| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
University of Montreal CHUM, Saint-Luc Hospital Montreal, QC H2X 3J4, Canada
By Douglas S. Fenton and Leo F. Czervionke. Philadelphia: Saunders, 448
pp., 2003. $149
Fenton and Czervionke are neuroradiologists associated with the Mayo Clinic in Jacksonville, FL. Three other radiologists, one neurosurgeon, and one anesthesiologist join them as contributing authors. The book is divided into 11 chapters. The first chapter is devoted to basic needle manipulation techniques, and the last chapter briefly addresses the pharmacology of the contrast agents, anesthetics, and steroids used during spinal procedures. The remaining nine chapters discuss specific spine procedures: facet joint and sacroiliac joint injections, medial branch blocks, facet joint denervation, selective nerve blocks, epidural injections, percutaneous spine biopsy, vertebroplasty, discography, and IntraDiscal ElectroThermal Therapy (Smith & Nephew, Andover, MA).
These nine chapters are written in a consistent fashion beginning with a discussion about the background of each technique that provides important clinical information as well as pertinent historical information about the procedure. This discussion is followed by a presentation of the pertinent anatomy with the use of excellent illustrations; anatomic sections; radiographs; CT images, including three-dimensional reconstruction images; and MRIs. Each procedure is then systematically discussed: patient selection criteria, contraindications to the procedure, equipment, medications, potential complications, postprocedure care and follow-up guidelines, sample dictations, and current procedural terminology (CPT) codes. The authors also take us on a comprehensive step-by-step journey through each procedure. A corresponding fluoroscopic or CT image accompanies each step. Concomitantly, the authors give many procedural tips that reflect extensive experiences performing these techniques.
With the exception of the first and last chapters, each chapter ends with commentaries by a spine neurosurgeon who describes how the procedure being discussed relates to practice. This section is particularly interesting because it brings to the radiologist performing the technique the perspective of the physician ordering the procedure.
Most chapters conclude with case studies. Instead of challenging cases that could have fostered a discussion to complement the information presented in the text, the case reports that are presented are straightforward cases and provide merely a repetition of the information found in the text. Strangely, in chapter 2, the medication used in the case studies differs from the protocol presented in the text.
In chapter 2, on facet joint injections, administration of contrast material is said to be optional. In my experience, contrast material injection is essential to ensure adequate intraarticular needle position and to exclude an intravascular injection. It is not rare that in the absence of spontaneous blood return the needle is located within a vascular structure. In chapter 9, the authors discuss direct percutaneous aspiration of synovial cysts of the lumbar facet joints. These lumbar facet synovial cysts can also be treated percutaneously with an intraarticular injection of corticosteroids with less risk of a dural sac puncture [2].
The text is well written and to the point. Some information is presented in a bulleted format, which makes it easy to find information related to a specific topic. Samples of useful forms, such as a discography pain assessment form (chapter 9) and detailed postprocedure instructions to patients, are provided and can be easily incorporated into one's practice.
In summary, Image-Guided Spine Intervention demystifies the current percutaneous needle techniques used in the diagnosis and treatment of spine disorders and should appeal to any physician who deals with patients who have spinal disorders. This book also fulfills its intended purpose of being an instructive procedural text that will become indispensable to any physician who performs any of the spine procedures it describes. Residents, fellows, and radiologists should greatly benefit from this book.
References
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
