Biological Approaches to Spinal Disc Repair and Regeneration for Clinicians

Härtl R, Bonassar LJ. Biological Approaches to Spinal Disc Repair and Regeneration for Clinicians. Thieme; 2017; 216 pp; 94 ill; $149.99

Cover of Härtl

The book Biological Approaches to Spinal Disc Repair and Regeneration for Clinicians is an inclusive review of the anatomy and pathology of the spinal disc, as well as the treatment modalities and strategies for the various pathologies affecting intervertebral discs. The book is authored by a diverse group including orthopedic and neurologic surgeons, biomechanics engineers, and basic scientists studying musculoskeletal regeneration and neuromodulation.

This publication is divided into 4 major partitions, including 21 different chapters. The first partition of the book is entitled Basics and comprises 4 chapters that discuss the anatomy and physiology of normal spinal discs, the pathophysiology of disc degeneration, as well as the imaging and biomechanics of these structures. While this part of the book involves an exhaustive anatomic, biomechanic, and even biochemical review of the topic, the only part that is relevant to the neuroradiologist is the third chapter dealing with the imaging of both healthy and diseased intervertebral discs. However, while this particular chapter involves a good general review of the topic, it is mostly useful for clinicians at the training level—be it residents or fellows. On the other hand, this chapter lacks the depth and profundity that would make it of significant value for a seasoned neuroradiologist.

The second major partition of the book, entitled Experimental Techniques, is composed of 4 chapters that discuss the differences between human discs and their counterparts in animal models, the grading scales for disc pathology, in vitro approaches to disc regeneration, and whole organ cultures of spinal discs. The 1 chapter within this part that may be of some relevance to neuroradiologists is the one addressing the radiologic grading systems of degenerating intervertebral discs. However, as the authors correctly note, while these grading systems have been used for various clinical studies, they are of little clinical value because “[they] have so far not proven applicable to influence clinical decision making or predict clinical outcome.” Their use by neuroradiologists is therefore rather limited.

The largest of this publication’s major partitions is the third one, which is listed under the title Treatment Strategies. This very large partition, which is composed of 7 different chapters, is of virtually no value to the neuroradiologist. These chapters deal with biologic treatment, tissue engineering, and molecular biologic and biochemical pathways of disc regeneration. This part of the book is arguably the most fascinating and thought-provoking, as it discusses novel and state-of-the-art experimental ideas for the regeneration of intervertebral discs. However, it is of most value to a basic science research audience rather than to a clinical crowd.

The last major partition of the book is entitled Clinical Experience and is composed of 5 different chapters that discuss clinical trials for biologic treatment of spinal disease, disc transplant, disc replacement, the regulatory environment surrounding biologic therapies, and the translational research from bench to industry. These chapters are followed by a short, conclusive one composed as an Outlook on the future, with perspectives from around the word. Again, while of interest to various audiences, this partition is of little value to neuroradiologists. In fact, this partition could have involved an additional chapter on postsurgical imaging, discussing the various types of implants used by surgeons that are commonly encountered by the radiologists on postoperative imaging. Such a chapter would have proven to be of significant value for neuroradiologists and would have been the first of its kind in the medical literature.

Overall, Biological Approaches to Spinal Disc Repair and Regeneration for Clinicians is the most comprehensive book dealing with the pathology as well as the advances in research and treatment for degenerative disc disease. No other book has covered this topic with the same breadth and to the same degree. Furthermore, it comprises some of the latest research innovations and discoveries on that topic. The images are adequate and clearly labeled, with suitably descriptive legends. However, this book is of little value to neuroradiologists. Rather, it is most suitable for an academic audience of basic science and translational researchers who are interested in conducting benchside research and subsequently carrying it over to the industry in order to devise new therapeutic approaches to degenerative intervertebral discs.

Biological Approaches to Spinal Disc Repair and Regeneration for Clinicians
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