During week three, the trainee will acquire foundational knowledge of spinal cord anatomy and physiology. The trainee will:

• Describe the basic anatomy of the spinal cord, including blood supply and organization of the motor and sensory tracts within the spinal cord
• Understand principles of intraoperative neuromonitoring for spine surgery including effects of physiologic and anesthetic factors.
• Discuss intraoperative management of patients undergoing spine surgery including airway management, analgesia, blood conservation strategies, and positioning concerns
• Understand presentation and pathophysiology of acute and chronic spinal cord injury and concerns for anesthetic management.

Anesthesia for Spine surgery

• Fellows’ and Residents’ Audio Corner – SNACC (Anesthesia for Spine Surgery, October 2016)
• Quiz 11: Anesthesia for Spine Surgery
• Quiz 51: Spine surgery and coexisting disease

Spinal Shock and Autonomic Hyperreflexia

• Quiz 15: Traumatic Spine Injury

Spine surgery: analgesic and blood conservation management

• Article: Non-opioid analgesics: Novel approaches to perioperative analgesia for major spine surgery (PMID: 27036605)
• Article: Perioperative Blood Conservation Strategies for Major Spine Surgery (PMID: 27036602)

Spine surgery: airway management in unstable spine

• Cervical Spine Injury PBLD
• Cervical Spine and Airway issue – Clinical Case
• Fellows’ and Residents’ Audio Corner – SNACC (Intubation of the Patient with Unstable Cervical Spine, February 2017)
• Expert Audio Corner: (October 2016, Airway Management of Cervical Spine)
• Article: Airway Management for Cervical Spine (PMID: 27036600)

Intraoperative neuromonitoring: basics and anesthetic influence

• Fellows’ and Residents’ Audio Corner – SNACC (Anesthesia for Neuromonitoring in Spine Surgery, October 2017)
• Fellows’ and Residents’ Audio Corner – SNACC (Neuromonitoring for Intracranial Surgery, January 2018)
• Intraoperative Neuromonitoring 1 – Clinical Case
• Intraoperative Neuromonitoring 2 – Clinical Case
• Expert Audio Corner (May 2016, Neuromonitoring)
• Article: Neuroanesthesia Guidelines for Optimizing TcMEP- Delphi Consensus Study (PMID: 32539292)

Posterior ischemic optic neuropathy

• Article: Update on Perioperative Ischemic Optic Neuropathy Associated With Non-ophthalmic Surgery (PMID: 30042726)
• Article: Practice Advisory for Postoperative Visual Loss 2019 (PMID: 22227790)

Supplementary Reading (SNACC Bibliography Collection) *The Bibliography Collection is currently under maintenance. 

• Postoperative Visual Loss articles
• Neurophysiologic Monitoring – Spine Surgery articles
• Spine Surgery