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The ability of the healthcare systems in the United States to generate new ideas, new technology, and new resources for clinical care never fails to astound those of us who have spent most of our working lives in a cash strapped British system, underresourced and overwhelmed with patients and pathology. The innovative potential of the American system is partly a reflection of sheer numbers of doctors involved in medical care in the United States. In neurosurgery alone there are more neurosurgeons in New York City than there are in the whole of the United Kingdom. However, another factor, and perhaps a more important one in this context, is that this large concentration of medical talent operates in a true market and must compete for market share. One of the effects of the application of market forces to the practice of neurology and neurosurgery in America is the proliferation of books of this type. It is perhaps symptomatic that in the introduction the authors, who are both members of the UCLA Medical School, advertise the courses which they run and on which the material for this book is based. The introduction also contains an email address, a web site address, and the names and addresses of suppliers of CD roms of the content of the book. As practitioners on both sides of the Atlantic have discovered. one of the best methods of advertising in medicine is to publish. As in other markets, for such medical advertising to be successful it is usually necessary for the advertising material to be obviously “state of the art”, “glossy”, and the title and content should be appropriately “sexy”. This book fulfils these criteria on all counts. Minimally invasive therapy is currently “sexy” and is thus a field of endeavour ripe for “niche” marketing. However, despite its “state of the art” pretensions, in the neurosciences minimally invasive therapy has a long and illustrious history. The stereotaxic technique was first described by Horsley and Clarke in 1908 and was first applied to patients in 1947 by Speigel and Wycis. Similarly, neuroendoscopy was first performed by Dandy in 1922. Although minimally invasive techniques in neurosciences have been around for a very long time indeed; what is new is the marriage of these techniques to modern imaging and computing technology. If the application of information technology in other fields is anything to go by an explosion of new developments in this field can be expected. Although there is little which is completely new in the book, it does provide a useful overview of the various areas where such techniques are beginning to be applied and it will be interesting to see how a second or third edition might look. Beautifully produced, the text is readable, the illustrations lavish, and the references provide a reasonable overview of the current literature. It represents a useful addition to the departmental library.
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