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mentioned in the previous chapter, there is no discussion of
what the long-term consequences of the use of metallic
hardware have on the growing child, particularly the very
young. The fifth deals with some of the more controversial
issues of the mechanical stabilization (atlantoaxial arthrod-
esis) of the pediatric atlantoaxial region. This chapter
outlines what the author considers to be the key issues of
atlantoaxial arthrodesis in children. These issues include the
clinical findings, management strategies, and the technical
details on the various operative techniques. Under the
patient evaluation section is a nice algorithm for the
treatment of atlantoaxial instability. Both conservative (ie,
nonsurgical) and surgical management plans are given for
the various types of instability. The author details here
some long-term follow up on the younger child with
mechanical C1-C2 screw fixation. In the 10-year experi-
ence, in children ranging from 18 months to 16 years, they
report no complications nor issues in growth around the
atlantoaxial region. Particularly useful for the pediatric
neurosurgeon is an extensive and well-illustrated section on
the operative technique for a C1-C2 transarticular screw
fixation. As the author points out, this is a particularly
complex and demanding technique and not for the faint of
heart! Having said that, the illustrations and technique
description are well done and easy to follow. Following up
on the previous chapter, the author now details the surgical
management of occipitocervical injuries. Included in this
chapter is the discussion of some of the complex issues that
neurosurgeons face in deciding on how to manage this
complex region (craniovertebral junction) of the spine.
Both surgical and nonsurgical management are discussed,
and then some of the newer fixation techniques are
discussed. Also provided in this chapter is a nice algorithm
for the treatment of occipitocervical instability. When
discussing cervicovertebral junction instability, various
scenarios are described along with further discussion on
the stability and reducibility of these lesions. Again, the
author here stresses that they have had little or no
complications to date in the use of mechanical instrumen-
tation for stabilization in the cervicovertebral junction
region. The various surgical approaches are nicely outlined.
The combined technique of using a C1-C2 transarticular
screw fixation coupled with an occipitocervical plate is
both well described and nicely illustrated. The final chapter
provides further surgical management details on the
cervical spine. Subaxial cervical injuries can be a partic-
ularly vexing problem in the pediatric spine. In these
situations, the neurosurgeon has to be prepared to adapt
both adult and pediatric principles in stabilization. The
author clearly outlines what he considers the major surgical
issues when dealing with the pediatric spine. Surgical
decision making is not easy, and the range of problems are
enormous! There is a nice discussion of some the available
plating systems along with the advantages and disadvan-
tages of each. The author also discusses the various surgical
approaches to the cervical spine: anterior, anterolateral,
posterior midline. The author includes some discussion on
the use of cable and wiring techniques along with various
graft materials.
Dr Brockmeyer and his coauthors are to be compli-
mented on taking on a complex task—the surgical
management of the pediatric cervical spine. This mono-
graph is well written and well illustrated. In addition,
critical issues unique to the pediatric spine are addressed,
although having said that, I look forward to a more long-
term follow up on the mechanically implanted pediatric
spine. Having now been in the craniofacial surgery business
for more than 20 years, I have become extremely disturbed
at the long-term complications of metallic and nonmetallic
implants that we have been using in the skull and facial
regions. Issues of migration, extrusion, and infection have
become major concerns over time. This book should be in
every neurosurgeon’s library. In addition, radiologists will
find this extremely helpful in understanding some of the
surgical principles and constructs. I think that pediatric
orthopedic surgeons would find this a most useful addition
to their libraries.
James T. Goodrich, MD, PhD, DSci (Hon)
Director and Professor
Clinical Neurological Surgery, Pediatrics, Plastic and
Reconstructive Surgery
Montefiore Medical Center
Bronx, NY 10467, USA
doi:10.1016/j.surneu.2006.02.007
Leonard Wood: rough rider, surgeon, architect of
American imperialismJ McCallum
New York7 University Press; 2005
ISBN #0-81-475699-9; hardcover 384 pp; $34.95.
