const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");

const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE";
pres.title = "Spine Anatomy – Radiological Teaching";
pres.author = "Radiology Teaching";

// ── PALETTE ──────────────────────────────────────────────────────────────────
const BG       = "0D1B2A";   // deep navy – dominant (60 %)
const PANEL    = "1A2E45";   // mid-navy panel
const ACCENT   = "00C2CB";   // teal accent
const ACCENT2  = "E8C84A";   // amber highlight
const TEXT_WH  = "FFFFFF";
const TEXT_LT  = "C8DCF0";
const TEXT_ACC = "00C2CB";
const GREY     = "4A6880";

// ── HELPERS ──────────────────────────────────────────────────────────────────
function addBg(slide) {
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: "100%", h: "100%",
    fill: { color: BG }, line: { color: BG }
  });
}

function slideTitle(slide, text, sub = "") {
  slide.addText(text, {
    x: 0.35, y: 0.18, w: 12.6, h: 0.55,
    fontSize: 26, bold: true, color: TEXT_WH, fontFace: "Calibri",
    charSpacing: 1
  });
  if (sub) {
    slide.addText(sub, {
      x: 0.35, y: 0.73, w: 12.6, h: 0.32,
      fontSize: 13, italic: true, color: ACCENT, fontFace: "Calibri"
    });
  }
  // accent bar
  slide.addShape(pres.ShapeType.rect, {
    x: 0.35, y: 0.15, w: 0.07, h: 0.55,
    fill: { color: ACCENT }, line: { color: ACCENT }
  });
}

function panel(slide, x, y, w, h, color = PANEL) {
  slide.addShape(pres.ShapeType.rect, {
    x, y, w, h,
    fill: { color }, line: { color: ACCENT, transparency: 60 }, rectRadius: 0.06
  });
}

function bulletBox(slide, items, x, y, w, h, opts = {}) {
  const rows = items.map((item, i) => ({
    text: item,
    options: { bullet: true, breakLine: i < items.length - 1, fontSize: opts.fontSize || 13.5, color: opts.color || TEXT_LT, fontFace: "Calibri" }
  }));
  slide.addText(rows, { x, y, w, h, valign: "top", margin: 8 });
}

function label(slide, text, x, y, w, h, opts = {}) {
  slide.addText(text, {
    x, y, w, h,
    fontSize: opts.fontSize || 12, color: opts.color || TEXT_ACC,
    fontFace: "Calibri", bold: opts.bold || false,
    align: opts.align || "left", italic: opts.italic || false,
    valign: opts.valign || "middle"
  });
}

function fetchImages(urls) {
  try {
    const result = execSync(
      `node /home/daytona/skills/shared/scripts/fetch_images.js ${urls.map(u => `"${u}"`).join(" ")}`,
      { timeout: 60000 }
    ).toString();
    return JSON.parse(result);
  } catch (e) {
    console.error("Image fetch error:", e.message);
    return urls.map(() => ({ base64: null, error: e.message }));
  }
}

