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Low Back Pain—Assessment and Management. by Dan M Spengler

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Low Back Pain—Assessment and Management. by Dan M Spengler J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.46.4.376 on 1 April 1983. Downloaded from 376 Book reviews concepts of "maturational delay" are most advance in terms of selectivity and fre- decessors. The anatomy is comprehensive often invoked. Ronnie would have been quency of unwanted effects. What has also and provides satisfying detail for both the especially disappointed by the last of these interested psychopharmacologists is the neuroanatomy student and the clinician. omissions but perhaps it was not discussed great variation in pharmacological effects Although it remains a predominantly because the queries he raised have yet to be between the new antidepressants. As yet anatomical text, it includes adequate answered and because there is little new to there is no satisfactory correlation between descriptions of related physiology, and report. The book deserves to be widely read their clinical effects and pharmacological where relevant, clinical topics are as much for the implicit unanswered actions but if it can be demonstrated that explained in brief vignettes. Some of these questions that arise, as for the wealth of they are effective antidepressants it shows are masterpieces of succinct, accurate and factual information it provides. that the old catecholamine hypothesis of illuminating writing. MICHAEL RUTTER affective disorders is untenable. In this vol- The clinical applications of anatomy and ume there is undeniable evidence that sev- physiology are explained for example in eral of the newer drugs are highly effective tests of vestibular function, visual fixation Low Back Pain-Assessment and Man- antidepressants, including bupropion, and muscle stretch reflexes. The correla- agement. By Dan M Spengler. (Pp 160; zimelidine, trazodone and mianserin. It is tions of syndromes with disturbed anatomy $24.00; £16-00.) New York: Grune and also clear that several other drugs have and physiology are shown in spinal cord Stratton Inc. 1982. interesting pharmacological effects consis- lesions, and in the brain stem infarcts which tent with their use of antidepressants but spawn so many eponyms. These are all There are too many books on backache their clinical efficacy is still not proven described with commendable clarity and which simply re-write standard teaching fully. These drugs include clovoxamine, brevity. A highlight of the book is a mul- and it is a pleasure to find an exception. sulpiride, viloxazine and amoxapine. The titude of superb, simple, line diagrams and Most books start with anatomy and disease book is a companion text to volume 31 of figures, each carefully conceived and label- and proceed to medical technology. Speng- the series; this is concerned primarily with led. ler starts with the patient and his pain and the mechanisms of action of antide- Any subject with such wide ramifications proceeds to clinical decision making and pressants. into preclinical and clinical disciplines problem solving, based on the evaluation Although there is no common theme to poses for the author a dilemma of achiev- of the whole patient. The medical tech- the book and a certain amount of overlap ing a judicious balance. To keep the text Protected by copyright. to nologist looking for the latest "up-to-date" between the individual contributions the a manageable length it is inevitable that treatment for backache may be disap- work described is right up to date and will some sections will receive but cursory men- pointed and this is not a book for be important reading for research workers tion: neurotransmitters and electro- orthopaedic surgeons preparing for an in the antidepressant field. Neuroendocrine physiology in this instance. But this is not a exam. It is, however, the thoughtful distil- aspects of depression are discussed in sev- criticism. The book takes as its expres- lation of long experience of dealing with eral chapters and illustrate the importance sed aim "providing a short but comprehen- the failures of conventional medical treat- of this productive field of enquiry. sive survey of the human nervous sys- ment for backache and contains many PETER TYRER tem ... written chiefly for the beginning apparently simple but fundamental con- student of neuroanatomy and cepts of how to treat patients rather than Manter and Gatz's Essentials of Clinical neurophysiology", and in this aim it suc- spines. It meets its claim of being clear, ceeds admirably. I would strongly recom- short and easily read- £16 and two hours. Neuroanatomy and Neurophysiology. Ed 6. By Sid Gilman and Sarah S Winans. (Pp mend this book both to undergraduates There are a few minor criticisms-the and to postgraduates training in clinical MMPI is a poor form of routine psycholog- 218; $16.25.) Philadelphia: FA Davis Company: 1982. neurology and neurosurgery. ical assessment and some of the radio- JMS PEARCE graphs are not clear on reproduction-but the whole book is well-planned, balanced Books of neuroanatomy have an unrivalled and well produced. I would unreservedly reputation for their ability to bore. This http://jnnp.bmj.com/ recommend this book to everyone who unfortunate and occasionally undeserved recognises-and even more strongly to slur probably derives from those drab 2nd those who fail to recognise-that their MB texts we all endured which provided a treatment of low back pain needs to be vast quantity of facts, often ill-digested, and improved. always apparently divorced from their G WADDELL functional and clinical contexts. Attempts to marry anatomy with its related subjects certainly leaven this burden. Typical and Atypical Antidepressants. Earlier editions of Manter & Gatz were on September 25, 2021 by guest. Clinical Practice. Edited by E Costa, Gior- eminently digestible, but were so sparing of gio Racagni. (Pp 400; $53.72.) New York, detail as to be of limited value. This sixth Raven Press: 1982. edition is written by Sid Gilman (well known to the British neurologists who have Although there is no evidence that any had associations with the Denny-Brown advance has been made to improve the school in Boston) and Sarah Winans, an efficacy of antidepressant drugs since they anatomist working in the same school of were first introduced in 1960 there is no Medicine in Michigan. It is altogether a doubt that the newer drugs represent some more substantial work than its early pre-.
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