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5. OITE > Spine 2015 > Flashcards

Spine 2015 Flashcards

1
Q
  1. Figure 7 is the lumbar spine lateral radiograph of a 33-year-old woman who experienced worsening back pain 4 months after undergoing lumbar surgery. What is the most appropriate treatment option?
  2. Laminectomy
  3. Facet injection
  4. Posterior fusion
  5. Revision arthroplasty
  6. Immobilization in a rigid orthosis
A
  1. Posterior fusion

RECOMMENDED READINGS

Harrison WD, Harrison DJ. The use of percutaneous lumbar fixation screws for bilateral pedicle fractures with an associated dislocation of a lumbar disc prosthesis. Case Rep Orthop. 2013;2013:676017. doi: 10.1155/2013/676017. Epub 2013 Nov 4. PubMed PMID: 24294533; PubMed Central PMCID: PMC3835198.

Patel AA, Brodke DS, Pimenta L, Bono CM, Hilibrand AS, Harrop JS, Riew KD, Youssef JA, Vaccaro AR. Revision strategies in lumbar total disc arthroplasty. Spine (Phila Pa 1976). 2008 May 15;33(11):1276-83. doi: 10.1097/BRS.0b013e3181714a1d. Review. PubMed PMID: 18469704.

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2
Q
  1. Figure 19 is the lateral radiograph of the lumbosacral junction and pelvis of a 67-year-old woman with a lumbar deformity who is being evaluated for surgery. Angle “x” refers to which radiographic parameter?
  2. Plumb line
  3. Sacral slope
  4. Lumbar lordosis
  5. Pelvic incidence
  6. Pelvic tilt
A
  1. Pelvic incidence

RECOMMENDED READINGS

Labelle H, Mac-Thiong JM, Roussouly P. Spino-pelvic sagittal balance of spondylolisthesis: a review and classification. Eur Spine J. 2011 Sep;20 Suppl 5:641-6. doi: 10.1007/s00586-011-1932-1. Epub 2011 Aug 2. Review. PubMed PMID: 21809015; PubMed Central PMCID: PMC3175928.

Mehta VA, Amin A, Omeis I, Gokaslan ZL, Gottfried ON. Implications of spinopelvic alignment for the spine surgeon. Neurosurgery. 2012 Mar;70(3):707-21. doi: 10.1227/NEU.0b013e31823262ea. Review. Erratum in: Neurosurgery. 2012 May;70(5):1324. PubMed PMID: 21937939.

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3
Q
  1. Figures 27a and 27b are the sagittal CT and T2-weighted MR images of the cervical spine of a 71-year-old man who has neck pain after falling from a standing height. What is the best next step?
  2. Halo orthosis
  3. Physical therapy
  4. Soft cervical collar
  5. Anterior cervical fusion
  6. Posterior cervical fusion
A
  1. Posterior cervical fusion

RECOMMENDED READINGS

Mathews M, Bolesta MJ. Treatment of spinal fractures in ankylosing spondylitis. Orthopedics. 2013 Sep;36(9):e1203-8. doi:10.3928/01477447-20130821-25. PubMed PMID: 24025014.

Whang PG, Goldberg G, Lawrence JP, Hong J, Harrop JS, Anderson DG, Albert TJ, Vaccaro AR. The management of spinal injuries in patients with ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis: a comparison of treatment methods and clinical outcomes. J Spinal Disord Tech. 2009 Apr;22(2):77-85. doi: 10.1097/BSD.0b013e3181679bcb. PubMed PMID: 19342927.