// ── FETCH ALL IMAGES ──────────────────────────────────────────────────────────
const imgUrls = [
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_23210f2872e8ac476534b362b587a1aad1c5f00d65dd836a78c1b89b858f7938.jpg",  // [0] vertebral column 3 views
  "https://cdn.orris.care/cdss_images/HARRISON_1763030928029_1575d48d-4f35-4bd0-9ab6-f32804998a9e.png",                           // [1] Harrison vertebral column
  "https://cdn.orris.care/cdss_images/475ea684fbb4e0e8121f1ffd62b2ca8145435ba7966370ec223366a2d7b88123.png",                       // [2] Bone marrow MRI (Fig 47.1)
  "https://cdn.orris.care/cdss_images/348b06d646c028e91b3814e44614849e06dada6d74f2dd37137b778920a7b82a.png",                       // [3] Plain film anatomy (Fig 47.2)
  "https://cdn.orris.care/cdss_images/00a4aead77ebf47b39c1aca28eb1ad8add183f18e57c7ed24c6c65336cccba8a.png",                       // [4] CT lumbar anatomy (Fig 47.3)
  "https://cdn.orris.care/cdss_images/961d0197c9a56527e1d71df11247d0c057f81de757ee0c91346b9f5df94100c4.png",                       // [5] Spinal ligaments MRI (Fig 47.5)
  "https://cdn.orris.care/cdss_images/d386cddbf2cfc5772e6cbe001a908f9e4125c944d6643c77f5a07037424dfd66.png",                       // [6] Ligamentum flavum (Fig 47.6)
  "https://cdn.orris.care/cdss_images/5d9baf1ced0754e8465fe3d578cfafc55d0b004013f57b8646b213bd2e3d900d.png",                       // [7] Cervical spine alignment (Fig 52.1)
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_f012224920ebf78e83464c17ad63ddea46dc84d65de5092b75ccc7e783162472.jpg",  // [8] CT facet angle + pedicle screws
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_383b0c8ab6906b6bec25243d7441aa81e7b9a6747afeaa8b422238afc803822a.jpg",  // [9] Axial MRI L4-L5 facet joints
];

console.log("Fetching images…");
const imgs = fetchImages(imgUrls);
console.log("Images fetched:", imgs.map((i, idx) => `[${idx}] ${i.error ? "ERR:"+i.error : "OK"}`).join(", "));

function img(slide, idx, x, y, w, h) {
  if (imgs[idx] && imgs[idx].base64 && !imgs[idx].error) {
    slide.addImage({ data: imgs[idx].base64, x, y, w, h });
  }
}

// ══════════════════════════════════════════════════════════════════════════════
//  SLIDE 1 — TITLE
// ══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s);

  // Dark gradient panel left
  s.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 8.5, h: 7.5,
    fill: { color: PANEL }, line: { color: PANEL }
  });

  s.addText("SPINE ANATOMY", {
    x: 0.5, y: 1.2, w: 7.5, h: 1.2,
    fontSize: 58, bold: true, color: TEXT_WH, fontFace: "Calibri",
    charSpacing: 4
  });
  s.addText("RADIOLOGICAL TEACHING", {
    x: 0.5, y: 2.4, w: 7.5, h: 0.6,
    fontSize: 24, bold: false, color: ACCENT, fontFace: "Calibri",
    charSpacing: 8
  });
  s.addShape(pres.ShapeType.rect, {
    x: 0.5, y: 3.1, w: 3.5, h: 0.06,
    fill: { color: ACCENT2 }, line: { color: ACCENT2 }
  });

  const tlBullets = [
    "Vertebral column overview & regional anatomy",
    "Bony architecture: body, neural arch, processes",
    "Joints: facet joints, intervertebral discs",
    "Ligaments of the spine",
    "Neural structures & vascular supply",
    "Craniocervical junction",
    "Imaging modalities & interpretation",
  ];
  s.addText(tlBullets.map((t, i) => ({
    text: t,
    options: { bullet: { type: "number" }, breakLine: i < tlBullets.length - 1, fontSize: 14, color: TEXT_LT, fontFace: "Calibri" }
  })), { x: 0.55, y: 3.4, w: 7.2, h: 3.2, valign: "top", margin: 6 });

  s.addText("Source: Grainger & Allison's Diagnostic Radiology", {
    x: 0.5, y: 6.9, w: 7.5, h: 0.3, fontSize: 11, italic: true, color: GREY, fontFace: "Calibri"
  });

  // Right column – spine diagram
  img(s, 0, 8.7, 0.3, 4.5, 6.9);
  s.addText("Vertebral column – AP, Lateral & Posterior views", {
    x: 8.7, y: 7.1, w: 4.5, h: 0.3, fontSize: 10, color: GREY, italic: true, fontFace: "Calibri", align: "center"
  });
}

// ══════════════════════════════════════════════════════════════════════════════
//  SLIDE 2 — VERTEBRAL COLUMN OVERVIEW
// ══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s);
  slideTitle(s, "Vertebral Column Overview", "Regions, curvatures and clinical significance");

