Book Review -- By Steven Savoie, DC

Overall, this text is well organized and well written. The authors have efficiently integrated diagrams into the text, which enhances the understanding of the concepts presented.

In chapter 1, a brief but thorough review of the relevant anatomy is presented. It is not just presented as static structures, but shows how the various anatomical components interact to accomplish the numerous movements required in the lumbar spine and pelvis.

The author progresses to a chapter devoted to examination. I found this chapter refreshing. In keeping with Dr. Logan's concepts, the examination integrates the more traditional orthopedic and neurologic exam procedures with the functional exam (motion palpation and postural evaluation) conducted by chiropractors. The chapter concludes with a discussion of organic versus structural causes and an assessment of "hot low back" emphasizing the key diagnostic points in the patient's presentation.

Chapter 3 addresses diagnostic imaging of the low back and pelvis. Dr. Joseph Howe contributes this chapter. Dr. Howe's expertise in diagnostic imaging is well known throughout the chiropractic profession. Readers won't be disappointed. The pertinent information obtained from imaging studies is presented in a logical, consistent sequence. The various anomalies, lesions and traumatic insults to this area are discussed along with excellent examples located throughout the text.

Muscle testing is discussed and illustrated in chapter 4. Again the integration of appropriate diagrams assists the reader in understanding the concepts. Chapter 5 introduces Dr. Logan's approach to adjustive techniques. The author expresses his preference, and presumably Dr. Logan's, for more "aggressive," not forceful adjusting procedures while not denigrating low force procedures. There is a presentation of the basic concepts of diversified technique. The principles of effective adjustment are also discussed in a manner that takes the reader through the process of finding the subluxation and correcting it. Even experienced chiropractors can benefit from reading this section. Just as sports professionals periodically receive instruction in the fundamentals, doctors of chiropractic should periodically review the principles of delivering an effective adjustment. The various subluxations and their proper correction are presented again with appropriate illustrations.

The final chapter discusses exercise in the care of this important area. Although not a comprehensive review of the use of exercise, the depth of the discussion is appropriate to this text. There are also two appendices, the first on organic problems and the low back. The author discusses the Meric system, neurovascular dynamics and organ muscle relationships. Appendix B reviews briefly (in my opinion too briefly) physical therapeutics. If the presentation of this material does not adequately discuss indications and contraindications for these therapeutic modalities, it would be better not to be discussed at all.

Overall, I thoroughly enjoyed this text. It is pleasing to see traditional examination procedures so effectively blended with chiropractic examination procedures.

Savoie rating: 9.5 out of 10