Spine surgery tricks of the trade

Abstract

The book Spine Surgery—Tricks of the Trade by AlexanderVaccaro and Todd Albert, Second Edition, definitely holdstrue to its title. On a little over 300 pages of this hardcoverbook, over 80 authors, mainly from the USA but also fromother countries, have put together a fascinating overview ofmodern spine surgery techniques. As stated in the title, thisbook is fostering on the technical aspects of spinal surgeryand is not a text book about spinal disease.The book is extremely well structured with systematicdescriptions of posterior then anterior approaches, eachfirst without instrumentation then with instrumentation,from the craniovertebral junction down to the sacrum.Special sections about deformity, minimally invasiveprocedures, bone grafting, external immobilization,motion-preserving procedures, and complication manage-ment follow to round up the spine surgeon's potentialarmamentarium. The last section “Complications Manage-ment” is particularly useful to busy spine surgeons asdealing with complications and awareness of their bestmanagement is often neglected in the current literature ascomplications are generally under-reported.Each surgical procedure is described in the samesystematic manner with the subheadings: “Description”,“Key principles”, “Indications”, “Contraindications”,“Special Considerations”, “Special instructions/position/anesthesia”, “Tips/pearls and lessons learned”, “Difficul-ties encountered”, “Key procedural steps”, “Bailout/rescue/salvage procedures”, and “Pitfalls”. The letter sizeis somewhat small and needs careful reading but seemsnecessary to confine text length to about 3–5 pages pertechnique on average, which maintains excellent over-view. Furthermore, this book is probably not designed forsystematic read-through but rather for a pinpointed work-up or brush-up of one or more specific procedures.Again, the clear structure here makes it a pleasure to findand read through the chapter(s) needed. The illustrationsfit well into the chapter, and though only black andwhite, they are clear and instructive. The index is helpfuland clear. There are no references; rather, the authors ofeach procedure chapter are listed directly below the titleof the chapter.As spinal surgery has impressively evolved over the pasttwo decades, it is of paramount importance not to lose theoverview of available surgical solutions and to know theirpros and cons. This is exactly what this book offers: onlyvery little (and understandable!) bias is noted in thetechnical descriptions by the authors. Rather, a useful self-critical style has been implicated by such subheadings as“Difficulties encountered”, “Bailout/rescue/salvage proce-dures”, and “Pitfalls”. Such a differentiated presentation ofstrengths and weaknesses of procedures will allow theneurosurgical or orthopedic resident, spine fellow, or fullytrained specialist to make his or her own and besttherapeutic choice in a given situation.