  // Regions table
  panel(s, 0.35, 1.1, 5.8, 5.8);

  const regionData = [
    ["Region", "Vertebrae", "Curvature", "Key Feature"],
    ["Cervical", "C1–C7", "Lordosis", "Most mobile; atlas & axis"],
    ["Thoracic", "T1–T12", "Kyphosis", "Rib articulations"],
    ["Lumbar", "L1–L5", "Lordosis", "Largest bodies; weight-bearing"],
    ["Sacrum", "S1–S5 (fused)", "Kyphosis", "Posterior pelvic wall"],
    ["Coccyx", "3–5 fused", "—", "Vestigial; coccygeal plexus"],
  ];
  s.addTable(regionData, {
    x: 0.5, y: 1.25, w: 5.5, h: 2.8,
    border: { pt: 0.5, color: ACCENT, transparency: 60 },
    fill: PANEL,
    color: TEXT_LT,
    fontSize: 12.5,
    fontFace: "Calibri",
    align: "left",
    rowH: 0.43,
    firstRow: true,
    firstRowFill: { color: ACCENT },
    firstRowColor: BG,
    firstRowFontBold: true,
  });

  s.addText("Key Clinical Points", { x: 0.5, y: 4.15, w: 5.5, h: 0.35, fontSize: 14, bold: true, color: ACCENT2, fontFace: "Calibri" });
  bulletBox(s, [
    "33 vertebrae total (7C + 12T + 5L + 5S + 4 coccygeal)",
    "S-shaped curvature essential for upright posture & shock absorption",
    "Cervical & thoracolumbar junctions are most vulnerable to injury",
    "Vertebrae increase in size inferiorly to accommodate greater loads",
  ], 0.5, 4.55, 5.5, 2.2, { fontSize: 13 });

  img(s, 1, 6.4, 1.0, 6.8, 6.3);
  s.addText("Anterior and lateral views — vertebral column (Harrison's)", {
    x: 6.4, y: 7.2, w: 6.8, h: 0.25, fontSize: 10, color: GREY, italic: true, fontFace: "Calibri", align: "center"
  });
}

// ══════════════════════════════════════════════════════════════════════════════
//  SLIDE 3 — VERTEBRAL BODY
// ══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s);
  slideTitle(s, "Vertebral Body", "Structure, bone marrow & radiological appearance");

  // Left content
  panel(s, 0.35, 1.1, 6.0, 6.1);
  label(s, "Bony Architecture", 0.5, 1.2, 5.7, 0.35, { fontSize: 14, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "Thin cortical rim + predominantly vertical trabecular framework",
    "Central framework stores phosphate & calcium and provides structural support",
    "Sclerotic bands at fusion sites (e.g. neurocentral junction, dens axis)",
    "Vascular channels visible on CT — can mimic fractures post-trauma",
    "Optimal evaluation: CT (cortex/trabecular) | MRI (marrow)",
  ], 0.5, 1.6, 5.7, 2.2, { fontSize: 13 });

  label(s, "Bone Marrow (MRI)", 0.5, 3.85, 5.7, 0.35, { fontSize: 14, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "Centre composed of red (haematopoietically active) marrow",
    "Normal adult distribution reached by age 25; yellow marrow increases with age",
    "Ricci patterns (T1-weighted MRI):",
    "  • Type 1: Uniform low signal + linear high signal around basivertebral vein (age ≤30)",
    "  • Type 2: Band-like high T1 periphery (age >40)",
    "  • Type 3: Multiple small indistinct high T1 foci throughout body",
    "  • Type 4: Multiple larger (5–15 mm) high T1 foci — advanced aging",
  ], 0.5, 4.25, 5.7, 2.8, { fontSize: 12 });

  img(s, 2, 6.6, 1.1, 6.6, 5.6);
  s.addText("Fig. 47.1 — Age-related bone marrow changes. Sagittal T1 MRI.\nA = 23 y (Type 1) | B = 44 y (Type 2) | C = 73 y (Type 4)\n(Grainger & Allison's Diagnostic Radiology)", {
    x: 6.6, y: 6.75, w: 6.6, h: 0.55, fontSize: 9.5, color: GREY, italic: true, fontFace: "Calibri", align: "center"
  });
}

