Chiropractic Management of Spine Related Disorders

Edited by -- Meridel I. Gatterman, D.C.

Published by -- Williams & Wilkins
428 East Preston Street
Baltimore, Maryland 21202

Hardcover -- 437 pages

With the plethora of chiropractic texts that are flooding the market these days, it's difficult to sometimes determine which ones might be good and those which are merely a rehash of what's already been done. Since the saying that "there's nothing new under the sun" is most likely quite true, we are left only with the judgmental role of evaluating the quality of what is presented and its value to the profession.

As I've said so often before, I'm a working chiropractor. What I'm not is a specialist or an entrepreneur. This is the reason I feel so safe reviewing the vast amount of material that comes to "DC" for review. In other words, I represent the vast majority of the profession who are neither diplomates in a specialty or have something to sell. The things I review must be germane to my practice and must be presented in a manner consistent with this approach. Because of this, I can approach things without educational or financial bias. This -- after all -- is why film critics aren't actors.

That said -- to the business at hand. Chiropractic Management of Spine Related Disorders is an excellent text. From the title, one is prone to ask, has this all been said before and will there be something "new" for me to use? Of course I can't speak for everyone, but I am a voracious reader, therefore I'm acutely aware of these things I can personally use.

The text covers a lot of ground we might all be familiar with, but in a different package. Since the subjects covered are approached from the perspective of different authors, each chapter has a freshness seldom displayed in volumes of this nature.

Following the introduction, which gives an historical synopsis of manipulative procedures, is a chapter on the functional anatomy of the spine. While not in great depth, it serves as an excellent reference for both the student and busy field practitioner. Along with the text are some of the best illustrations I've seen in a long time.

While it won't take the place of White and Panjabi's classic text, the second chapter on the kinesiology and mechanics of the spine serves as an interesting crystallization of sound biomechanical principles.

This is followed, in turn, by a chapter on the principles of chiropractic in which the author draws upon both osteopathic as well as chiropractic research. Chapter IV is one of the most important because it covers both the complications and contraindications of spinal adjustive procedures. This is a subject that we don't address often enough. Anything that can be of value can be the reverse -- and as Hippocrates is quoted, "Primim non nocere."

The next of the volume's 15 chapters is on the application of a spinal examination, followed in order by chapters on chiropractic radiology, disorders of the pelvic ring, of the lumbar spine, the thoracic spine and the cervical spine.

Chapter 11 covers the postural complex followed by a chapter on muscle and myofascial pain syndromes. Chapter 13 was one of my favorites, dealing as it did with the use of physiological therapeutics in one of the most comprehensive ways I've ever had the pleasure of reading. This chapter is almost worth the price of the book.

It was chapter 14, however, that I was waiting for -- the one concerned with structure affecting function. This is a very difficult subject to cover without becoming too philosophically verbose or idealogically eccentric. The author of this chapter is to be congratulated for the professional manner in which the subject was developed. My personal belief is that structural integrity effects visceral function. If I didn't believe this I would consider myself little more than a technician. We are physicians who affect the function of the body via the neurovascular apparatus by specific adjustive procedures. This chapter reinforces such an hypothesis.

The last chapter acts as a testimonial to the validity of chiropractic therapeutics with all the preceding followed by an interesting glossary and the index.

You might say that Chiropractic Management of Spine Related Disorders is a digest version of much that we have been taught or learned through practice. Something like this is long overdue. It serves as an important reference for the student and doctor alike and has already taken an important place in my reference library. You've heard of "must get" books? This is one of them.

RHT