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4
Q
  1. Figure 35 is the sagittal T2-weighted MR image of the lumbar spine of a 56-year-old man who has been experiencing back pain for several years. Which treatment has been shown to give rise to clinical outcomes that are equivalent to those observed following fusion surgery?
  2. Gabapentinoid administration
  3. Chiropractic care
  4. Epidural injections
  5. Cognitive-behavioral therapy
  6. Intradiskal electrothermal annuloplasty
A
  1. Cognitive-behavioral therapy

RECOMMENDED READINGS

Mannion AF, Brox JI, Fairbank JC. Comparison of spinal fusion and nonoperative treatment in patients with chronic low back pain: long-term follow-up of three randomized controlled trials. Spine J. 2013 Nov;13(11):1438-48. doi: 10.1016/j.spinee.2013.06.101. Epub 2013 Nov 5. PubMed PMID: 24200413.

Brox JI, Sørensen R, Friis A, Nygaard Ø, Indahl A, Keller A, Ingebrigtsen T, Eriksen HR, Holm I, Koller AK, Riise R, Reikerås O. Randomized clinical trial of lumbar instrumented fusion and cognitive intervention and exercises in patients with chronic low back pain and disc degeneration. Spine (Phila Pa 1976). 2003 Sep 1;28(17):1913-21. PubMed PMID: 12973134.

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5
Q
  1. Figure 45 is the postsurgical lateral radiograph of a 72-year-old woman who undergoes lumbar fusion for L5 spondylolysis. Immediately after surgery, one of her legs feels colder. This condition is most likely caused by an intraoperative injury to which structure?
  2. Sympathetic trunk
  3. Cauda equina
  4. Iliac vein
  5. S1 nerve root
  6. Superior hypogastric plexus
A
  1. Sympathetic trunk

RECOMMENDED READINGS

Kasliwal MK, Deutsch H. Anhidrosis after anterior retroperitoneal approach for L4-L5 artificial disc replacement. J Clin Neurosci. 2011 Jul;18(7):990-1. doi: 10.1016/j.jocn.2010.11.022. Epub 2011 May 12. PubMed PMID: 21570302.

Schulte TL, Adolphs B, Oberdiek D, Osada N, Liljenqvist U, Filler TJ, Marziniak M, Bullmann V. Approach-related lesions of the sympathetic chain in anterior correction and instrumentation of idiopathic scoliosis. Eur Spine J. 2010 Sep;19(9):1558-68. doi: 10.1007/s00586-010-1455-1. Epub 2010 May 26. PubMed PMID: 20502925; PubMed Central PMCID: PMC2989285.

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6
Q
  1. A 27-year-old man with paraplegia is prescribed gabapentin for his neuropathic pain after sustaining a thoracic-level spinal cord injury. What is the mechanism of action of this medication?
  2. Disrupts production of arachidonic acid by inhibiting phospholipase A2
  3. Inhibits the receptor activator of nuclear factor kappa beta ligand
  4. Impedes postsynaptic sodium channels and prevents membrane depolarization
  5. Binds to presynaptic calcium channels and limits the release of neurotransmitters
  6. Reduces uptake of serotonin and norepinephrine by blocking transporter proteins
A
  1. Binds to presynaptic calcium channels and limits the release of neurotransmitters

RECOMMENDED READINGS

Bennett MI, Simpson KH. Gabapentin in the treatment of neuropathic pain. Palliat Med. 2004 Jan;18(1):5- 11. Review. PubMed PMID: 14982201.

Mehta S, McIntyre A, Dijkers M, Loh E, Teasell RW. Gabapentinoids are effective in decreasing neuropathic pain and other secondary outcomes after spinal cord injury: a meta-analysis. Arch Phys Med Rehabil. 2014 Nov;95(11):2180-6. doi: 10.1016/j.apmr.2014.06.010. Epub 2014 Jun 30. Review. PubMed PMID: 24992021.