// ══════════════════════════════════════════════════════════════════════════════
//  SLIDE 4 — NEURAL ARCH & PROCESSES
// ══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s);
  slideTitle(s, "Neural Arch & Posterior Elements", "Pedicles, laminae, spinous & transverse processes");

  // Two-column layout
  panel(s, 0.35, 1.1, 6.0, 6.1);
  label(s, "Neural Arch (Posterior Arch)", 0.5, 1.2, 5.7, 0.35, { fontSize: 14, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "Forms bony lateral and posterior border of spinal canal",
    "Lamina: between transverse process and spinous process",
    "Pedicle: between transverse process and vertebral body",
    "Pedicle notched superiorly & inferiorly → intervertebral foramen",
    "Spinal nerves exit through the intervertebral foramen",
  ], 0.5, 1.6, 5.7, 2.2, { fontSize: 13 });

  label(s, "Spinous & Transverse Processes", 0.5, 3.85, 5.7, 0.35, { fontSize: 14, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "Spinous process: most posterior part of neural arch",
    "Transverse processes: arise from lateral edge of neural arch",
    "Both serve as major attachments for deep back muscles",
    "Divide the neural arch into anatomical segments",
    "Plain film oblique view: 'Scottie dog' silhouette of neural arch",
  ], 0.5, 4.25, 5.7, 2.6, { fontSize: 13 });

  img(s, 3, 6.5, 1.1, 6.7, 5.6);
  s.addText("Fig. 47.2 — Normal spinal anatomy on plain film radiography.\nLateral (A), PA (B) and oblique (C) views.\nI=inf. articular process, L=lamina, O=foramen, P=pedicle, S=sup. articular process, Sp=spinous process, T=transverse process\n(Grainger & Allison's Diagnostic Radiology)", {
    x: 6.5, y: 6.7, w: 6.7, h: 0.65, fontSize: 9, color: GREY, italic: true, fontFace: "Calibri", align: "center"
  });
}

// ══════════════════════════════════════════════════════════════════════════════
//  SLIDE 5 — FACET JOINTS & INTERVERTEBRAL DISC
// ══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s);
  slideTitle(s, "Joints of the Spine", "Facet (zygapophyseal) joints & intervertebral discs");

  // Left panel – facet joints
  panel(s, 0.35, 1.1, 6.0, 2.9);
  label(s, "Facet Joints (Zygapophyseal Joints)", 0.5, 1.2, 5.7, 0.35, { fontSize: 13.5, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "Diarthrodial synovial joints between inf. & sup. articular processes",
    "Articular processes arise from articular pillars (pedicle–lamina junction)",
    "Uncovertebral joints (Luschka) in cervical spine: limit lateral disc herniation",
    "Degenerative hypertrophy + ligamentum flavum thickening → spinal stenosis",
    "CT: measure facet angle (normally ~40–45° in lumbar spine)",
  ], 0.5, 1.58, 5.7, 2.3, { fontSize: 12.5 });

  // Left panel – IVD
  panel(s, 0.35, 4.1, 6.0, 3.1);
  label(s, "Intervertebral Disc (Symphysis)", 0.5, 4.2, 5.7, 0.35, { fontSize: 13.5, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "Nucleus pulposus: water, proteoglycans, loose collagen; embryologically notochordal",
    "Annulus fibrosus: concentric fibrocartilage layers (Sharpey fibres at periphery)",
    "Annular fibres at 30° oblique angle → strong, flexible meshwork",
    "MRI: nucleus pulposus high T2 signal (water content); signal ↓ with degeneration",
    "Vacuum phenomenon (gas in disc space) = degenerative disc disease on CT/XR",
  ], 0.5, 4.58, 5.7, 2.5, { fontSize: 12.5 });

