Knowledge Domain

I. Foundation Knowledge

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Learning objectives concerning: development and anatomy

  1. Learner will be able to describe the normal embryologic development and growth of the spine and neural axis and their relation to function.
  2. Learner will be able to describe changes in spine and related structures (including lung and thoracic cage) when altered by aging and/or pathology.
  3. Learner will be able to identify basic anatomy, biomechanics and alignment (including 3-dimensional alignment) of the spine.
  4. Learner will be able to list the major etiological factors and describe the biomechanical principles of spinal deformities.
  5. Learner will be able to specify the importance of epigenetics in the development of spine pathologies. Learner will be able to describe the biology, physiology and biomechanical principles of bone growth and healing including the physes.

Learning objectives defining and identifying: clinical and radiological parameters; patient health related quality of life (HRQoL) and guiding the treatment decision making process

  1. Learner will be able to perform a comprehensive history and physical examination of the patient presenting with spinal deformity.
  2. Learner will be able to perform appropriate radiographic measurements to assess curve pattern, magnitude and flexibility including 3D assessment.
  3. Learner will be able to describe current validated tools for HRQoL assessment including their reliability and responsiveness.

Learning objectives concerning: Defining, formulating and recommending treatment options, considering safety, and predicting outcomes and potential complications

  1. Learner will be able to describe the goals and general principles of conservative treatment modalities for spinal deformities.
  2. Learner will be able to describe bone physiology and healing, how they apply to bone fusion and to discuss the advantages and disadvantages of the available bone grafting materials and substitutes.
  3. Learner will be able to describe the basic biomechanics of spinal implants.
  4. Learner will be able to demonstrate appropriate patient counseling and ability to obtain informed consent.
  5. Learner will be able to describe the use of safety checklists (e.g., surgical site infection) and other safety measures for minimizing complications in spinal deformity surgery.
  6. Learner will be able to describe principles of managing blood loss in spinal deformity surgery.
  7. Learner will be able to describe the advantages and disadvantages of current modalities for neuromonitoring and response algorithms.

Citations

  1. State of the art review: Vertebral Osteotomies for the management of Spinal Deformity
    a, A.S., Cerpa, M. & Lenke, L.G. State of the art review: Vertebral Osteotomies for the management of Spinal Deformity. Spine Deform 8, 829-843 (2020). https://doi.org/10.1007/s43390-020-00144-y

Chapters

Perioperative Pain Control Considerations

Authors: Michael D. Kelly, MD; Serena S. Hu, MD

Perioperative Nutrition Assessment and Optimization

Authors: Michael P. Kelly, MD; Serena S. Hu, MD

Anterior Surgery of the Thoracic and Lumbar Spine: Principles, Approaches and Technical considerations

Authors: Jwalant S. Mehta; Peter O. Newton; Robert W. Gaines, Jr

The Embryological Development of the Human Spine

Authors: John R Dimar II,, MD Naveed Nabizadeh, MD

Bone Grafting and Interbody Fusion Devices for Spinal Deformity Treatment

Authors: Aidin Kashigar MD, John R. Dimar II, MD

Anesthesia for Adult Spinal Deformity Surgery, including Malignant Hyperthermia

Authors: Kimona Issa MD, John Dimar MD, James Sanders MD, Jeff Gum MD

Navigation in Spinal Deformity Surgery

Authors: Christina K. Hardesty, MD

The Management of Durotomies and Cerebrospinal Fluid Leaks in Spinal Deformity Surgery

Authors: Brian A. O'Shaughnessy, M.D.; Lawrence G. Lenke, M.D.

Spine Embryology, Growth, Development and Genetics

Authors: Sarwark, John F.; Wichman, Matthew P.

Bone Grafting

Authors: Polly, David W.; Yson, Sharon; Sembrano, Jonathan; Santos, Edward

Principles of, Indications for, and Responses to Changes in Neuromonitoring

Authors: Branigan, Timothy D.; Roach, James W.

Anesthesia for Spine Deformity Surgery, including Malignant Hyperthermia

Authors: Sanders, John

Spinal Fixation with Hook, Screw, and Wire Anchorage for the Posterior Occipital, Cervical, Thoracic, and Lumbar Regions of the Spine

Authors: Louie Philip K..; Shimer, Adam l. ;Albert, Todd J

Anterior Exposures to the Thoracic and Lumbar Spine

Authors: Newton, Peter O.

Posterior Thoracic, Lumbar, and Sacral Anatomy and Surgical Approaches

Authors: Arlet, Vincent; Hamilton, D. Kojo; McKisic, M. Sean;Sansur, Charles A.

Management of Neurologic Complications in Spinal Deformity Correction

Authors: Sugrue, Patrick A.

Posterior Vertebral Column Resection (VCR)

Authors: Lenke, Lawrence G.

Perioperative Blood Management: Spinal Deformity Surgery

Authors: Franzone, Jeanne M.; Roye, David P.

Immediate and Postoperative Complications of Spinal Deformity Surgery

Authors: Arlet, Vincent; Hicks, John

Biomechanics of Spinopelvic Fixation

Authors: Mehbod, Amir A.; Transfeldt, Ensor E.; Wu, Chunhui W.

Clinical Biomechanics of the Spine

Authors: Caruso, Steven; Haher, Thomas R. Evan Belanger, Ross Moquin

Osteotomies: Smith-Petersen, Pedicle Subtraction

Authors: Bridwell, Keith