Master spine imaging,
one case at a time.
An imaging-first, adaptive question bank for orthopaedic and neurosurgery residents. Real scans, succinct vignettes, a per-topic Spine Score that climbs as you learn — and AI-coached explanations that anchor every answer in the underlying pathophysiology.
What's coming
5 questions already in the bank, with more being added daily.
What you'll learn
The curriculum maps every pathology a spine fellow needs to recognise on imaging. Each topic breaks down into specific subtopics — disc herniations, classifications, cord syndromes, tumor types — with targeted question counts per training level.
Degenerative
13 subtopicsDisc pathology, spondylolisthesis, stenosis, myelopathy, instability.
- Lumbar disc herniation
- Cervical disc herniation
- Lumbar spinal stenosis
- Cervical myelopathy
- +9 more
Trauma
14 subtopicsClassifications (AO, SLIC, AS), unstable injuries, SCI, sacral fractures.
- AO thoracolumbar classification
- Thoracolumbar burst fracture
- Chance / flexion-distraction injury
- Thoracolumbar translational / Type C injury
- +10 more
Deformity
9 subtopicsPediatric + adult spinal deformity, sagittal balance, kyphosis.
- Adolescent idiopathic scoliosis (AIS)
- Early-onset scoliosis
- Neuromuscular scoliosis
- Adult degenerative scoliosis
- +5 more
Malignancy
12 subtopicsMetastatic disease, primary tumors, intradural lesions, scoring systems.
- Metastatic spine disease
- SINS (spinal instability neoplastic score)
- Tokuhashi / Tomita prognostic scores
- Metastatic epidural cord compression
- +8 more
Infection
5 subtopicsVertebral osteomyelitis, epidural abscess, tuberculous spondylitis.
- Pyogenic vertebral osteomyelitis / discitis
- Spinal epidural abscess
- Tuberculous spondylitis (Pott's disease)
- Postoperative spine infection
- +1 more
Congenital
8 subtopicsDysraphism, tethered cord, craniocervical anomalies, congenital scoliosis.
- Spina bifida occulta
- Myelomeningocele
- Tethered cord syndrome
- Diastematomyelia / split cord malformation
- +4 more
Built for every level
Each case is authored at a specific tier and complexity. The adaptive engine serves you questions in your stretch zone — hard enough to teach, not so hard you stall.
Foundational
PGY 1–2Identify the level. Name the bone. Spot the obvious finding. Build the visual vocabulary before the clinical reasoning has to land on it.
Senior
PGY 3–5Diagnose from imaging plus vignette. Pick the next imaging study. Choose the initial management. Decide when to escalate to the staff.
Expert
FellowOperative planning. Approach selection given comorbidities. Classification subtleties, complications, salvage decisions, sagittal balance.
Try a sample case
This is exactly how the bank works — imaging on the left, vignette and answer choices on the right, per-option rationale and a teaching point the moment you submit. Pick an answer and see it in action.
Illustration — real cases use clinical imaging.
A 32-year-old presents with three days of severe low back pain that radiates down both legs. Over the last 12 hours she has developed urinary retention and numbness across the perineum and inner thighs. On exam, ankle reflexes are absent bilaterally; perianal sensation is reduced. The sagittal T2-weighted MRI is shown.
The problem we're solving
Orthopaedic and neurosurgery residents — and the spine fellows following them — are routinely tested not just on what to do about a spine problem, but on whether they correctly recognised the pathology in the first place. In our experience, the failures on Royal College and fellowship examinations disproportionately happen at the diagnostic step, not the management step. Trainees track down the wrong reasoning pathway because they misread the imaging.
Toronto Spine Education is built around that exact gap. Every case starts with a real scan. Every distractor is what an under-prepared resident would actually pick. Every explanation anchors back to what the imaging shows. We're actively developing the bank so the next cohort of trainees walks into their examinations with the diagnostic step already automated.
About Dr. Oitment
Orthopaedic Spine Surgeon · Scarborough Health Network · University of Toronto
Dr. Colby Oitment is heavily involved in resident and fellow education at Scarborough General Hospital. He teaches Family Medicine residents the foundations of MSK and neurological examination — including a focused spine teaching block — and works with Orthopaedic Surgery residents on the spine content they need for Royal College preparation.
He is Program Director of the Adult and Pediatric Complex Spine Fellowship Program at Scarborough General Hospital, and the Scarborough site lead for the University of Toronto Spine Fellowship's Area of Focused Competence (AFC) program.
This question bank is an extension of that teaching practice — built from the cases that come up on rounds, in clinic, and on examinations, and shaped by what trainees consistently struggle to recognise on imaging.