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John D. Loeser, MD, Department Editor
Reviewed by John D. Loeser, MD
D.R. Murphy (Ed.), McGraw-Hill, New York, 2000, 747 pages, $95 (hardcover), ISBN 0-8385-6386-4
This is a large-format, well-illustrated, and referenced book that covers most aspects of cervical spine diseases. Its editor and most of the chapter authors are chiropractors, but physicians, nurses, and psychologists also have contributed excellent chapters. The book covers most of the aspects of the anatomy, physiology, and pathology of cervical spine problems from the viewpoint of musculoskeletal medicine. The importance of treating the entire patient and not just seven cervical vertebrae and their associated structures is emphasized.
Yes, there are several chapters on chiropractic manipulation that many of us traditional physicians would question, but, on the whole, the book contains much useful information. The viewpoints in some chapters contrast markedly with those in others, but this happens in multiauthored texts. Some popular, but totally unproven, therapies receive attention that seems to be beyond the evidence for their utility. Attempts are made to review outcomes data, but, as everyone who has looked at any aspect of clinical practice realizes, very little of our traditional approaches to patient care can be based in outcomes data. There are several practical how-to-do-it chapters that are very well illustrated and can serve as guides to patient care. A chapter on vertebrobasilar stroke following chiropractic manipulation is a treasure-trove of information on a rare, but disastrous outcome of manipulation of the cervical spine.
The biopsychosocial model is espoused in a few chapters; others imply that all a person needs is good posture and ergonomics. The level of analysis in most chapters would make this a useful text for healthcare students and trainees. The chapters are all well referenced, and they can serve as the starting point for an in-depth literature search. This book demonstrates the continuing move by traditional medicine and chiropractic medicine toward each other. It is educational for most physicians to see how similar these disciplines are becoming.
John D. Loeser is professor of neurological surgery and anesthesiology at the University of Washington in Seattle.
