6. Spine MCQs

A 40-year-old man sustains an axial load injury to his head resulting in a Jefferson fracture. Open-mouth odontoid radiographs reveal lateral displacement of the lateral masses of C1 relative to C2. According to the Rule of Spence, what total combined overhang of the lateral masses strongly suggests incompetence of the transverse atlantal ligament?

If the C 6 cervical spine nerve root is injured during a posterior decompression of the cervical spine, then sensation is lost in which of the following areas:

If the brachioradialis reflex is diminished after a posterior spinal decompression, then which of the following nerve roots is injured:

If the triceps muscle is weak after a spinal decompression, then which of the following nerve roots is injured:

If the flexor carpi radialis is weak after a spinal decompression, then which of the following nerve roots is injured:

A patient has a fracture dislocation of the cervical spine. Which of the following nerve roots must be spared to preserve intact finger extension:

The left medial and lateral gastrocnemius muscles are weak in a patient after a lumbar spine decompression. Which of the following nerve roots is injured:

A patient with cauda equina syndrome has decreased perianal sensation. Which of the following groups of nerve roots is involved:

A patient with a fracture dislocation of the spine has a sensory level at the nipple line. Which of the following nerve root levels indicates this finding:

An elderly patient with pre-existing cervical stenosis experiences a hyperextension injury to the neck. Examination reveals profound weakness in the upper extremities with relatively preserved lower extremity strength. What is the most likely diagnosis?

Following a burst fracture of C5, a patient has bilateral loss of motor function and pain/temperature sensation below the level of injury, but intact proprioception and vibratory sense. Which spinal cord syndrome is present?

During evaluation of a 65-year-old male with clumsy hands and gait imbalance, flicking the nail of the middle finger results in flexion of the thumb and index finger. What is this clinical sign called?

A patient complains of right-sided neck pain radiating to the shoulder. Extension, lateral bending, and axial compression of the neck reproduce the radiating arm pain. Which of the following is the most appropriate term for this test?

A 70-year-old patient falls and sustains a fracture through the base of the odontoid process. Why does this specific fracture type have a high rate of nonunion?

Traumatic spondylolisthesis of the axis (Hangman's fracture) typically involves bilateral fractures of the pars interarticularis of C2. What is the classic mechanism of injury?

A 25-year-old male dove into a shallow pool and sustained a burst fracture of the C1 ring. Which radiographic finding on the open-mouth odontoid view is most critical for determining the integrity of the transverse atlantal ligament?

A patient undergoes anterior cervical discectomy and fusion at C5-C6. Postoperatively, a new C6 nerve root palsy is noted. Which motor deficit is most likely expected?

A 60-year-old male with long-standing ankylosing spondylitis sustains a minor fall. He complains of severe neck pain but has no immediate neurological deficits. What is the most critical management step?

A 55-year-old Asian male presents with progressive clumsiness of his hands and a spastic gait. Lateral cervical radiographs reveal a dense, radiopaque strip along the posterior aspect of the cervical vertebral bodies. What is the most likely diagnosis?

During a posterior cervical mass screw placement at C1, the surgeon must be cautious of the vertebral artery. Where does the vertebral artery typically lie in relation to the C1 posterior arch?