6. Spine MCQs

A 45-year-old man presents with neck pain, numbness in the thumb, and weakness in wrist extension. MRI reveals a posterolateral cervical disc herniation at the C5-C6 level. Which nerve root is most likely compressed?

Which of the following structures forms the superior border of the lumbar intervertebral foramen?

During an anterior approach to the thoracolumbar spine, care must be taken to avoid injury to the artery of Adamkiewicz. On which side and at what spinal levels does this artery most commonly originate?

A patient sustains a whiplash injury and is suspected of having craniocervical instability. The alar ligaments primarily limit which of the following movements?

The orientation of the facet joints in the subaxial cervical spine most closely approximates which of the following planes?

Discogenic back pain is mediated by sensory fibers in the outer annulus fibrosus. Which nerve provides the primary innervation to the posterior aspect of the lumbar intervertebral disc?

During a posterior cervical spine fusion, screw placement into the lateral mass of C7 must be done carefully to avoid vascular injury. Why is the vertebral artery generally not at risk within the C7 transverse foramen?

A 45-year-old male presents with severe right leg radiculopathy. MRI of the lumbar spine reveals a far lateral (extraforaminal) disc herniation at the L4-L5 level. Which nerve root is most likely compressed by this specific pathology?

A trauma patient sustains a highly comminuted cervical spine fracture. A CT angiogram is ordered to evaluate the vertebral artery. In a normal anatomic variant, at which cervical level does the vertebral artery typically first enter the transverse foramen?

During posterior spinal fusion for scoliosis, a surgeon places pedicle screws in the thoracic spine. Which level of the thoracic spine typically has the greatest transverse pedicle angle (most medial angulation)?

A patient suffers a stab wound to the thoracic spine resulting in a classic Brown-Séquard syndrome. Which of the following physical examination findings is characteristic of this anatomic spinal cord injury?

During placement of a pedicle screw in the lumbar spine, an inferior cortical breach of the pedicle places which of the following structures at highest risk of immediate injury?

During an anterior cervical discectomy and fusion (ACDF), excessive lateral dissection over the longus colli muscle places the vertebral artery at risk. At which cervical level does the vertebral artery most commonly enter the transverse foramen?

During pedicle screw insertion in the midthoracic spine (T6-T8) for adolescent idiopathic scoliosis, a medial cortical breach of the pedicle occurs. Which of the following structures is at the most immediate risk of injury?

A 45-year-old male presents with right leg pain radiating to the dorsum of his foot and weakness in ankle dorsiflexion. MRI reveals a far lateral (extra-foraminal) disc herniation at the L4-L5 level. Which nerve root is most likely compressed?

During a thoracolumbar corpectomy, the surgeon must be mindful of the artery of Adamkiewicz to prevent anterior spinal cord syndrome. From which of the following regions does this vessel most commonly arise?

A 40-year-old patient with rheumatoid arthritis presents with neck pain and myelopathy. Flexion-extension radiographs demonstrate atlantoaxial instability. Which of the following ligaments is the primary restraint to anterior translation of the atlas on the axis?

A spine surgeon is performing a posterior cervical foraminotomy at C5-C6. To avoid injury to the vertebral artery, the surgeon must be aware of its typical anatomic course. The vertebral artery typically enters the transverse foramen at which cervical level?

A 60-year-old man is diagnosed with a Levine-Edwards Type IIa Hangman's fracture (traumatic spondylolisthesis of C2) following a motor vehicle collision. The fracture demonstrates severe angular deformity without significant translation. What is the pathomechanics of this specific injury and the appropriate initial management?

A 30-year-old man sustains a transabdominal gunshot wound. The bullet traverses the colon and lodges within the L3 spinal canal. Neurological examination confirms a complete cauda equina syndrome. What is the primary indication for surgical decompression and removal of the bullet in this specific case?