Dieter Grob It is the merit of the "Bone and Joint in view of the generally reduced Decade" to draw our attention with health situation of the involved - increased intensity to the problem of tients. The important role of the the changes related to aging of our biphosphonates in the treatment, and musculoskeletal system and the asso- perhaps even more so in the prev- ciated socioeconomic implications. tion, of osteoporosis is emphasized In view of the increasing age of the by Fleisch. worldwide population the impact Any successful surgical treatment seems to be tremendous. I congratu- starts with accurate diagnostic pro- late the editors of the present supple- dures. The profound knowledge and ment of the European Spine Journal sophisticated diagnostic techniques in picking up this interesting topic of the complex pathoanatomical and engaging opinion leaders to con- changes in the spine including the tribute their knowledge in this sup- involvement of the neural structures plement. The various contributions (contribution by Dvorak) often go cover some of the important prob- beyond the capacity of a spine s- lems, which are included in the vast geon. Teamwork and adequate c- specter of aging spine: osteoporosis, munication is mandatory.

Joint replacement is a logical step in the treatment of severe joint pathologies with irreversible lesions resisting conservative therapy. At the spinal level, arthrodesis became, very early, the gold standard of treatment for severe intervertebral disc pathologies. The next logical step was to envision functional replacement, and this step was taken as early as 1956, when the first intervertebral implant was described. However, it took many more years and a great variety of proposed implant designs before clinical applications could be attempted.

Low back pain is a very common problem that is increasingly being treated surgically. This book aims to evaluate carefully the possible surgical approaches to low back pain, with detailed appraisal of the factors leading to their success or failure. It begins by explaining the scientific basis for surgery and considering the different diagnostic techniques that may be employed, thereby elucidating the surgical rationale, indications, and contraindications. The value of conservative options is also assessed to help the reader weigh the need for surgery. The various surgical modalities, including the most recent, are then fully described and evaluated with the aid of numerous illustrations. The book concludes with a chapter devoted to evidence-based analysis of the outcome of surgery in patients with low back pain. This book will be invaluable to orthopaedic and neurosurgeons, rheumatologists, neurologists, and all who are concerned with the effective treatment of this often debilitating condition.