Thoracolumbar Spine & Deformity MCQs

In the evaluation of a patient with an L5-S1 isthmic spondylolisthesis, which of the following spinopelvic parameters is a fixed morphologic feature of the pelvis that does not change with patient positioning?

A 35-year-old male falls from 10 feet, sustaining an isolated L1 burst fracture. He is neurologically intact. CT imaging shows 30% canal compromise, and MRI confirms an intact posterior ligamentous complex. According to the Thoracolumbar Injury Classification and Severity (TLICS) score, what is the most appropriate management?

A 22-year-old male is involved in a high-speed motor vehicle collision wearing a lap-belt only. Imaging reveals a flexion-distraction (Chance) fracture at L2. Which associated injury has the highest likelihood of being present and must be urgently ruled out?

A 35-year-old male sustains a T12 burst fracture after a fall. He is neurologically intact. MRI demonstrates an intact posterior ligamentous complex (PLC). According to the Thoracolumbar Injury Classification and Severity (TLICS) scale, his score is calculated as 2 (Burst = 2, Neurologic status = 0, PLC = 0). What is the most appropriate management?

A 22-year-old female is involved in a high-speed motor vehicle collision while wearing a lap belt. She complains of severe mid-back pain. CT scan reveals a transverse fracture extending through the pedicles, transverse processes, and vertebral body of L1. Which of the following associated injuries is most commonly seen in this patient?

According to the principles of thoracolumbar trauma management, which of the following is considered an absolute indication for surgical decompression and stabilization of a thoracolumbar burst fracture?

When comparing degenerative spondylolisthesis (DS) and isthmic spondylolisthesis (IS) in the adult population, which of the following characteristics accurately differentiates DS from IS?

A 24-year-old man falls from a height of 15 feet and sustains a T12 fracture. CT scan shows a burst fracture with 40% loss of anterior vertebral body height, 15 degrees of kyphosis, and 20% canal compromise. He is neurologically intact. According to the Thoracolumbar Injury Classification and Severity Score (TLICS), what is his total score and the recommended treatment?

A 50-year-old man presents with an L2 burst fracture after a fall. He is neurologically intact. Radiographs show 20 degrees of focal kyphosis and 30% loss of anterior body height. According to current evidence, what is the expected long-term clinical outcome of conservative management with an orthosis compared to surgical stabilization?

A 35-year-old male falls from a ladder, sustaining an L1 burst fracture. He is neurologically intact. MRI demonstrates disruption of the posterior ligamentous complex (PLC). According to the Thoracolumbar Injury Classification and Severity Score (TLICS), what is the most appropriate management?

In a patient presenting with L4-L5 degenerative spondylolisthesis, which of the following MRI findings is most highly predictive of segmental instability and the likelihood of future slip progression?

To establish a definitive radiographic diagnosis of Scheuermann's kyphosis based on the classic Sorensen criteria, a patient must demonstrate anterior wedging of at least 5 degrees in a minimum of how many consecutive vertebrae?

A 22-year-old female sustains a severe seatbelt-type flexion-distraction injury (Chance fracture) at the L2 level during a high-speed motor vehicle collision. Which concomitant visceral injury is most classically associated with this specific fracture pattern?

A 25-year-old man is brought to the trauma bay after a motorcycle accident. He has a T12 burst fracture with 50% loss of vertebral body height and 20 degrees of kyphosis. Neurological examination is completely normal. MRI confirms that the posterior ligamentous complex (PLC) is intact. According to the Thoracolumbar Injury Classification and Severity (TLICS) score, what is the most appropriate management?

A 30-year-old male falls from a roof, 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) score, what is his total score and recommended treatment?

In the surgical planning for a 65-year-old woman with adult degenerative scoliosis and sagittal imbalance, her pelvic incidence (PI) is measured at 55 degrees. To achieve optimal sagittal alignment and minimize the risk of adjacent segment disease, what should be the target postoperative lumbar lordosis (LL)?

In the surgical planning for adult degenerative scoliosis, sagittal balance is a critical determinant of postoperative outcomes. If a patient has a pelvic incidence (PI) of 55 degrees, what should the target lumbar lordosis (LL) ideally be to minimize the risk of adjacent segment disease?

A 16-year-old boy presents with back pain and a prominent thoracic curvature. On physical examination, the kyphosis is rigid and does not correct with hyperextension. Standing lateral radiographs reveal irregular vertebral endplates and Schmorl's nodes. By classic Sørensen criteria, Scheuermann's kyphosis requires anterior wedging of at least 5 degrees in how many consecutive vertebrae?

A 35-year-old construction worker falls 10 feet, 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) score, what is the patient's total score and recommended management?

In evaluating a patient with adult spinal deformity, which of the following spinopelvic parameters is a morphologic constant that does not change with patient positioning?