Fractures of the Thoracic and Lumbar Spine. S. D. Gertzbein. Williams & Wilkins, Baltimore, 1992. Pages: 293. Price: $75.00.
This is a single-author text by an orthopedic surgeon, Stanley Gertzbein, who attempts to review his extensive experience in the management of thoracic and lumbar fractures. The text is divided into 11 chapters. The first chapter offers a brief description of the anatomy of the thoracolumbar spine and relevant biomechanics. Following it is a description of the various forms of thoracolumbar fractures. This is an excellent chapter, which describes a classification of thoracic and lumbar fractures, based on the type of loading forces presented to the spine.
The chapter on radiology of spinal trauma is notable for its excellent reproductions of three-dimensional computed tomographic reconstructions of the spine. Gertzbein employs multiple algorithms, which make the descriptions of management strategies easier to comprehend. The author also gives a very balanced view of the nonoperative treatment of certain fractures. The text then proceeds to a series of chapters covering both posterior and anterior surgical approaches for treatment. The text concludes with chapters on the postoperative care and rehabilitation of this group of patients, and there is a brief review of complications associated with these fractures. The final chapter consists of a short overview, using algorithms for the management and identification of fracture types.
In general, the text is very easy to read, and the chapters are well referenced. The illustrations, both diagrams and radiographs, are clear and well described. The major criticism of the text is that it does not address the application of universal instrumentation systems in the management of thoracic and lumbar fractures. The author primarily concerns himself with describing the use of Harrington rod techniques. In addition, I do not think the chapters on surgical management are comprehensive enough to be used as a “how-to” text.
The audience that would be most appreciative of this text would be residents in training and spine fellows. For practicing spine surgeons looking for a “how-to” technique book, however, this text probably will not meet their needs.