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Spinal instrumentation: Surgical techniques

Over the last two decades Spinal Surgery as a subspecialty has developed and transformed beyond recognition. As well as modifications of older operative techniques, new innovative and minimally invasive procedures have flourished. In part this is due to better operative equipment and image guidance, the operating microscope, better understanding of biomechanics and disease processes. The greater part however is as a result of huge, huge advances in spinal instrumentation. This is the subject matter of this unique text: Spinal Instrumentation. The editors have called upon either the inventors of a particular implant or those with expertise to provide a clear detailed description of the instrumentation, its application, its limitations and the equipment and techniques needed to implant. Alongside this there are tips on operative technique, complications and their avoidance and within each section an excellent review of operative anatomy and surgical approaches. The text however does not address what one may term the evidence base: Evidence either that such instrumentation is needed or whether one technique is superior to another. This of course, is more a reflection of the activities of the spinal implant surgical fraternity rather than an omission by the authors. Each available spinal implant is reviewed! It is a big and heavy textbook! The chapters are set out in similar format: Highlights, Indications and Contraindications, Operative Technique to Complications and Avoidance and Discussion. This standardization of the chapters particularly helps when comparing implants. Further, without fail the chapters are well written, beautifully and copiously illustrated and broadly referenced. In my opinion this is an excellent and long overdue publication. It unravels the complexity of the variety of implants available chapter by chapter and will be a treasure to both trained and trainee spinal surgeon. I promise you it will not disappoint.