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Neurosurgery. The Scientific Basis of Clinical Practice. Third edition
  1. RUPERT KETT-WHITE

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    Neurosurgery. The Scientific Basis of Clinical Practice. Third edition. Edited by crockard, hayward, and hoff (two volumes, £285.00). Published by Blackwell Science, Oxford, 1999. ISBN 0632048387.

    This two volume book is unique in providing a comprehensive overview of all the aspects of basic neuroscience relevant to the neurosurgeon. As such it can be regarded as an essential source of information for neurosurgical trainees around the world. The authors state in the foreword to this edition that their ambition was to “reflect in as up to date fashion as possible the expanding knowledge so essential both to trainees and established neurosurgeons alike if they are to base their clinical practice on a proper scientific basis.” They can be congratulated on fulfilling their objective with such a well presented and beautifully illustrated new edition. Although clearly intended for a neurosurgical readership, there are sections that would be valuable for practitioners in other disciplines, particularly neurologists, oncologists, and orthopaedic surgeons involved in spinal surgery.

    The third edition has expanded with the increased range of knowledge required by the clinical neurosurgeon. There are new and increased sections covering genetics, embryology, biomechanics, and measurement, bringing the total of chapters to 83 in 11 sections. An additional feature distinguishing it from the blue second edition is the handsome red cover, perhaps unconsciously reflecting changes in the political climate! Each chapter is very clearly laid out with an introductory outline, well structured headings, a summary, references, and a list for further reading. The manuscript is well proportioned, confining experts to present their knowledge in a concise manner in often quite short chapters. This means that the busy reader can quickly assimilate the aspects of importance.

    The devotion of a section to biomechanics appears justified. The field has expanded rapidly and is a field that contains concepts with which the neurosurgeon should, at the very least, be familiar. Knowledge of how the spine responds to forces after injury and following fixation is a prerequisite to planning treatment. This has been well described, with plenty of good illustrations and radiographic images.

    The chapters in the new section “Measurement and the Neurosurgeon” are welcome. They have been written in a fresh, understandable style that is kind to the reader and have been specifically targeted to the neurosurgeon. A thorough appreciation of assessment scales, outcome scores, statistical analysis, and study design is essential for those aiming to improve their management of patients by estimating the likelihood of success. Familiarity with outcome assessment is now expected not only by examiners, but is also increasingly necessary for clinical practice as doctors must justify treatments to patients and the institutions that fund healthcare.

    In summary, this book is an authoritative, relevant, and comprehensive account of the scientific basis for the clinical practice of neurosurgery. It can be highly recommended not only to those preparing for an examination but also to those who might find themselves on the other side of the table.

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