Cervical Spine MCQs

An 82-year-old female presents after a ground-level fall with neck pain. CT shows a Type II odontoid fracture with 2mm of posterior displacement. Neurologic examination is completely intact. What is the most appropriate initial management for this patient?

A 50-year-old male presents with progressive clumsiness in his hands and an unsteady gait. CT demonstrates a continuous band of dense ossification along the posterior aspect of the C3-C6 vertebral bodies. The ossified mass occupies 65% of the spinal canal, and his cervical spine is lordotic. Which surgical approach is generally preferred?

A 5-year-old boy is evaluated after a minor fall. His lateral cervical spine radiograph shows 3mm of anterior displacement of C2 on C3. The Swischuk line passes 1mm anterior to the anterior aspect of the C3 posterior arch. What is the correct interpretation?

A 78-year-old female sustains a fall and is diagnosed with a displaced Type II odontoid fracture. She has a history of mild COPD and hypertension. Which of the following management strategies offers the highest rate of bony union for this specific patient?

A 78-year-old female sustains a Type II odontoid fracture after a ground-level fall. Displacement is 2 mm, and she is neurologically intact. Given her age and comorbidities, what is the most appropriate initial management?

A 21-year-old collegiate baseball pitcher undergoes ulnar collateral ligament (UCL) reconstruction. Biomechanically, which bundle of the native UCL is the primary restraint to valgus stress at 30 degrees of elbow flexion, and therefore the primary target of this reconstruction?

A 21-year-old baseball pitcher presents with medial elbow pain during the late cocking phase of throwing. He is diagnosed with a severe ulnar collateral ligament (UCL) tear. Which bundle of the UCL acts as the primary restraint to valgus stress at 90 degrees of elbow flexion?

A 21-year-old collegiate pitcher undergoes ulnar collateral ligament (UCL) reconstruction using a palmaris longus autograft. Which bundle of the native UCL is the primary restraint to valgus stress between 30 and 120 degrees of elbow flexion, and thus the target for reconstruction?

A 22-year-old collegiate baseball pitcher complains of medial elbow pain during the late cocking phase of throwing. What is the primary restraint to valgus stress at the elbow during this specific phase of the throwing motion?

In the throwing athlete, the medial ulnar collateral ligament (UCL) of the elbow is subjected to significant stress. Which specific bundle of the UCL provides the primary restraint to valgus stress at 90 degrees of elbow flexion?

In the medial ulnar collateral ligament (MUCL) complex of the elbow, which structural component provides the primary restraint to valgus stress between 30 and 90 degrees of flexion?

A 45-year-old female undergoes an anterior cervical discectomy and fusion (ACDF) at C5-C6. During the immediate postoperative period in the recovery room, she develops a rapidly expanding anterior neck mass, respiratory distress, and stridor. What is the most critical and immediate step in her management?

A 55-year-old male presents with progressive upper extremity clumsiness and lower extremity spasticity. CT imaging reveals ossification of the posterior longitudinal ligament (OPLL) from C3 to C6. If an anterior cervical corpectomy is planned, what is the most significant intraoperative risk specifically associated with OPLL excision?

An 82-year-old man sustains a Type II odontoid fracture after a ground-level fall. He is neurologically intact but has multiple medical comorbidities. Which of the following treatments is associated with an unacceptably high rate of mortality in this specific demographic and is generally avoided?

A 55-year-old Asian male presents with progressive clumsiness in his hands and a wide-based gait. CT of the cervical spine reveals a continuous ossified mass posterior to the vertebral bodies from C3 to C6. If an anterior decompression (corpectomy) is planned, what is the most significant intraoperative complication directly associated with the pathology?

A 55-year-old female with long-standing rheumatoid arthritis is scheduled for an elective total knee arthroplasty. Pre-operative flexion-extension cervical spine radiographs reveal an anterior atlantodental interval (ADI) of 11 mm. What is the most appropriate management regarding her cervical spine?

A 6-year-old boy presents with severe neck pain and torticollis 10 days after a tonsillectomy. He holds his head tilted to the right and rotated to the left. Neurological examination is normal. Radiographs reveal an increased atlantodental interval (ADI) of 4.5 mm. Which of the following is the most likely diagnosis?

A 55-year-old female with severe rheumatoid arthritis is evaluated prior to elective surgery. Flexion-extension cervical spine radiographs are obtained. Which of the following parameters represents an absolute indication for operative stabilization of the cervical spine?

A 55-year-old female with long-standing rheumatoid arthritis requires intubation. Flexion-extension cervical radiographs are obtained. Which measurement is the most reliable radiographic indicator of potential neurological compromise due to atlantoaxial subluxation?

An 82-year-old female presents with a Type II odontoid fracture following a ground-level fall. She has multiple comorbidities but is neurologically intact. What is the preferred definitive treatment for this patient to minimize mortality and optimize union rates?