Functional Anatomy of the Spine.

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Oliver J, Middleditch A. Stoneham, MA 02180, Butterworth-Heinemann, 1991, paperback, 328 pp, illus, $39.95.

The authors state their purpose to be that of providing a text that addresses the unique background content needs of physical therapists specializing in spinal mobilization. With such information, the authors hope that practicing therapists will be better able to determine a working clinical diagnosis prior to the initiation of treatment of spinal lesions. They also hope that the reader will develop a dearer interpretation of the patient's signs and symptoms.

The text is divided into 10 chapters addressing structure of the vertebral column, intervertebral disks, vertebral column musculature, blood supply of the spinal cord and vertebral column, normal movement, sacroiliac joints, vertebral column innervation, biomechanics of the spinal cord and meninges, posture, and development and degeneration of the spine. The chapters considering structural anatomy are well done and include derailed structure linked with function. Guidelines for palpation of structures appropriate to each chapter follow that anatomical content immediately. The authors clearly describe those structures that cannot be palpated effectively. The first part of the chapter devoted to muscle is written at a level much lower than that of the rest of the chapter and the text itself. Topics that are covered in these early sections include basics such as agonists/antagonists, slow and fast fiber types, motor units, types of work, and types of contraction. It may seem to the reader that this particular content was written for a different audience than was the rest of the text. The remainder of the chapter groups muscles by the control each has on the trunk, thus returning to the focus of the text Activity of both loaded and unloaded postural muscles are presented with their appropriate electromyographic tracings for a more visual explanation of loading effects. The chapter on the sacroiliac joints, though short, is relatively complete and is included because of the anatomical attachment of the sacrum and ilium to the spine.

The chapter on normal movement takes gender, age, and genetics into account for an interesting approach to individual differences. The chapters on biomechanics of the spinal cord and meninges and on embryology, development, and degeneration of the spine are short and to the point. The last chapter on posture presents very thorough information concerning the mechanics of sitting and also provides content regarding general body mechanics in repetitive loading, push/pull activities, and lifting.

This text is written for the clinician or physical therapy graduate student who has a special interest in the spine. The book would be valuable for any practicing therapist who wishes to have a single-volume source for the anatomical and biomechanical basis of spinal care. It is well written, inexpensive, and a useful addition to the professional literature.

Nancey A Bookstein, PT Univ of Colorado Health Sciences Center Denver, Colo