Rating: ***
Recommended audience: neurosurgeons, neurologists, historians, active
duty and retired medical and line general officers (07 and above), and
foreign service officers.
The USS Leonard Wood was an attack transport ship
during World War II that earned 8 battle stars, serving in
both the Atlantic and Pacific theatres often delivering
troops and supplies straight into combat. After World War
II, the Leonard Wood was relegated to the scrap heap. The
irony of the story of the ship is that the tale of the life of
the man for whom the ship was named follows a similar
path—distinction followed by near oblivion. Were it not for
a US Army Fort in the Ozark Mountains of central
Missouri named after him and a NASCAR Hall of Fame
member with the same name, bLeonard WoodQ would be
truly unknown.
That Wood suffered for a number of years with a
parasagittal meningioma and was to some extent able to
disguise and overcome his seizure disorder and hemiparesis
is an interesting tale for the contemporary neurosurgeon
Book Reviews / Surgical Neurology 65 (2006) 525–528 527
accustomed to seeing patients so afflicted at a much earlier
stage of the clinical course. That our father figure Harvey
Cushing agonized over Wood’s postoperative death and the
arguably flawed decision to attempt complete tumor
removal in one stage instead of two reminds us that our
decisions involving surgical care profoundly affect the
outcome of our patients and that sometimes patient
preferences regarding expediency should be looked upon
with skepticism in the light of reasoned expectation and
experience with similar cases.
Our neurosurgical colleague Jack McCallum, MD, PhD,
has written a biography of Dr/Gen Leonard Wood,
chronicling the life of this 1884 graduate of Harvard
Medical School/Boston City Hospital. Wood received the
Medal of Honor for his service during the Apache Indian
Wars pursuing Geronimo along the US border with Mexico
and became the Chief of Staff of the US Army, the only
medical man ever to have done so. Wood served as the
commanding officer of the Rough Riders (one of whose
subordinate officers was Wood’s friend and president-to-be
Theodore Roosevelt) in Cuba during the Spanish-American
War. Wood facilitated Walter Reed’s yellow fever and
malaria mosquito work and served as military governor in
Cuba and the Philippine Islands. His admirable efforts in
public health and responsible governmental administration
in Cuba stand in contrast to his harsh, some might say
murderous, treatment of the mostly Muslim rebels in the
Moro district of the Philippines. Contemporary high-ranking
military officers, especially those considering political office
after military service and those hired as military bexpert Qtelevision commentators, might do well to review Wood’s
unsuccessful campaign for the Republican presidential
nomination in 1920 and his commentaries and diatribes
while in and out of uniform.
McCallum does a praiseworthy job with the subject
matter. The book is well written and well edited and
thoroughly researched and documented. The only negative
criticism is the absence of maps or diagrams of the
battlefields and surrounding geographies in which Wood
fought—the US-Mexico border, Cuba, and the Philippines.
Although McCallum is objective and does not speculate, we
are left to ponder what effect the brain tumor had on Wood’s
career and what part did it play in his shortcomings, which
became particularly apparent as the tumor progressed.
Howard Morgan, MD
Department of Neurosurgery
UT Southwestern
Dallas, TX 75390, USA
doi:10.1016/j.surneu.2006.01.009
Errata
TO THE READERSHIP: In Fibrous dysplasia of the clivus with a second T8 bone lesion: case report by Contratti et al
(Surg Neurol 2006;65:202), the name of the first author was misspelled. The correct spelling is Filiberto Contratti, MD.
DOI of original artilce 10.1016/j.surneu.2005.05.025doi:10.1016/j.surneu.2006.03.001
Note: Ratings indicate the book’s value to its intended audience, not its
overall quality. Therefore, a one-star rating means that, although the book
may be interesting and well-written, it is not necessarily an important
resource; a four-star rating indicates that the book is strongly recommended.
Book Reviews / Surgical Neurology 65 (2006) 525–528528