1. General Principles & Basic Science MCQs

In an MIS TLIF, endplate preparation can be challenging due to the limited visual corridor. Inadequate endplate preparation is most strongly associated with which postoperative complication?

When comparing long-term follow-up (e.g., 2 to 5 years) between patients who underwent MIS TLIF versus Open TLIF, the literature generally shows equivalence in:

The use of expandable interbody cages in MIS TLIF has gained popularity. A theoretical biomechanical advantage of an expandable cage over a static cage inserted through a small tubular retractor is:

Which of the following statements is true regarding minimally invasive posterior lumbar interbody fusion:

In relation to the lumbar pedicle, the exiting nerve root is found:

Regarding the anatomy of the lumbar pedicle, which of the following statements is true:

Which of the following serves as the best landmark for proper screw entry into the lumbar pedicle:

Aggressive osteoblastomas are distinguished from conventional osteoblastomas primarily by which histologic feature?

A 35-year-old female presents with an unresectable giant cell tumor of the sacrum. Which targeted pharmacologic therapy is most appropriate to induce tumor consolidation?

What is the most critical factor in preventing local recurrence of a sacral chordoma following surgical management?

A 22-year-old male presents with dull, aching back pain that is not completely relieved by NSAIDs. Imaging reveals an expansile, radiolucent lesion measuring 3.5 cm in the posterior elements of L3. Histology shows disorganized osteoid surrounded by plump osteoblasts. Which of the following differentiates this lesion from an osteoid osteoma?

A 32-year-old female undergoes curettage of an epiphyseal lytic lesion in the proximal tibia. Histology shows numerous multinucleated giant cells in a background of mononuclear stromal cells. If systemic therapy is required for unresectable disease, which cell surface receptor is targeted by the most appropriate pharmacological agent?

A 65-year-old man with a history of renal cell carcinoma presents with acute myelopathy due to a pathologic fracture of L2. Decompression and stabilization are planned. Which preoperative intervention is most critical?

A 35-year-old woman presents with a destructive lytic lesion in the sacrum. Biopsy reveals multinucleated giant cells intermixed with mononuclear stromal cells. The stromal cells are positive for H3F3A mutation. What is the most effective medical adjunct to surgery?

A 30-year-old female presents with a sacral mass causing bowel dysfunction. Biopsy reveals multinucleated giant cells and mononuclear stromal cells. If surgical resection carries unacceptable morbidity, which targeted medical therapy is most appropriate?

Which of the following targeted treatments is correctly paired with its mechanism of action for managing unresectable giant cell tumors of bone?

Patients with anterior cord syndrome usually presents with:

Osteochondromatosis is a hereditary genetic disorder that is:

In a normal, asymptomatic adult, the C7 plumb line (Sagittal Vertical Axis) should fall within what distance relative to the posterior superior corner of the S1 endplate?

A 65-year-old patient requires a corrective osteotomy for a rigid flatback deformity. Approximately how much sagittal correction can be expected from a single-level pedicle subtraction osteotomy (PSO)?