Guy S, Mehta S, Leff L, Teasell R, Loh E. Anticonvulsant medication use for the management of pain following spinal cord injury: systematic review and effectiveness analysis. Spinal Cord. 2014 Feb;52(2):89-96. doi: 10.1038/sc.2013.146. Epub 2013 Dec 3. Review. PubMed PMID: 24296804

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7
Q
  1. A patient is positioned prone for a T10-S1 instrumented decompression and fusion for treatment of degenerative scoliosis. After surgery the patient has numbness and tingling in the ring and small fingers. Weakness is found in the hand intrinsic muscles. What is the most likely location for a neurologic injury associated with positioning?
  2. Ulnar nerve
  3. Radial nerve
  4. Median nerve
  5. Cervical nerve root
  6. Brachial plexus
A
  1. Ulnar nerve

RECOMMENDED READINGS

Labrom RD, Hoskins M, Reilly CW, Tredwell SJ, Wong PK. Clinical usefulness of somatosensory evoked potentials for detection of brachial plexopathy secondary to malpositioning in scoliosis surgery. Spine (Phila Pa 1976). 2005 Sep 15;30(18):2089-93. PubMed PMID: 16166901.

Schwartz DM, Sestokas AK, Hilibrand AS, Vaccaro AR, Bose B, Li M, Albert TJ. Neurophysiological identification of position-induced neurologic injury during anterior cervical spine surgery. J Clin Monit Comput. 2006 Dec;20(6):437-44. Epub 2006 Sep 8. PubMed PMID: 16960753.

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8
Q
  1. Figure 77 is the lateral thoracic radiograph of an 86-year-old woman who has acute midback pain after a slip and fall at home. She denies lower extremity pain and has normal motor and sensory examination findings. What is the best next step?
  2. Open biopsy
  3. Vertebroplasty
  4. Osteoporosis evaluation
  5. Posterior thoracic arthrodesis
  6. Anterior corpectomy and arthrodesis
A
  1. Osteoporosis evaluation

RECOMMENDED READINGS

Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, Graves S, Staples MP, Murphy B. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009 Aug 6;361(6):557-68. doi: 10.1056/NEJMoa0900429. PubMed PMID: 19657121.

U.S. Preventive Services Task Force. Screening for osteoporosis: U.S. preventive services task force recommendation statement. Ann Intern Med. 2011 Mar 1;154(5):356-64. doi: 10.7326/0003-4819-154-5- 201103010-00307. Epub 2011 Jan 17. PubMed PMID: 21242341.

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9
Q
  1. Figures 94a and 94b are the MR images of a 72-year-old woman who has pain radiating into both legs with ambulation. Her pain is improved with bending forward. Her neurologic examination reveals normal strength and sensation. She has attempted nonsurgical treatment for 3 months and has experienced progressive worsening pain. What is the most effective treatment option?
  2. Facet injections
  3. L4-S1 anterior and posterior fusion
  4. Epidural steroid injections
  5. Posterior L4-L5 lumbar decompression
  6. Posterior L4-L5 lumbar decompression and arthrodesis
A
  1. Posterior L4-L5 lumbar decompression and arthrodesis

RECOMMENDED READINGS

Weinstein JN, Lurie JD, Tosteson TD, Zhao W, Blood EA, Tosteson AN, Birkmeyer N, Herkowitz H, Longley M, Lenke L, Emery S, Hu SS. Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis. four-year results in the Spine Patient Outcomes Research Trial (SPORT) randomized and observational cohorts. J Bone Joint Surg Am. 2009 Jun;91(6):1295-304. doi: 10.2106/ JBJS.H.00913. PubMed PMID: 19487505.

