Contemporary Conservative Care for Painful Spinal Disorders.

As the title suggests this books provides a review of the spine as it relates to its evaluation and care. Specific emphasis is placed on the pain which is incurred by the individual as a result of a spinal injury. The spine has given the medical community, especially surgeons, many problems over the past years. Within the last several decades rapid advance of technology has invalidated some practices and called into question others. This book intends to address these issues by presenting an overview of the spine from injury through diagnosis, treatment, and rehabilitation.

The editors have carefully selected individual contributors who have credentials in spinal injury. Up-to-date information is provided which should provide medical professionals a book which can be a significant resource. Other professionals such as physical therapists, occupational therapists, and rehabilitation counselors will find this book contains extremely useful information.

This volume seemed to be organized with the intention to review all major issues currently being addressed in spine care. The book was divided into eight parts. The topics covered in these parts were: 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 disorders; the place for surgical treatment; rehabilitation of the patient with chronic disorders; and special issues in spinal care. Each topic is subdivided into a number of small chapters each of which concentrates on a specific topic. For instance, there is a chapter on The Chiropractic View of Acute Spinal Disorders. Interestingly many texts dealing with a major medical topic appear reluctant to even mention the chiropractic view much less devote an entire chapter to it.

Of special concern to rehabilitation counselors would be the section on pain, the section which considers the rehabilitation of the patient with chronic spinal disorders, and the last section which deals with special issues, but which includes a chapter specifically titled Vocational Rehabilitation. Also included in this section is a discussion on ergonomics and employment. Several of the authors writing in this section have some rehabilitation background and are not listed as medical doctors. While the medical model seems to be preserved, an interdisciplinary team concept is fostered and the need for vocational specialists is noted on occasion. The issue of empowerment of the client is not addressed. The chapters which showcase the rehabilitation counselor, ergonomics, and employment are adequate considering the type of book this is and what it accomplishes. The references will provide the reader with ample opportunity to further research these areas.

Throughout the book liberal use is made of references to authorities in the field. On the average there were approximately forty-six references per chapter. This quantity of references allows the reader greater freedom in following up on what has been presented. A sizeable percentage of the references are recent, i.e., from the mid-1980's through and including 1989. The use of figures and tables occurs on a regular basis throughout the book, figures, usually pictures and drawings, appear twice as often as tables. The only drawback to the pictures was that the quality did not seem to be consistent with the overall quality of the book. They even seemed to be dated. Presentations of other films, such as X-rays, were of good resolution. The various drawings were well executed.

This book is not intended as a definitive text for all issues dealing with spinal disorders. Rather, the editors have carefully chosen an organizational path which allows treatment of individual topics in a general manner but providing some insight into specifics. It is up to the reader to take the next step and advance in their knowledge of this field.

It is suggested that any rehabilitation counselor who has a specialty caseload of spinal disorders should purchase this volume or suggest that it be obtained and put in a Vocational Rehabilitation agency district library. This text would be an excellent supplement to a medical aspects course in the rehabilitation counseling program curriculum. A client with a reading level consistent with this book should be advised of its existence.

Ronald Spitznagel Assistant Professor Rehabilitation Counseling Department University of Florida