  img(s, 9, 6.5, 1.1, 6.7, 3.0);
  s.addText("Axial T2 MRI L4–L5 — vertebral body, spinal canal, lamina, facet joints and facet joint thickness measurement", {
    x: 6.5, y: 4.0, w: 6.7, h: 0.35, fontSize: 9.5, color: GREY, italic: true, fontFace: "Calibri", align: "center"
  });

  img(s, 4, 6.5, 4.2, 6.7, 3.0);
  s.addText("Fig. 47.3 — 3D CT L3: posterior (A), lateral (B), superior (C) views. *=spinal canal\n(Grainger & Allison's Diagnostic Radiology)", {
    x: 6.5, y: 7.1, w: 6.7, h: 0.3, fontSize: 9.5, color: GREY, italic: true, fontFace: "Calibri", align: "center"
  });
}

// ══════════════════════════════════════════════════════════════════════════════
//  SLIDE 6 — SPINAL LIGAMENTS
// ══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s);
  slideTitle(s, "Spinal Ligaments", "Anterior column, posterior column & interconnecting ligaments");

  panel(s, 0.35, 1.1, 6.0, 6.1);

  const ligData = [
    ["Ligament", "Location & Function"],
    ["Anterior Longitudinal (ALL)", "Anterior vertebral bodies – entire spine; thick, limits extension"],
    ["Posterior Longitudinal (PLL)", "Vertebral canal, dens → sacrum; thicker in thoracic spine; limits flexion"],
    ["Ligamentum Flavum", "Paired; connects laminae; posterior wall of spinal canal; elastic – resists flexion"],
    ["Supraspinous", "Connects tips of spinous processes"],
    ["Interspinous", "Connects base of adjacent spinous processes"],
    ["Intertransverse", "Connects transverse processes"],
  ];
  s.addTable(ligData, {
    x: 0.5, y: 1.25, w: 5.5, h: 3.5,
    border: { pt: 0.5, color: ACCENT, transparency: 60 },
    fill: PANEL,
    color: TEXT_LT,
    fontSize: 12,
    fontFace: "Calibri",
    align: "left",
    rowH: 0.5,
    firstRow: true,
    firstRowFill: { color: ACCENT },
    firstRowColor: BG,
    firstRowFontBold: true,
    colW: [2.2, 3.3],
  });

  label(s, "Clinical Pearls", 0.5, 4.85, 5.7, 0.35, { fontSize: 14, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "ALL thinner over vertebral bodies, wider over discs",
    "PLL separated from vertebral body by anterior epidural space (fat + veins)",
    "Ligamentum flavum visible on MRI (T1/T2) and CT — thickening → stenosis",
    "Ligamentum flavum forms lateral border of neuroforamina (fuses with facet capsule)",
  ], 0.5, 5.25, 5.7, 2.0, { fontSize: 12.5 });

  // Right – spinal ligaments MRI image
  img(s, 5, 6.5, 1.1, 6.7, 4.7);
  s.addText("Fig. 47.5 — Spinal ligaments on sagittal T1 MRI (lumbar).\n1=ALL, 2=PLL, 3=interspinous ligament, 4=supraspinous ligament\n(Grainger & Allison's Diagnostic Radiology)", {
    x: 6.5, y: 5.8, w: 6.7, h: 0.45, fontSize: 9.5, color: GREY, italic: true, fontFace: "Calibri", align: "center"
  });

  img(s, 6, 6.5, 6.3, 6.7, 1.0);
  s.addText("Fig. 47.6 — Ligamentum flavum on axial MRI (A,B) and CT (C,D)", {
    x: 6.5, y: 7.25, w: 6.7, h: 0.2, fontSize: 9, color: GREY, italic: true, fontFace: "Calibri", align: "center"
  });
}

