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Book review
Decision Making in Spinal Care
  1. Reza Yassari1,
  2. Todd Miller2
  1. 1Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
  2. 2Department of Radiology, Montefiore Medical Center, Bronx, New York, USA
  1. Correspondence to Dr R Yassari, Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, 3316 Rochambeau Ave., Bronx, NY 10467, USA; ryassari{at}

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This is a review of the second edition of Decision Making in Spinal Care, which was updated for 2013. The intended audience is practitioners caring for patients with spine related issues, which are often complex problems requiring a detailed workup. This book provides a synthesis of current best practice and relevant evidence to provide decision making support for specific clinical scenarios. It does not provide instruction on operative technique. The impressive list of 121 expert contributors has been updated and expanded by the editors, who are recognized by their peers as world class leaders in the field of spine care. Updated reference lists of essential literature on each topic are provided with brief summaries of each article of suggested reading. The focus on the decision making process is achieved by providing a plan of care algorithm as the first page of each chapter. The overall organization is by anatomic region and diagnosis. Busy practitioners encountering patients exhibiting the breadth of spine disease during busy workdays will especially appreciate the quick reference format of the book.

We used the digital version for this review. The book is oriented toward both operative and non-operative diagnosis and treatment options, and hence is intended for use by both surgeons and non-surgical specialists. The superb quality of this second edition published by Thieme is readily apparent. The cover conveyed the focus on spinal care and the decision making purpose of the text. The book is divided into 16 logically arranged sections, allowing the reader to easily identify the necessary chapter based on clinical queries. Each of the chapters follows a standard organization, with an algorithmic diagram on the first page that outlines the decision and management process for the individual topics. We find these diagrams of exceptional benefit because they allow for quick reference and outline the main message of each chapter. They are well thought out and updated to reflect suggestions from reviews of the first edition. The chapters are brief and easy to navigate. They follow a standard outline to address the topic at hand, divided among classification systems, workup (including classical clinical presentation, gold standard imaging modalities, and typical findings), treatment options (non-operative and operative), and finally outcomes and complications. Only chapter 70 had the very helpful edition of a paragraph entitled ‘decision making’, which fleshed out the algorithm from the first page. The editors should consider the value of adding a similar section to each chapter.

Although images are sparse, most were excellent. Some chapters have excellent pictorial and tabular illustrations that facilitate understanding. Some complex chapters without illustrations would benefit from a similar approach. There were few tables, but those that were included were substantive additions to the text of the respective chapters. More tables, like 33.1, summarizing the literature on spondylolyis, would have been a welcomed addition. References are detailed and complete. Chapters concluded with a list of suggested readings, which is an excellent way of providing further information beyond the intended scope of the book. One of the most valuable aspects of the text is a brief description of why each included suggestion is on the list. This approach allows the reader to efficiently obtain the information that they seek and, if necessary, read more about the subject in a concise, detailed, and accurate fashion. There is an extensive index, and the text is searchable and selectable in the digital edition.

The focused nature of the text, the homogeneity of the chapter layout, and the large collection of contributing experts introduce both strengths and weaknesses. This approach allows the reader to develop rapid familiarity and quickly reference specific topics. However, there is some repeated information applicable to most patients with spine disease. The physical examination, imaging workup, and complications sections are repeated in limited fashion throughout multiple chapters. This information may have been more efficiently conveyed through more detailed chapters devoted to each topic early in the text and referenced in a brief bulleted fashion with added specifics for each chapter. As expected in a book of this size, multiple contributors overlap to some extent on aspects of several topics in their chapters. The editors might have utilized this opportunity to add their higher level appreciation of the subject matter and provide a smoother transition between sections.

The text does not include any details about the surgical techniques and procedures it mentions. This was clearly not the intent of the book, and readers (specially orthopedics and neurosurgery residents) who are interested in operative techniques will need to augment their reading by adding a choice from the selected reading lists devoted specifically to such topics. However, even for those readers interested in surgical technique, this book is an indispensable companion to the more technically oriented textbooks because it provides comprehensive background information to a wide range of topics related to spinal disease. The knowledge base introduced in this book strikes a balance between breadth and detail.

This text will quickly become a trusted go-to source for the busy professional encountering patients requiring spine care. Students, generalists, and subspecialists will appreciate the clear decision making algorithms, well organized chapters, and fantastic updated reading lists with annotations supporting the recommendations. Few professionals will encounter patients presenting with all of the entities discussed with any regularity. When you come across a patient with issues you have not considered in a while, you will appreciate the real value of this handy reference.

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  • Edited by D Greg Anderson, Alexander R Vaccaro. 2nd Edn, 2013. Published by Thieme, Paperback/Electronic 638 Pages. Language: English.

  • Contributors All authors contributed to this book review.

  • Competing interests None.

  • Provenance and peer review Commissioned; not externally peer reviewed.

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