the contributions that all health care practitioners bring to the treatment arena. I enthusiastically recommend this text as a reference for both students and experienced clinicians alike and would suggest that it become required reading for the primary care physician, who often serves as the front-line defense against the low back pain syndrome problem.