// ══════════════════════════════════════════════════════════════════════════════
//  SLIDE 7 — NEURAL STRUCTURES & VASCULAR SUPPLY
// ══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s);
  slideTitle(s, "Neural Structures & Vascular Supply", "Spinal cord, nerve roots, conus medullaris & arteries");

  panel(s, 0.35, 1.1, 6.0, 3.0);
  label(s, "Spinal Canal & Neural Contents", 0.5, 1.2, 5.7, 0.35, { fontSize: 14, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "Spinal canal shape: oval (cervical/thoracic) → triangular (lower lumbar)",
    "Dura mater: anteriorly contacts PLL; laterally contacts medial pedicle borders",
    "Spinal cord: central butterfly grey matter on T2 MRI; wide normal variation in size",
    "Conus medullaris: terminal cord at L1–L2; tapers into cauda equina below",
    "Cervical/thoracic nerve roots exit horizontally; lumbar roots first descend in lateral recess",
  ], 0.5, 1.58, 5.7, 2.4, { fontSize: 12.5 });

  panel(s, 0.35, 4.2, 6.0, 3.0);
  label(s, "Vascular Supply", 0.5, 4.3, 5.7, 0.35, { fontSize: 14, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "3 longitudinal arteries: 1 anterior spinal artery + 2 posterior spinal arteries",
    "Cervicothoracic region: segmental supply from vertebral arteries & great vessels",
    "Midthoracic region: watershed zone — collateral from superior/inferior arteries",
    "Thoracolumbar: segmental aortic/iliac arteries; artery of Adamkiewicz (T9–L2, usually left)",
    "Venous: Batson plexus — valveless, allows retrograde flow (tumour spread route)",
  ], 0.5, 4.68, 5.7, 2.4, { fontSize: 12.5 });

  img(s, 8, 6.5, 1.1, 6.7, 3.0);
  s.addText("CT: Quantitative lumbar spine anatomy — facet angle measurement (A) & sagittal view with pedicle screws (B)", {
    x: 6.5, y: 4.05, w: 6.7, h: 0.3, fontSize: 9.5, color: GREY, italic: true, fontFace: "Calibri", align: "center"
  });

  // info box
  panel(s, 6.5, 4.45, 6.7, 2.8, "163060");
  label(s, "⚡  Artery of Adamkiewicz", 6.65, 4.55, 6.4, 0.35, { fontSize: 13, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "Largest radiculomedullary artery supplying thoracolumbar cord",
    "Origin: T9–L2 (most commonly left sided, ~75%)",
    "Critical landmark in aortic surgery — damage → anterior cord ischemia",
    "Best visualised on CT angiography or MR angiography",
  ], 6.65, 4.95, 6.3, 2.2, { fontSize: 12, color: TEXT_LT });
}

// ══════════════════════════════════════════════════════════════════════════════
//  SLIDE 8 — CRANIOCERVICAL JUNCTION
// ══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s);
  slideTitle(s, "Craniocervical Junction", "Occiput – C1 (Atlas) – C2 (Axis) anatomy & imaging");

  panel(s, 0.35, 1.1, 6.0, 6.1);

  label(s, "Bony Anatomy", 0.5, 1.2, 5.7, 0.35, { fontSize: 14, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "Atlas (C1): ring vertebra, no body or spinous process; anterior & posterior arches",
    "Axis (C2): odontoid process (dens) — projects superiorly through atlas ring",
    "Atlanto-occipital joint: condylar joint; allows flexion/extension & lateral tilt",
    "Atlanto-axial joint: pivot joint; 50% of cervical rotation occurs here",
    "Posterior elements C2: large spinous process; bifid in C3–C6",
  ], 0.5, 1.58, 5.7, 2.4, { fontSize: 12.5 });

