Spine

Curriculum

 

Basic Science (Regional)

Anatomy

Development of the spine, spinal cord and nerve roots

Anatomy and principles of surgical approaches: anterior and posterior at each level and endoscopic access

Physiology

Physiology of nerve function affecting the spinal cord and emerging nerves
Spinal shock and associated secondary problems

Pathology

The aging spine and degenerative disease
Acute and chronic infections of the spine
Metabolic conditions affecting the spine
Neurological conditions affecting the spine

Deformity
Congenital and acquired conditions causing deformity around the spine e.g. scoliosis and kyphosis

Pain
Causes of the acutely painful back, including referred pain e.g. acute prolapsed disc

Neoplasia
Primary and secondary tumours of the spine

Biomechanics & Biomaterials

Biomechanics of the cervical and lumbar spine

Spinal instability as applied to trauma, tumour, infection and spondylolysis/listhesis

Spinal deformity

Spinal instrumentation and internal fixation devices
Use of spinal bracing

Investigations

Radiological investigations (and their interpretation) used to assess common spine conditions
Role of diagnostic and therapeutic injections
Role of biopsy including routes and complications

Blood tests,

Electrophysiological studies (including cord monitoring)

Critical Conditions

Cauda equina syndrome
Spinal trauma – assessment, immediate care and appropriate referral
Infections e.g. tuberculosis
Important complications of inflammatory spinal conditions – rheumatoid instability and ankylosing spondylitis
Metastatic spinal cord compression
The painful spine in the child

Assessments

History and examination of the painful and injured spine including special clinical tests
Examinations of conditions causing referred symptoms to the spine (e.g. renal pain)
Recognition of somatisation
Assessment of patients after failed spinal surgery for deformity and reconstruction for non- degenerative disease

Treatments

Operative

Indications, options and complications for compressive conditions
Indications, options and complications of instability of the spine
Principles of management of tumours around the spine
Principles of management of deformity of the spine
Principles of the application of spinal bracing

Non-operative

Non-operative treatment of disorders ,such as low back pain, sciatica
Management of spinal fractures e.g. osteoporotic fractures
Principles of interventional radiology in the management of spinal problems
Initial and ward care of the paralysed patient

Complications

Management of failed spinal surgery
Management of consequences of delayed surgery