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Spine Curriculum
Anatomy and basic science

Anatomy

Ascending spinal tracts: spinothalamic, dorsal column, spinocerebellar, spinoreticular, spinotectal

Descending spinal tracts: corticospinal, reticulospinal, rubrospinal, vestibulospinal, tectospinal

Spinal roots: myotomes and dermatomes

Spinal vasculature: vertebral artery, anterior spinal artery, thyrocervical trunk, artery of Adamkiewicz

Biomaterials

Titanium, cobalt chrome, stainless steel, PEEK, ultra-high molecular weight polyethylene, surface coating

Bone morphogenetic proteins, hydroxyapatite, tricalcium phosphate

Biomechanics

Kinematics

Alignment: sagittal, coronal, axial; segmental, regional, global

Instrumentation: tension band, 3- and 4-point bending, cantilever beam

Physics: Young’s modulus, fatigue, durability, stiffness, axial load

Pathologic conditions

Congenital/Developmental

Split cord malformation, diastematomyelia, spina bifida, lipoma

Chiari, tethered spinal cord

Atlas assimilation, Klippel-Feil, butterfly vertebra

Neuroenteric cysts

Arachnoid cysts

Deformity

Spinal balance: SVA, Pelvic incidence, lordosis, kyphosis, coronal balance

Basilar invagination

Scoliosis: congenital, adolescent idiopathic, degenerative

Spondylolisthesis: Isthmic, degenerative, Meyerding grades

Degenerative

Disc disease: rupture, collapse, Scheuermann’s kyphosis

Osteoporosis, osteopenia, metabolic bone disease

DISH, OPLL, OLF

Central canal stenosis, lateral recess stenosis, foraminal stenosis

Radiculopathy, cervical spondylotic myelopathy, neurogenic claudication

Infection

Osteomyelitis: medical and surgical management

Epidural abscess: surgical management

Inflammatory/Immune

Rheumatoid arthritis

Ankylosing spondylitis

Sacroiliitis

Arachnoiditis

ALS, transverse myelitis, Guillaine Barre

Neoplasia

Primary benign tumors: hemangioma, LCH, osteoid osteoma, osteoblastoma, osteochondroma, aneurysmal bone cyst, giant cell tumor

Intramedullary tumors: ependymoma, myxopapillary ependymoma, hemangioblastoma, astrocytoma

Extramedullary tumors: nerve sheath tumors, meningioma

Primary malignant tumors: osteosarcoma, chondrosarcoma, chordoma, multiple myeloma, Ewing sarcoma

Metastatic spine tumors: Assessment of instability: scoring systems, SINS

Trauma

Spinal cord syndromes: anterior, central, posterior, Brown-Sequard

Classifications: ASIA, SLICS, TLICS

CVJ: Atlanto-occipital dislocation, occipital condyle fractures, C1C2 rotatory subluxation, Jefferson fracture, Odontoid fractures, Hangman fractures

Vertebral injuries: burst, compression, teardrop, chance

Facet injuries: unilateral dislocation, bilateral dislocation, perched, fracture

Sacral fractures

Vertebral artery injuries

Spinal shock

Vascular

Spinal AVMs

Spinal AV fistula

Infarcts

Clinical evaluation

Decision-making: nonsurgical and surgical treatment options

Examination

Physical examination

Imaging: radiographs, CT, MR, radionuclide bone scan, DEXA scan

Laboratory: ESR CRP, HLA B-27, Vitamin D

Electrophysiology: EMG, NCV, SEP

Intraoperative monitoring: MEP, SEP, spontaneous and triggered EMG

Surgical techniques

Posterior approaches

Decompressive: Laminectomy, laminoplasty, foraminotomy

Osteotomies: Ponte, pedicle subtraction

Fusion: Spinous process, laminar, facet, transverse process PLIF, TLIF

Lateral approaches

Decompressive: transpedicular, costotransversectomy

Fusion: LLIF

Anterior approaches

Decompression/Fusion: ACDF, ACCF, ALIF, OLIF

Arthroplasty: cervical, lumbar

Anterior osteotomy

Vertebral column resection

Instrumentation

Occipital cervical, C12, anterior odontoid screw

Subaxial cervical: interbody grafts and cages, standalone cages, anterior plates, lateral mass screw rod fixation, cervical pedicle fixation, cable techniques

Thoracolumbar: Cages, hooks, screws/rods, interspinous spacers

Pelvis: screw/rod fixation, SI joint fusion fixation

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Spine Curriculum

The Society of Neurological Surgeons