Abdu WA, Lurie JD, Spratt KF, Tosteson AN, Zhao W, Tosteson TD, Herkowitz H, Longely M, Boden SD, Emery S, Weinstein JN. Degenerative spondylolisthesis: does fusion method influence outcome? Four-year results of the spine patient outcomes research trial. Spine (Phila Pa 1976). 2009 Oct 1;34(21):2351-60. doi: 10.1097/BRS.0b013e3181b8a829. PubMed PMID: 19755935

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10
Q
  1. Figure 110 is the MR image of a 54-year-old man who has had severe neck pain, upper extremity pain, and weakness for 6 months. He has progressive gait instability, and examination reveals bilateral weakness in his biceps, triceps, and hand intrinsics. He has 3+ biceps, triceps, and quadriceps reflexes with sustained ankle clonus. What is the chief posterior decompression contraindication?
  2. Age
  3. Severe neck pain
  4. Cervical kyphosis
  5. Multiple-level diseases
  6. Duration of symptoms
A
  1. Cervical kyphosis

RECOMMENDED READINGS

Suda K, Abumi K, Ito M, Shono Y, Kaneda K, Fujiya M. Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy. Spine (Phila Pa 1976). 2003 Jun 15;28(12):1258-62. PubMed PMID: 12811268.

Chiba K, Ogawa Y, Ishii K, Takaishi H, Nakamura M, Maruiwa H, Matsumoto M, Toyama Y. Long-term results of expansive open-door laminoplasty for cervical myelopathy–average 14-year follow-up study. Spine (Phila Pa 1976). 2006 Dec 15;31(26):2998-3005. PubMed PMID: 17172996.

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11
Q
  1. Figure 124 is the lateral radiograph of a 63-year-old man who has had a long-standing history of chronic neck and right upper extremity pain. He recently reported progressive weakness in his right shoulder and biceps that developed over the course of 90 days. He has a history of hepatitis C attributable to intravenous (IV) drug use in the remote past. He denies any history of spinal trauma, and his temperature in the office is 37°C. What is the most appropriate next step?
  2. Dual-energy x-ray absorptiometry (DEXA) scan
  3. CT scan with contrast
  4. MR imaging without contrast
  5. MR imaging with and without contrast
  6. Flexion extension plain film images
A
  1. MR imaging with and without contrast

RECOMMENDED READINGS

Schoenfeld AJ. Spine infections. In: Cannada LK, ed. Orthopaedic Knowledge Update 11. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2014:737-747.

Schoenfeld AJ, Wahlquist TC. Mortality, complication risk, and total charges after the treatment of epidural abscess. Spine J. 2015 Feb 1;15(2):249-55. doi: 10.1016/j.spinee.2014.09.003. Epub 2014 Sep 21. PubMed PMID: 25241303.

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12
Q
  1. Figure 141 is the axial MR image of a 73-year-old man with a history of hypertension. He has had bilateral buttock pain when walking more than 4 blocks for 4 weeks. A complete diagnostic workup should include
  2. examination of the peripheral pulses.
  3. CT myelogram.
  4. peripheral muscle biopsy.
  5. laboratory evaluation including prothrombin time and international normalized ratio.
  6. electromyography and nerve conduction studies.
A
  1. examination of the peripheral pulses.

RECOMMENDED READINGS

Issack PS, Cunningham ME, Pumberger M, Hughes AP, Cammisa FP Jr. Degenerative lumbar spinal stenosis: evaluation and management. J Am Acad Orthop Surg. 2012 Aug;20(8):527-35. doi: 10.5435/ JAAOS-20-08-527. Review. PubMed PMID: 22855855.

Young IA, Hyman GS, Packia-Raj LN, Cole AJ. The use of lumbar epidural/transforaminal steroids for managing spinal disease. J Am Acad Orthop Surg. 2007 Apr;15(4):228-38. Review. PubMed PMID: 17426294.

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13
Q
  1. Figure 163 is the MR image of a 43-year-old woman who has a 3-week history of neck pain radiating into her left arm. She denies numbness or problems with balance. Examination reveals her pain is reproduced with ipsilateral neck rotation. What is the best next step?
  2. Radiofrequency ablation
  3. Chiropractic manipulation
  4. Posterior cervical foraminotomy
  5. Anterior cervical diskectomy and fusion
  6. Initiation of nonsteroidal anti-inflammatory drugs (NSAIDs)
A
  1. Initiation of nonsteroidal anti-inflammatory drugs (NSAIDs)

RECOMMENDED READINGS

Rhee JM, Yoon T, Riew KD. Cervical radiculopathy. J Am Acad Orthop Surg. 2007 Aug;15(8):486-94. Review. PubMed PMID: 17664368.

