6. Spine MCQs

Thoracic disc herniations represent approximately what percentage of all symptomatic spinal disc herniations?

Which of the following features on MRI indicates a worse prognosis for recovery following decompression of a thoracic disc herniation causing myelopathy?

The "safe zone" for inserting a pedicle screw in the mid-thoracic spine is limited medially by the spinal cord and laterally by the:

What is the anatomical rationale for utilizing a right-sided thoracotomy approach rather than a left-sided approach for a central T7-T8 disc herniation?

A patient undergoes an anterior thoracic discectomy at T9-T10. Postoperatively, the patient develops a unilateral, segmental, severe neuropathic pain along the 9th rib. Which intraoperative action most likely caused this?

When planning an anterior thoracotomy for a left-sided T9-T10 disc herniation, the surgeon must be mindful of the artery of Adamkiewicz to prevent anterior spinal artery syndrome. At what level and side does this radiculomedullary artery most commonly originate?

Which of the following is considered a distinct advantage of a costotransversectomy approach compared to an anterior transthoracic approach for the excision of a lateral thoracic disc herniation?

The classic Sorensen radiographic criteria for the diagnosis of Scheuermann's kyphosis require which of the following findings?

To minimize the risk of ischemic spinal cord injury during a left-sided thoracotomy for a T8 corpectomy, how should the segmental vessels be managed?

A 35-year-old female complains of diffuse, glove-like numbness in both upper extremities accompanied by mid-thoracic back pain. Electromyography and cervical MRI are completely normal. A diagnostic sympathetic block at the upper thoracic level provides immediate and complete relief of her symptoms. What is the most likely diagnosis?

A 65-year-old male is incidentally noted to have flowing ossification along the anterolateral aspect of his thoracic spine. According to the Resnick criteria, which of the following is required to establish a diagnosis of Diffuse Idiopathic Skeletal Hyperostosis (DISH)?

A 25-year-old male sustains a T12 Chance fracture following a high-speed motor vehicle collision while wearing a lap belt. What associated injury must be urgently ruled out during his initial trauma evaluation?

Ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine most commonly presents with slowly progressive myelopathy and is most prevalent in which of the following patient demographics?

A 30-year-old patient falls from a height, sustaining a T11 burst fracture with 60% canal compromise. The patient is neurologically intact, and MRI confirms an intact posterior ligamentous complex. What is the most appropriate management plan?

When placing pedicle screws in the thoracic spine, knowledge of normal morphometry is crucial. At which of the following thoracic levels are the pedicles typically the narrowest in their transverse dimension?

A patient undergoes a transforaminal epidural steroid injection for a right T10 radiculopathy. Immediately post-procedure, the patient develops profound bilateral lower extremity flaccid paralysis and loss of pain sensation, but proprioception is preserved. What is the most likely etiology of this complication?

During an initial clinical evaluation, a patient with a known central thoracic disk herniation demonstrates normal upper extremity reflexes but exhibits spastic paraparesis, hyperreflexia in the lower extremities, and absent abdominal reflexes. Based on these reflex findings, the lesion is most likely located above which spinal level?

A 60-year-old patient presents with symptoms of tandem spinal stenosis affecting both the cervical and thoracic regions. Which clinical finding uniquely distinguishes a thoracic myelopathy from a cervical myelopathy?

A 55-year-old man presents with progressive lower extremity weakness and myelopathy. Imaging reveals a large, central, calcified disc herniation at T8-T9 causing severe cord compression. Which of the following is the most appropriate surgical approach?

During an anterior corpectomy for a T11 burst fracture, the surgeon must be mindful of the vascular supply to the anterior spinal cord. The artery of Adamkiewicz most commonly enters the spinal canal at which of the following locations?