The Spine Handbook

Spinal disorders are responsible for a significant amount of morbidity in the medical world. Their treatment encompasses a wide variety of interventions, and involves continuous and committed interdisciplinary patient management. As a neuroanesthesiologist involved regularly in spine surgery and postoperative pain management, I was very interested to read The Spine Handbook, by Dr Mehul Desai, an eminent pain physician himself. The book provides an overview of the myriad problems that arise in the human spine and the various diagnostic and therapeutic challenges that go along with it. The book is neatly divided into 6 sections, with a total of 33 chapters. Section 1 deals with examination and assessment of the spine and its pathology; sections 2, 3, and 4 encompass the cervical, thoracic, and lumbar spine; and sections 5 and 6 are devoted to emerging issues and neuromodulation, respectively. It is available as a paperback, which is handy in size and quite compact, and also online as an e-book in an easy-to-read format. The chapters are lined with images, figures, and tables, which are extremely useful tools to illustrate the underlying concepts, making it appealing to read for paramedical professionals involved in spine care, as well as physicians. Each section of the online book can be separately navigated, which allows for quick reference to a distinct topic. I faced no difficulty using various devices to access the e-book, including Android phone, iPad, and desktop, making it convenient to read on the go. The quality of the print of the paperback issue is appealing, and the glossy pages work well for taking notes or highlighting text, as preferred by the reader. Each chapter begins with a table of contents and a textbox highlighting key points covered throughout the text. Authors include experts from such diverse specialties as anesthesiology, radiology, orthopedics, neurosurgery, physical therapy, psychology, and psychiatry. Chapters are extensively referenced, yet deliver a succinct, concise message to the reader about the topic at hand. Tables of various clinicopathological and functional classifications are provided in great detail, offering insight into the disease process and the clinician’s thinking, as well as providing medical quiz junkies with superb data sets. Chapter 25 on core strengthening was quite the eye-opener in terms of actual rehabilitation and the exact exercises that a patient can and cannot do on the road to full functional recovery. The major strength of this book is its easy delineation of concepts in spine pathophysiology and the impact of treatments on clinical and functional outcome. Many newer treatments that are currently all the rage in spine treatment are outlined in section 5 as emerging and special issues, like ultrasound-guided spine interventions, biologic and regenerative therapies, such as stem cell therapy, platelet-rich plasma injections, and the challenges and controversies of opioids in spine pain. These chapters, along with the section on neuromodulation including spinal cord stimulation, were of most interest to me, as an anesthesiologist. The author’s approach is clear and simple, with images and tables reinforcing the points made. In addition, I would have liked to see a description of neuromonitoring during spine surgery, including evoked potentials and depth of anesthesia monitors, among others, and their impact on clinical and functional outcomes. Perhaps it may be a valuable addition in upcoming editions. The book manages to capture the attention of the beginner reader, whether in medical science or allied professions like nursing, physiotherapy, and occupational therapy, with an overlay of concepts, both illustrative and contextual, and diagnostic and therapeutic maxims for the spine, making reading an enlightening and pleasurable experience. The Spine Handbook is also a good read for those who wish to update themselves with the latest in spine disease therapeutics, making the book a valuable addition to most medical libraries. It is also reasonably priced at 125 dollars, a cost within reach of most health care professionals in the Western hemisphere. The book also serves as a handy refresher on the various treatment modalities and surgical approaches to the spine, allowing the reader to comprehend the impact of injury and disease pathology, thereby tailoring therapy to aim for better outcomes. The chapters are designed to provide a ready reference to various facets of spinal disorders. Compared to the usual tomes on the spine, this book can easily fit on most shelves, including mine. The trained pain physician is equally likely to have the book as the curious patient who lines up to see what he or she is in for when visiting the spine physician or the occupational therapist. This successful condensing is what makes this book a must-have for everyone involved in multispecialty spine treatment. Sujoy Banik, MBBS, MD, DMDepartment of Anesthesia and Perioperative MedicineLondon Health Sciences CentreSchulich School of Medicine and DentistryUniversity of Western OntarioLondon, Ontario, Canada[email protected]

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