Dreyer SJ, Boden SD. Nonoperative treatment of neck and arm pain. Spine (Phila Pa 1976). 1998 Dec 15;23(24):2746-54. Review. PubMed PMID: 9879100.

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14
Q
  1. Figure 180 is the MR image of a 68-year-old woman who has experienced neck pain for several years. Recently she began to notice gait imbalance and handwriting changes. What is the most appropriate next step?
  2. Cervical traction
  3. Epidural steroid injections
  4. Single-level anterior diskectomy and fusion
  5. Multilevel posterior decompression and fusion
  6. Evaluation by a neurologist for demyelinating disease
A
  1. Multilevel posterior decompression and fusion

RECOMMENDED READINGS

Emery SE. Cervical spondylotic myelopathy: diagnosis and treatment. J Am Acad Orthop Surg. 2001 Nov-Dec;9(6):376-88. Review. PubMed PMID: 11767723.

Gerard CS, O’Toole JE. Current techniques in the management of cervical myelopathy and radiculopathy. Neurosurg Clin N Am. 2014 Apr;25(2):261-70. doi: 10.1016/j.nec.2013.12.005. Epub 2014 Jan 31. Review. PubMed PMID: 24703445.

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15
Q
  1. Figure 194 is the lateral weight-bearing radiograph of a 72-year-old woman who has a 2-year history of lower back and bilateral lower extremity pain with prolonged walking. Which surgical treatment will provide the best long-term results?
  2. Laminectomy
  3. Laminectomy with instrumented fusion
  4. Lumbar microdiskectomy
  5. Interspinous process spacer
  6. Anterior lumbar interbody fusion
A
  1. Laminectomy with instrumented fusion

RECOMMENDED READINGS

Majid K, Fischgrund JS. Degenerative lumbar spondylolisthesis: trends in management. J Am Acad Orthop Surg. 2008 Apr;16(4):208-15. Review. PubMed PMID: 18390483.

Fischgrund JS, Mackay M, Herkowitz HN, Brower R, Montgomery DM, Kurz LT. 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine (Phila Pa 1976). 1997 Dec 15;22(24):2807-12. PubMed PMID: 9431616.

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16
Q
  1. The mechanism of action of etanercept in the treatment of rheumatoid arthritis is based on its ability to act as an
  2. antagonist of tumor necrosis factor-alpha.
  3. agonist of Interleukin-1 (IL-1).
  4. antagonist of IL-1.
  5. agonist of pyrimidine synthesis.
  6. antagonist of cyclooxygenase-1.
A
  1. antagonist of tumor necrosis factor-alpha.

RECOMMENDED READINGS

Howe CR, Gardner GC, Kadel NJ. Perioperative medication management for the patient with rheumatoid arthritis. J Am Acad Orthop Surg. 2006 Sep;14(9):544-51. Review. PubMed PMID: 16959892.

Smolen JS, Nash P, Durez P, Hall S, Ilivanova E, Irazoque-Palazuelos F, Miranda P, Park MC, Pavelka K, Pedersen R, Szumski A, Hammond C, Koenig AS, Vlahos B. Maintenance, reduction, or withdrawal of etanercept after treatment with etanercept and methotrexate in patients with moderate rheumatoid arthritis (PRESERVE): a randomised controlled trial. Lancet. 2013 Mar 16;381(9870):918-29. doi: 10.1016/ S0140-6736(12)61811-X. Epub 2013 Jan 17. PubMed PMID: 23332236.

