endoscopic spine surgeryKim DH, Choi G, Lee S, et al. Endoscopic Spine Surgery. 2nd ed. Thieme 2018; 512 pp; 1,095 ill; $189.99

Endoscopic Spine Surgery begins by effectively and succinctly making the case for the current importance of endoscopic spine surgery and the impact it promises to have on the field of spine care and the healthcare system more broadly. Despite being in its developing stages, the shorter hospital stays and earlier functional recovery that the techniques are able to provide create benefits for patients and the ever cost-conscious physicians and payors. The intended audience is clearly stated to include surgeons, fellows, and residents who care for spine pathology. It is also recommended to other practitioners and stakeholders who are affected by the implications of the techniques described such as nurses, physical therapists, and even medical device professionals.

Organized anatomically with dedicated sections describing applications in the lumbar, thoracic, and cervical spine, the reader is able to remain within the framework of anatomic considerations and pathophysiology that is unique to each region. The most common location for the application of endoscopic techniques, the lumbar spine, is the focus of over half of the text. Each anatomic section begins with a chapter elaborating on applied anatomy and percutaneous approaches. By familiarizing the reader with the basics of operating endoscopically in each region, an appreciation of the advantages and limitations of specific techniques is established.

Each subsequent chapter contains a comprehensive description of a specific endoscopic procedure, accomplished with bullets as opposed to narrative text. This results in easy visual access of information in a stepwise format and complements the procedurally-based global organization. A brief historical review is included to provide context for the pathology being treated and the nuances of the technique to be applied. Surgical indications, preoperative imaging, patient positioning, devices used, surgical approach as well as postoperative care and pitfalls to beware of are all explained.
The voice of each chapter’s author shines through the text, offering specific tips and tricks built by personal experience. While a cursory review may deem inclusion of such practical case-specific details in each chapter repetitive, it allows the reader to internalize subtle differences that influence the optimal execution of each procedure.

Also included are several chapters dedicated to novel devices employed in endoscopic spine surgery, of which a surgeon not familiar with the techniques may not possess a working understanding. These devices include the ultrasonic bone dissector, video telescope operating monitor, and three-dimensional stereo-tubular device. Endoscopic spine-specific applications of more well-known instruments are explained in depth within specific chapters.

The images used are of high quality and include medical drawings, intraoperative photographs, endoscopic images, and advanced imaging. These modalities are often presented together to allow for spatial correlation. Displayed in color, they are labeled within the images themselves when appropriate, and in a majority of cases referenced, within the text on the same page to enable seamless visual enhancement. Legends are adequately descriptive to allow for understanding of each image’s purpose without directly referencing the chapter’s text. Video supplements are also provided on a website easily accessible via instructions and access code provided with the physical text. They offer an abundance of engaging content that practically reviews the concepts and procedural steps of most chapters.

As much of the book is presented in the format of a technical review, the bulk of material presented is without direct reference. However, the concise reviews are sourced from scholarly articles published in reputable and high-impact journals. Many landmark papers are used when presenting descriptions of the development of specific techniques and relevant anatomic data. The breadth of cited references has an international scope and in many cases have been published within the last 5-10 years.

The teaching value of this text is superb. A broad theoretical overview of the applications of endoscopy to the spine surgeon is provided; in addition to all-inclusive descriptions of specific techniques from start to finish. The reader not only learns how to perform these procedures, but also comes to appreciate their context, learning the ideal patient for whom to offer them as well as for whom they should be avoided. A high level of accuracy is apparent; this text simply embodies the state-of-the-art. It enlists a large number of international contributors who in their own right have individually established themselves as pioneers in this burgeoning field. The editors are recognized as experts and innovators in minimally invasive techniques. Endoscopic spine surgery as topic is covered comprehensively; any reader would be hard-pressed to scour the literature for a technique that has not made its way into the text.

An attempt to compare this book to others on the subject is met with the challenge of finding any other published work that equals its focus. A search of Google Books on the topic yields no other texts that exclusively review the applications of endoscopy for spine surgery. There are many textbooks reviewing minimally- invasive spine surgery that make mention of endoscopy, though these inclusions are cursory in comparison. With a simple and decidedly fitting title, Endoscopic Spine Surgery represents the exclusive and definitive treatise on the subject, unrivaled in its level of comprehensiveness, detail and practicality.

 

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