Spinal Fracture

Question 1

What is a spinal fracture?

1 - damage to the spinal cord
2 - damage to the spinal cord and vertebrae
3 - damage to the vertebrae

Answer 1

3 - damage to the vertebrae

Question 1

The spine acts to stabilise 3 forces, Which of the following is NOT one of these forces?

1 - distraction
2 - rotation
3 - torsion
4 - compression

Answer 1

2 - rotation

Question 2

Most spinal fractures occur in the thoracic and lumbar region of the spine. What % of spinal fractures occur at the the thoracolum,bar region of the spine?

1 - 5%
2 - 15%
3 - 20%
4 - 50%

Answer 2

4 - 50%

Question 3

Most spinal fractures occur in the thoracic and lumbar region of the spine. But what % of spinal fractures occur at the the cervical region of the spine?

1 - 5%
2 - 15%
3 - 20%
4 - 50%

Answer 3

3 - 20%

Question 4

Are men or women more likely to have a spinal fracture?

Answer 4

• men

Question 5

What is the average age of a spinal fracture?

1 - 10 y/o
2 - 30 y/o
3 - 50 y/o
4 - >65 y/o

Answer 5

2 - 30 y/o

Question 6

It is important to identify neurological impairments in patients with a spinal fracture to ensure that treatment can be provided and spinal cord injury can be assessed.

Question 7

Are spinal cord fractures of the vertebral body generally stable or unstable?

Answer 7

• stable

Question 8

Are fractures affecting the space for the spinal cord stable or unstable?

Answer 8

• always considered unstable until proven otherwise

Question 9

Patients with osteoporosis have an increased risk of spinal fracture. What % of women have osteoporosis?

1 - 3%
2 - 15%
3 - 30%
4 - 65%

Answer 9

3 - 30%

• women are generally more affected

Question 10

Which of the following is the most common type of fracture of the vertebrae in patients with osteoporosis?

1 - Compression
2 - Burst
3 - Flexion-distraction
4 - Fracture-dislocation.

Answer 10

1 - Compression

• affects 1.5 million Americans annually
• generally involves vertebral body and is therefore stable

Question 11

What is the most common site for a osteoporotic vertebral fracture?

1 - C1-C2
2 - T2-T4
3 - T11-T12
4 - S1-S2

Answer 11

3 - T11-T12

• this is the thoracolumbar junction, which is the most common site for all spine fractures

Question 12

All of the following can occur following an osteoporotic spinal fracture, EXCEPT which one?

1 - chronic/acute pain and reduced QoL
2 - reduced risk of falls and fractures
3 - increased mortality
4 - increase incidence of new fractures

Answer 12

2 - reduced risk of falls and fractures

• there is an increased risk of falls

Question 13

What age does peak bone density generally occur?

1 - 12-18 y/o
2 - 18-29 y/o
3 - 30-35 y/o
4 - 40-50 y/o

Answer 13

2 - 18-29 y/o

Question 14

Does the density of spongy (cancellous) bone increase or decrease in osteoporosis?

Answer 14

• decreases
• makes the bones weak and brittle

Question 15

Does estrogen increase or decrease the risk of osteoporosis?

Answer 15

• decreases
• estrogen is protective, thats why older women experience it more following menopause

Question 16

Spinal cord fracture can be caused by a myriad of things. Which of the following would NOT be a spinal cause differential?

1 - Osteoporotic fracture
2 - Metastatic disease
3 - Primary bone pathology
4 - Leukaemia

Answer 16

4 - Leukaemia

Question 17

Spinal cord fracture can be caused by a myriad of things. Which of the following would NOT be a spinal cause differential?

1 - Aortic aneurysm (dissecting)
2 - Urinary tract infection, urinary calculi
3 - Pancreatitis, cholecystitis, duodenal ulcer
4 - Prostatitis
5 - Gynaecological – e.g. endometriosis, ectopic pregnancy
6 - testicular torsion

Answer 17

6 - testicular torsion

Question 18

When investigating if a patient has a spinal cord injury we measure all of the following EXCEPT:

1 - FBC
2 - U&Es
3 - CRP/ESR
4 - alkaline phosphotase
5 - LFTs

Answer 18

5 - LFTs

Question 19

How many views are generally taking in any X-ray including a patient with a suspected spinal fracture?

1 - 4
2 - 3
3 - 2
4 - 1

Answer 19

3 - 2

Question 20

Which imaging modality is generally 1st choice in spinal fractures?

1 - X-ray
2 - MRI
3 - CT
4 - DEXA

Answer 20

1 - X-ray

• CT and MRI may be able to detect small fracture and pathology
• DEXA would be used following X-ray in someone at risk of osteoporosis

Question 21

If a spinal fracture is left untreated, is this ok?

Answer 21

• depends on the patients stability
• HOWEVER an untreated fracture can lead to deformity

Question 22

A stable spine fracture is typically one that affects the body of the vertebrae. Which of the following is NOT typically a management approach of this type of fracture?

1 - Analgesia
2 - Physiotherapy
3 - Movement
4 - Steroid injections
5 - Bracing

Answer 22

4 - Steroid injections

• acute surgery is rarely performed

Question 23

An unstable spine fracture is typically one that affects the vertebral arch. This generally requires specialist input but would be treated using:

1 - surgery
2 - bracing