17
Q
  1. The arrow in Figure 205 points to which structure?
  2. Left L3 nerve root
  3. Left L4 nerve root
  4. Right L3 nerve root
  5. Right L4 nerve root
  6. Right segmental vessel
A
  1. Right L3 nerve root
18
Q
  1. A 72-year-old woman recently started taking denosumab after sustaining a second osteoporotic vertebral body compression fracture. What is the mechanism of action of this medication?
  2. Increases serum calcium levels by activating vitamin D
  3. Impairs the formation of the ruffled border of osteoclasts
  4. Functions as a selective estrogen receptor modulator
  5. Stimulates osteoblastic differentiation of pluripotential stem cells
  6. Inhibits the receptor activator of nuclear factor kappa beta ligand (RANKL)
A
  1. Impairs the formation of the ruffled border of osteoclasts

RECOMMENDED READINGS

Väänänen HK, Zhao H, Mulari M, Halleen JM. The cell biology of osteoclast

function. J Cell Sci. 2000 Feb;113 ( Pt 3):377-81. Review. PubMed PMID: 10639325.

Boyce BF. Advances in the regulation of osteoclasts and osteoclast functions. J Dent Res. 2013 Oct;92(10):860-7. doi: 10.1177/0022034513500306. Epub 2013 Aug 1. Review. PubMed PMID: 23906603; PubMed Central PMCID: PMC3775372.

Warriner AH, Saag KG. Osteoporosis diagnosis and medical treatment. Orthop Clin North Am. 2013 Apr;44(2):125-35. doi: 10.1016/j.ocl.2013.01.005. Epub 2013 Feb 26. Review. PubMed PMID: 23544819.

Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, Delmas P, Zoog HB, Austin M, Wang A, Kutilek S, Adami S, Zanchetta J, Libanati C, Siddhanti S, Christiansen C; FREEDOM Trial. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009 Aug 20;361(8):756-65. doi: 10.1056/NEJMoa0809493. Epub 2009 Aug 11. Erratum in: N Engl J Med. 2009 Nov 5;361(19):1914. PubMed PMID: 19671655.

19
Q
  1. An 83-year-old man has had an L1 osteoporotic burst fracture with progressive lower extremity weakness for 4 days. He can no longer walk because of back and leg pain and leg weakness. Examination reveals bilateral weakness in his hip flexors and quadriceps. MR imaging reveals severe canal stenosis and compression on the conus medullaris and cauda equina. What is the best treatment option?
  2. Kyphoplasty
  3. Vertebroplasty
  4. Laminectomy
  5. Laminectomy and fusion
  6. Thoracic lumbar sacral orthosis
A
  1. Laminectomy and fusion

RECOMMENDED READINGS

Ughwanogho E, Hu X, Lieberman IH. Vertebral compression fractures. In: Cannada LK, ed. Orthopaedic Knowledge Update 11. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2014:775-782.

Patel AA, Vaccaro AR. Thoracolumbar spine trauma classification. J Am Acad Orthop Surg. 2010 Feb;18(2):63-71. PubMed PMID: 20118323.

Esses SI, McGuire R, Jenkins J, Finkelstein J, Woodard E, Watters WC 3rd, Goldberg MJ, Keith M, Turkelson CM, Wies JL, Sluka P, Boyer KM, Hitchcock K. The treatment of symptomatic osteoporotic spinal compression fractures. J Am Acad Orthop Surg. 2011 Mar;19(3):176-82. PubMed PMID: 21368099.

20
Q
  1. A 90-year-old woman has neck pain and an incomplete spinal cord injury associated with a cervical spine fracture after sustaining a ground-level fall. This patient’s age puts her at heightened risk for which complication?
  2. Mortality
  3. Chronic pain
  4. Wound infection
  5. Pulmonary embolism
  6. Intracranial hemorrhage
A
  1. Mortality

RECOMMENDED READINGS

Fassett DR, Harrop JS, Maltenfort M, Jeyamohan SB, Ratliff JD, Anderson DG, Hilibrand AS, Albert TJ, Vaccaro AR, Sharan AD. Mortality rates in geriatric patients with spinal cord injuries. J Neurosurg Spine. 2007 Sep;7(3):277-81. PubMed PMID: 17877260.