  label(s, "Radiological Assessment", 0.5, 4.05, 5.7, 0.35, { fontSize: 14, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "Anterior atlantodental interval (AADI): <3 mm adults, <5 mm children",
    "Clivus–odontoid line: clivus line should intersect tip of dens (cranio-cervical alignment)",
    "CT: preferred for bony injury; coronal/sagittal reformats essential",
    "MRI: ligamentous & neurological injury (apical/alar ligaments, cord signal)",
    "Biomechanics: most mobile → highest injury risk in polytrauma",
  ], 0.5, 4.43, 5.7, 2.6, { fontSize: 12.5 });

  img(s, 7, 6.5, 1.1, 6.7, 4.5);
  s.addText("Fig. 52.1 — Alignment on lateral cervical spine radiograph.\nNormal smooth contour of anterior spinal, posterior spinal, spinolaminar & facet joint lines.\n(Grainger & Allison's Diagnostic Radiology)", {
    x: 6.5, y: 5.55, w: 6.7, h: 0.4, fontSize: 9.5, color: GREY, italic: true, fontFace: "Calibri", align: "center"
  });

  // Key measurement summary
  panel(s, 6.5, 6.05, 6.7, 1.4, "163060");
  const measData = [
    ["Measurement", "Normal"],
    ["Anterior atlantodental interval", "≤3 mm (adults), ≤5 mm (children)"],
    ["Retropharyngeal space (C2)", "≤5 mm"],
    ["Retrotracheal space (C6)", "≤22 mm"],
  ];
  s.addTable(measData, {
    x: 6.5, y: 6.1, w: 6.7, h: 1.35,
    border: { pt: 0.5, color: ACCENT, transparency: 60 },
    fill: "163060",
    color: TEXT_LT,
    fontSize: 11,
    fontFace: "Calibri",
    rowH: 0.32,
    firstRow: true,
    firstRowFill: { color: ACCENT2 },
    firstRowColor: BG,
    firstRowFontBold: true,
    colW: [3.5, 3.2],
  });
}

// ══════════════════════════════════════════════════════════════════════════════
//  SLIDE 9 — IMAGING MODALITIES
// ══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s);
  slideTitle(s, "Imaging Modalities in Spine Radiology", "X-ray · CT · MRI — indications, strengths & interpretation");

  const mods = [
    {
      name: "Plain Radiography (X-ray)",
      color: "1A3550",
      accentC: ACCENT,
      points: [
        "First-line for bony alignment, fractures, degenerative change",
        "Views: AP, Lateral, Oblique ('Scottie dog' sign for spondylolysis)",
        "Lateral: assess 4 spinal lines (anterior, posterior, spinolaminar, facet)",
        "Limitation: poor soft tissue; overlapping structures; misses ~15% fractures",
        "Odontoid (open-mouth) view: C1–C2 alignment",
      ]
    },
    {
      name: "Computed Tomography (CT)",
      color: "1A3550",
      accentC: ACCENT2,
      points: [
        "Gold standard for bony injury, fracture classification, complex anatomy",
        "Multiplanar reformats (sagittal/coronal) replace plain films in polytrauma",
        "Excellent: cortical detail, facet joints, vertebral body fractures",
        "CT myelography: CSF space opacification if MRI contraindicated",
        "Vascular channels on CT may mimic fractures — compare with clinical context",
      ]
    },
    {
      name: "Magnetic Resonance Imaging (MRI)",
      color: "1A3550",
      accentC: "E05A8A",
      points: [
        "Gold standard for soft tissue, disc, cord, ligament, marrow assessment",
        "T1: marrow fat, anatomy; T2: disc water content, cord lesions, fluid",
        "STIR: marrow oedema (fracture, infection, neoplasm)",
        "Conus position (L1–L2), cauda equina, ligamentous integrity",
        "Indicated: neurological deficit, suspected ligamentous injury, post-trauma",
      ]
    },
  ];

  mods.forEach((mod, i) => {
    const x = 0.35 + i * 4.35;
    panel(s, x, 1.1, 4.15, 6.1, mod.color);
    s.addShape(pres.ShapeType.rect, {
      x, y: 1.1, w: 4.15, h: 0.08,
      fill: { color: mod.accentC }, line: { color: mod.accentC }
    });
    label(s, mod.name, x + 0.12, 1.22, 3.9, 0.4, { fontSize: 13, bold: true, color: mod.accentC });
    bulletBox(s, mod.points, x + 0.12, 1.7, 3.9, 5.3, { fontSize: 12 });
  });
}

