British Journal of Radiology (2004) 77, 626
© 2004 British Institute of Radiology
doi:
Image-guided spine intervention. By D S Fenton and L F Czervionke, pp. xv + 298, 2003 (W.B. Saunders Co. Ltd, Philadelphia, PA), £120.00 ISBN 0-7216-0021-2
J M Bell
This book covers a wide range of percutaneously performed interventional procedures, used in both the diagnosis and treatment of spinal pain. As well as established techniques including facet joint and sacroiliac joint injections, facet joint degeneration, selective nerve blocks and epidural injections, spinal biopsy and discography it also covers newer techniques including vertebroplasty and intradiscal electrothermal therapy (IDET). It also has a useful introductory chapter covering general techniques of needle placement and a short chapter at the end covering the pharmacology of some of the more frequently injected substances. A separate chapter is devoted to each technique. The majority of these are written by the two main authors, although a few are contributed by other authors. All chapters follow essentially the same format with a background section, a review of relevant anatomy, advice on patient selection and contraindications. The procedure, including the equipment needed to perform it, is then described in detail, with reviews of alternative equipment systems where relevant. The section on techniques is subdivided where appropriate to describe different techniques used in different regions of the spine and using different methods of image guidance (fluoroscopy or CT). Potential complications of the procedures are described with advice on post procedural patient care and follow up. Each chapter ends with reproduction of one or two specimen reports under the heading "sample dictations"; followed by a few case reports illustrating the technique and its potential benefits. The final section in each chapter lists current procedural terminology and codes, presumably based on the American insurance system. Attached to each chapter is also a brief view from a neurosurgeon, giving his perception of the procedures role in his practice.
The overall standard of the book is excellent. Both the anatomy and the technique sections are well illustrated with numerous diagrams, radiographic and CT images and the odd clinical photograph. All the illustrations are of high quality and well produced, all are clearly labelled. They are thoughtfully placed in relation to the text, in order to minimize the amount of page turning required when reading the section to which they relate.
The descriptions of the techniques are detailed and clear and the lists of equipment are comprehensive. Everything is presented in a logical order, which is easy to follow. After reading some sections, one almost feels that with the information provided one could walk straight into the screening room and carry out the procedure. The authors however are careful to stress at several points the importance of instruction and supervision for those performing procedures for the first time.
The book will prove of immense value to those who regularly perform spinal interventional procedures, be they radiologists, anaesthetists or surgeons. It will also interest many other more generally based Radiologists who may on occasion be asked to perform things like spinal biopsies, sacroiliac joint or disc aspirations. Radiological trainees could also learn much from the excellent chapter on basic needle manipulation techniques and may also gain much from the pharmacology section. At a price of £120 the book still provided excellent value for money and I would recommend its purchase by any department involved in spinal or intervention.
