Thieme, New York, 2003, $89
In this collaborative radiologic and orthopedic text, the early chapters define the clinical and radiologic terminology used to describe degenerative lumbar spine disease. The authors recognize the lack of uniformity in spinal terminology between academic and private centers, as well as between North America and Europe, and stress the importance of strong interdisciplinary relationships in order to ensure optimal patient care. The first half of the book also provides a concise review of lumbar spine anatomy and of the various clinical manifestations of lumbar nerve root syndromes.
The majority of this atlas is made up of 78 in-depth cases. Each case study is presented in the same format, covering the following topics:
- Clinical presentation
- MRI sequences, findings and diagnosis
- Treatment rendered
- Clinical course
- Comments
Each case is heavily annotated and illustrated (there are over 450 illustrations in the book). A minor criticism is that multiple types of arrows and arrowheads are used on a single image to mark pathology, creating occasional confusion when correlating the description with pertinent findings.
The first 70 cases demonstrate a plethora of disc pathology, including protrusions, extrusions and sequestrations as well as the postoperative spine. They are illustrated at each level of the lumbar spine from L5-S1 to T12-L1. Many examples of each entity are provided; the authors must firmly believe that repetition is the key to learning. The final eight cases are of degenerative spinal stenosis.
The attention given to the clinical and therapeutic aspects of degenerative lumbar spine makes this atlas different than other radiology texts. For example, the first half of the book devotes an entire section to indications for, and performance of, percutaneous CT-guided lumbar spine interventions. There is also a brief description of surgical technique and strategy. Additionally, the case studies provide great detail about clinical presentation, treatment, operative findings and clinical course.
The title of the atlas is somewhat misleading, as this is an atlas of degenerative lumbar spine disease, and not an all-encompassing MRI atlas of lumbar spine pathology. No neoplastic, infectious/inflammatory, or congenital pathology is presented.
Although not an especially sexy topic, degenerative diseases of the lumbar spine afflict millions of patients. To some degree, practicing radiologists and those in training need to be proficient in the appropriate diagnosis of degenerative lumbar spine pathology. MR Imaging of the Lumbar Spine: A Teaching Atlas is a quick read that provides an extremely thorough and well illustrated review of degenerative lumbar spine disease.
By Dr. Jeff KnakeAuntMinnie.com contributing writer
June 19, 2003
Dr. Knake is a fourth year radiology resident at the University of Virginia in Charlottesville. He will be a musculoskeletal radiology fellow at the university in July 2004.
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