// ══════════════════════════════════════════════════════════════════════════════
//  SLIDE 10 — DEGENERATIVE SPINE & SUMMARY
// ══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s);
  slideTitle(s, "Degenerative Changes & Teaching Summary", "Spondylosis, disc degeneration & key learning points");

  panel(s, 0.35, 1.1, 6.0, 3.1);
  label(s, "Degenerative Changes (OA of Spine)", 0.5, 1.2, 5.7, 0.35, { fontSize: 13.5, bold: true, color: ACCENT2 });
  bulletBox(s, [
    "Most common at cervical & lower lumbar spine",
    "Disc height loss + vacuum phenomenon (CT/XR) = degeneration",
    "Osteophytes arise anteriorly from vertebral bodies (plain film/CT)",
    "Sclerotic endplate changes; bridging osteophytes (DISH when ≥4 contiguous levels)",
    "Facet OA: osseous hypertrophy + ligamentum flavum thickening → spinal stenosis",
    "Spondylolisthesis: degenerative (posterior elements slip anteriorly with body) vs spondylolysis (pars defect)",
  ], 0.5, 1.58, 5.7, 2.5, { fontSize: 12 });

  panel(s, 0.35, 4.3, 6.0, 3.0);
  label(s, "Key Teaching Summary", 0.5, 4.4, 5.7, 0.35, { fontSize: 13.5, bold: true, color: ACCENT });
  const summary = [
    "7C + 12T + 5L + 5S + coccyx → 33 vertebrae; S-curve essential for posture",
    "Vertebral body: cortex + vertical trabeculae; marrow changes with age (Ricci types 1–4)",
    "Neural arch = pedicle + lamina; forms posterior spinal canal wall",
    "Facet joints: synovial; uncovertebral joints protect against lateral disc herniation",
    "IVD: nucleus pulposus (notochordal, water-rich) + annulus fibrosus (fibrocartilage, 30° oblique fibres)",
    "Key ligaments: ALL, PLL, ligamentum flavum (most radiologically significant)",
    "Conus medullaris normally at L1–L2; below → cauda equina",
    "Artery of Adamkiewicz: T9–L2 (left-sided); critical in aortic surgery",
  ];
  s.addText(summary.map((t, i) => ({
    text: t,
    options: { bullet: { type: "number" }, breakLine: i < summary.length - 1, fontSize: 12, color: TEXT_LT, fontFace: "Calibri" }
  })), { x: 0.5, y: 4.78, w: 5.7, h: 2.4, valign: "top", margin: 6 });

  img(s, 0, 6.5, 1.1, 6.7, 6.2);
  s.addText("Vertebral column — anterior, lateral, posterior views\n(Spine anatomy overview for reference)", {
    x: 6.5, y: 7.2, w: 6.7, h: 0.3, fontSize: 9.5, color: GREY, italic: true, fontFace: "Calibri", align: "center"
  });

  // Footer
  s.addText("Source: Grainger & Allison's Diagnostic Radiology | Grainger & Allison's 8e | Teaching edition 2026", {
    x: 0.35, y: 7.3, w: 13.0, h: 0.2, fontSize: 9.5, italic: true, color: GREY, fontFace: "Calibri"
  });
}

// ══════════════════════════════════════════════════════════════════════════════
//  WRITE FILE
// ══════════════════════════════════════════════════════════════════════════════
const outPath = "/home/daytona/workspace/spine-anatomy-ppt/Spine_Anatomy_Radiology_Teaching.pptx";
pres.writeFile({ fileName: outPath }).then(() => {
  console.log("✅ Written:", outPath);
}).catch(err => {
  console.error("❌ Error:", err);
  process.exit(1);
});

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/spine-anatomy-ppt/build.js'