Thoracolumbar Spine & Deformity MCQs

When evaluating an adult patient for a long-segment spinal fusion for degenerative scoliosis, which of the following spino-pelvic parameters correlates most strongly with postoperative health-related quality of life (HRQOL)?

A 30-year-old woman sustains an L1 burst fracture after a fall. She is neurologically intact. MRI demonstrates an intact posterior ligamentous complex. According to the Thoracolumbar Injury Classification and Severity (TLICS) score, what is her total score and the recommended treatment?

A 65-year-old woman presents with worsening back pain and an inability to stand up straight. Radiographs show adult degenerative scoliosis. Her pelvic incidence (PI) is 55 degrees, pelvic tilt (PT) is 30 degrees, and sacral slope (SS) is 25 degrees. To achieve optimal sagittal balance postoperatively, her lumbar lordosis (LL) should be reconstructed to approximately:

In adult spinal deformity surgery, achieving optimal sagittal balance is critical to improving health-related quality of life outcomes. Which of the following sets of spinopelvic parameters represents the universally accepted SRS-Schwab postoperative target?

When planning corrective surgery for adult degenerative scoliosis, restoring optimal sagittal balance is highly correlated with improved clinical outcomes. To achieve this, the lumbar lordosis (LL) should be corrected to closely match which pelvic parameter?

According to the Thoracolumbar Injury Classification and Severity (TLICS) score, which of the following findings is the strongest determinant indicating the need for operative stabilization of a thoracolumbar burst fracture?

In evaluating a patient with adult spinal deformity and "flatback" syndrome (loss of lumbar lordosis), the body attempts to compensate to maintain an upright posture. Which radiographic finding represents a primary pelvic compensatory mechanism for positive sagittal malalignment?

In a 68-year-old female presenting with adult degenerative scoliosis and severe sagittal imbalance, the goal of surgical reconstruction is to achieve a mismatch between Pelvic Incidence (PI) and Lumbar Lordosis (LL) of less than what value to optimize clinical outcomes?

A 65-year-old female presents with severe back pain and an inability to stand up straight. Which of the following radiographic parameters correlates most strongly with poor health-related quality of life (HRQOL) scores in adult spinal deformity?

A 35-year-old male sustains a fall. CT shows a burst fracture of L1 with 40% canal compromise. He is neurologically intact, and MRI confirms the posterior ligamentous complex (PLC) is intact. What is his Thoracolumbar Injury Classification and Severity (TLICS) score and recommended management?

In preoperative planning for a 60-year-old patient with flatback syndrome and adult degenerative scoliosis, the surgeon aims to restore ideal sagittal balance. To achieve optimal postoperative alignment, the lumbar lordosis (LL) should be within how many degrees of the pelvic incidence (PI)?

A 68-year-old woman with adult degenerative scoliosis presents with severe back pain and a forward stooped posture. Standing full-length radiographs reveal a sagittal vertical axis (SVA) of +12 cm. To achieve optimal sagittal balance postoperatively, surgical correction should aim for a relationship between Pelvic Incidence (PI) and Lumbar Lordosis (LL) of:

A 30-year-old construction worker falls from a scaffolding, sustaining an L1 burst fracture. He is neurologically intact. MRI demonstrates an intact posterior ligamentous complex (PLC). According to the Thoracolumbar Injury Classification and Severity (TLICS) system, what is his total score and the recommended management?

A 35-year-old construction worker falls from a height and presents with paraplegia at the T10 level.

Imaging demonstrates a T10 flexion-distraction injury with posterior ligamentous complex disruption. What associated injury must be urgently ruled out?

A 65-year-old woman presents with severe back pain, forward-leaning posture, and difficulty standing upright. Radiographs reveal adult spinal deformity. Her pelvic incidence (PI) is 60 degrees. To achieve a harmonious sagittal alignment postoperatively, what is the ideal target for her lumbar lordosis (LL)?

A 14-year-old gymnast presents with chronic lower back pain. Radiographs reveal a Grade II isthmic spondylolisthesis at L5-S1. She has failed 6 months of bracing and physical therapy. If surgery is performed, what is the most appropriate procedure?

A 45-year-old man falls from a height and sustains an L1 burst fracture. He is neurologically intact. MRI demonstrates that the integrity of the posterior ligamentous complex (PLC) is indeterminate. Based on the Thoracolumbar Injury Classification and Severity (TLICS) score, what is the most appropriate management approach?

A 65-year-old woman presents with neurogenic claudication and a grade 1 degenerative spondylolisthesis at L4-L5. Which of the following anatomic features is most strongly implicated in the pathogenesis of her spondylolisthesis?

In the assessment of adult spinal deformity, which of the following spinopelvic parameters is considered a fixed morphological characteristic of the pelvis that remains constant regardless of patient positioning?