The author's case material is based on patients operated upon by the neurosurgical staff of the Massachusetts General Hospital over a period of 16 years. All patients had one or more spinal operative procedures. A thorough chapter on the observations of surgical wound infections leads directly to infectious complications after surgery of the spine.
The important aspect of preoperative diagnostic studies and the possible complications due to infections are not neglected. Here, as throughout, the author depicts most vividly the watchfulness necessary to guard against contamination during procedures which appear so "routine." This must be checked again and again with the sense of alertness for the possibility of a breakdown in sterile technique. The disastrous sequelae of infections of the spine—osseous, nervous, and mesenchymal—are presented.
Most welcome is the discussion of causes and prevention of sterile inflammatory reactions. Because of the emphasis in preventive measures, eg, ultraviolet radiation of the