Irwin ZN, Arthur M, Mullins RJ, Hart RA. Variations in injury patterns, treatment, and outcome for spinal fracture and paralysis in adult versus geriatric patients. Spine (Phila Pa 1976). 2004 Apr 1;29(7):796-802. PubMed PMID: 15087803.

21
Q
  1. When performing lateral transpsoas interbody fusion at L4-5, which nerve(s) may be injured when dissecting through the abdominal wall?
  2. Sciatic nerve
  3. L4 and L5 nerve roots
  4. Ilioinguinal and iliohypogastric
  5. Lateral femoral cutaneous and obturator
  6. Lateral femoral cutaneous and saphenous
A
  1. Ilioinguinal and iliohypogastric

RECOMMENDED READINGS

Ahmadian A, Deukmedjian AR, Abel N, Dakwar E, Uribe JS. Analysis of lumbar plexopathies and nerve injury after lateral retroperitoneal transpsoas approach: diagnostic standardization. J Neurosurg Spine. 2013 Mar;18(3):289-97. doi: 10.3171/2012.11.SPINE12755. Epub 2012 Dec 21. Review. PubMed PMID: 23259543.

Uribe JS, Vale FL, Dakwar E. Electromyographic monitoring and its anatomical implications in minimally invasive spine surgery. Spine (Phila Pa 1976). 2010 Doi: 15;35(26 Suppl):S368-74. doi: 10.1097/ BRS.0b013e3182027976. Review. PubMed PMID: 21160402.

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Q
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23
Q
  1. Figure 243 is the lateral radiograph of a 32-year-old basketball player who has had low-back and leg pain for 4 years. An examination reveals exacerbation of back pain with extension. She has normal motor examination findings and normal sensation. Which pelvic parameter correlates with this condition?
  2. Pelvic tilt
  3. Pelvic incidence
  4. Sacral slope
  5. Slip angle
  6. Spinopelvic angle
A
  1. Pelvic incidence

RECOMMENDED READINGS

Labelle H, Roussouly P, Berthonnaud E, Dimnet J, O’Brien M. The importance of spino-pelvic balance in L5-s1 developmental spondylolisthesis: a review of pertinent radiologic measurements. Spine (Phila Pa 1976). 2005 Mar 15;30(6 Suppl):S27-34. Review. PubMed PMID: 15767882.

Hanson DS, Bridwell KH, Rhee JM, Lenke LG. Correlation of pelvic incidence with low- and high-grade isthmic spondylolisthesis. Spine (Phila Pa 1976). 2002 Sep 15;27(18):2026-9. PubMed PMID: 12634563.

24
Q
  1. Figures 249a and 249b are the cervical angiogram images of a 56-year-old woman with a cervical spine fracture resulting from a motor vehicle collision. Which fracture pattern is most commonly associated with this type of injury?
  2. C5 facet with subluxation
  3. C3 transverse process
  4. Type 2 odontoid
  5. Hangman
  6. Jefferson
A
  1. C5 facet with subluxation

RECOMMENDED READINGS

Lebl DR, Bono CM, Velmahos G, Metkar U, Nguyen J, Harris MB. Vertebral artery injury associated with blunt cervical spine trauma: a multivariate regression analysis. Spine (Phila Pa 1976). 2013 Jul 15;38(16):1352-61. doi: 10.1097/BRS.0b013e318294bacb. PubMed PMID: 23574813.

Dreger T, Place H, Piper C, Mattingly T, Brechbuehler J. Analysis of Cervical Angiograms in Cervical Spine Trauma Patients, Does it Make a Difference? J Spinal Disord Tech. 2014 Aug 1. [Epub ahead of print] PubMed PMID: 25089671.

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