6. Spine MCQs

A 50-year-old female presents with neck pain and right arm radiculopathy in the C6 distribution. She has a positive Spurling's test. Conservative treatment for 6 weeks has failed. MRI shows a right paracentral disc herniation at C5-C6. Which of the following motor deficits is most likely present?

A 22-year-old male dives into shallow water and sustains an isolated Jefferson (C1) burst fracture. An open-mouth odontoid view demonstrates combined lateral overhang of the C1 lateral masses on C2 of 8 mm. What does this radiographic finding indicate?

A 40-year-old male is involved in a motor vehicle collision and sustains a severe hyperflexion injury to his thoracic spine. Imaging reveals a Chance fracture (flexion-distraction injury) at T12. Which of the following associated injuries is most commonly found with this fracture pattern?

A 35-year-old male presents with persistent low back pain and stiffness, particularly worse in the morning and improving with activity. He is HLA-B27 positive. Radiographs demonstrate squaring of the vertebral bodies and marginal syndesmophytes. In patients with this condition, which of the following fracture patterns is most likely to result in an epidural hematoma?

Which of the following is an absolute indication for surgical intervention in a patient with an acute spinal epidural abscess?

A 65-year-old man presents with bilateral leg pain and fatigue that worsens after walking two blocks. Which of the following findings is most characteristic of neurogenic claudication secondary to lumbar spinal stenosis, as opposed to vascular claudication?

A 60-year-old man undergoes a C3-C6 posterior cervical laminectomy and fusion for cervical spondylotic myelopathy. On postoperative day 2, he develops new-onset unilateral weakness in shoulder abduction and elbow flexion. What is the most likely etiology of this complication?

A 4-year-old boy presents with refusal to walk, bleeding gums, and petechiae. Radiographs show osteopenia and an exaggerated white line of Frankel. The underlying defect involves an impairment in which of the following steps of collagen synthesis?

During a posterior cervical foraminotomy, the surgeon must be acutely aware of the vertebral artery's course. The vertebral artery typically enters the transverse foramen at which cervical level?

Which of the following best describes the precise anatomic origin of the reflected head of the rectus femoris?

In the setting of a hip arthroscopy, the surgeon must be cautious when establishing the anterolateral portal to avoid injury to a major nerve. The lateral femoral cutaneous nerve (LFCN) is at risk. What is the typical anatomical course of the LFCN as it exits the pelvis?

A 16-year-old elite track athlete presents with acute, severe pain over the anterior pelvis after forcefully kicking a ball. Radiographs demonstrate an avulsion fracture of the anterior inferior iliac spine (AIIS). Which muscle is responsible for this avulsion?

An adolescent soccer player sustains a pelvic avulsion fracture resulting from a forceful kick. Radiographs confirm an avulsion of the anterior superior iliac spine (ASIS). Which muscle is primarily responsible for this injury?

Half of all cervical spine rotation occurs at the atlantoaxial (C1-C2) articulation. Which of the following ligaments is the primary restraint to anterior translation of the atlas on the axis?

The alar ligaments play a critical role in craniocervical stability. What is their primary biomechanical function?

A 25-year-old professional javelin thrower presents with medial elbow pain. Valgus stress testing is positive at 30 degrees of elbow flexion. Which structure is the primary restraint to valgus instability in this position?

Normal kinematics of the subaxial cervical spine exhibit obligate coupled motions due to the spatial orientation of the facet joints. When a patient performs active lateral bending of the neck to the right, which obligate coupled motion naturally occurs?

A 65-year-old man presents with neurogenic claudication. Lumbar MRI reveals severe central canal stenosis at L4-L5, largely secondary to hypertrophy of the posterior ligamentous structures. Which of the following extracellular matrix components is disproportionately high in the normal anatomy of the specific ligament contributing most to this compression?

Which of the following arteries typically provides the major blood supply to the anterior lower two-thirds of the spinal cord and most commonly arises on the left side between T8 and L1?

During an anterior cervical discectomy and fusion (ACDF), lateral dissection carries the risk of injuring the vertebral artery. At which cervical level does the vertebral artery typically first enter the transverse foramen?