spine

Question 1

biceps reflex nerve root

Answer 1

C5

Question 2

brachioradialis tendon reflex nerve root

Answer 2

C6

Question 3

tricpes tendon reflex nerve root

Answer 3

C7

Question 4

wrist extension nerve root

Answer 4

C6

Question 5

wrist flexion nerve root

Answer 5

C7

Question 6

finger flexion nerve root

Answer 6

C8

Question 7

achilles tendon reflex nerve root

Answer 7

S1

Question 8

tib ant nerve root

Answer 8

L4

Question 9

EDL nerve root

Answer 9

L5

Question 10

what ADI indicates mechanical instability in RA?

Answer 10

> 9-10 mm

Question 11

what PADI/SAC indicates mechanical instability in RA and is an indication for surgery?

Answer 11

< 14 mm

Question 12

most common location for degen spondy

Answer 12

L4-L5

Question 13

most common location for isthmic spondy

Answer 13

L5-S1

Question 14

amount of correction with Smith-Pete osteotomy

Answer 14

5-10 degrees sagittal plane

Question 15

amount of correction with pedicle subtraction osteotomy

Answer 15

30 degrees sagittal plane

Question 16

amount of correction with vertebral column resection

Answer 16

30-40 degrees sagittal plane

Question 17

in adult deformity what is the most reliable predictor of clinical symptoms post op

Answer 17

sagittal balance

Question 18

GAG and collagen content in the annulus fibrosus?

Answer 18

low GAG, high collagen

Question 19

GAG and collagen content in the nucleus pulposus?

Answer 19

high GAG, low collagen

Question 20

what happens to the aging disc?

Answer 20

decreased water content, GAG, proteoglycans, chondroitin sulfate. increased collagen diameter, keratin sulfate

Question 21

most sensitive imaging for isthmic spondy

Answer 21

SPECT

Question 22

what symptoms is a/w worse prognosis in myelopathy?

Answer 22

LE weakness (corticospinal tracts)

Question 23

what amount of AADI motion on flexion and extension indicates instability in RA atlantoaxial subluxation?

Answer 23

> 3.5 mm

Question 24

safe zone for anterior halo pin placement

Answer 24

above eyebrow, middle to lateral third to avoid supraorbital nerve

Question 25

anterior cord syndrome

Answer 25

spinothalamic tract - loss of motor, pain, and temperature. preserved proprioception and deep pressure

Question 26

brown-sequard syndrome

Answer 26

ipsilateral loss of motor and proprioception, contralateral loss of pain and temperature

Question 27

posterior cord syndrome

Answer 27

loss of proprioception, vibration, deep pressure

Question 28

symptoms of autonomic dysreflexia

Answer 28

HTN, headache, flushing, sweating, blurred vision, nasal congestion

Question 29

which spinal cord injury syndrome has the worst prognosis?

Answer 29

anterior cord syndrome

Question 30

which spinal cord injury syndrome has the best prognosis?

Answer 30

brown-sequard

Question 31

powers ratio

Answer 31

basion to posterior arch of atlas divided by opisthion to anterior arch of atlas

Question 32

what radiographic measurement indicates transverse ligament rupture?

Answer 32

combined lateral mass displacement greater than 6.9 mm

Question 33

what does ADI > 3.5 mm indicate

Answer 33

transverse ligament damaged

Question 34

what does ADI > 5 mm indicate

Answer 34

transverse and alar ligaments damaged

Question 35

risk factors for nonunion in type 2 dens fracture

Answer 35

displacement > 5mm, posterior displacement, age > 40, delayed treatment, angulation > 10 degrees

Question 36

best posterior fixation construct for C1-2

Answer 36

harms C1 lateral mass-C2 pedicle screw. modified Gallie is worst (autograft iliac crest over C2 spinous process + 1 sublaminar wire)

Question 37

what determines stability of a Jefferson fracture?

Answer 37

integrity of transverse ligament

Question 38

what is a jefferson fracture and what causes it

Answer 38

traumatic spondylolisthesis of axis due to C2 fracture, hyperextension and secondary flexion

Question 39

different in jefferson fracture type 2 and 2a morphology and treatment

Answer 39

2 - vertical fracture line, treat with traction. 2a horizontal fracture line, treat with compression halo (traction makes it worse)

Question 40

threshold that indicates pedicle breach

Answer 40

<8

Question 41

significant changes on neuromonitoring

Answer 41

50% decrease in amplitude, 10% increase in latency

Question 42

when is combined anterior-posterior cervical decompression and fusion indicated for myelopathy?

Answer 42

cervical kyphosis > 12 degrees and > 2 levels of compression

Question 43

what type of neuromonitoring is most sensitive early indicator of intra-op spinal cord injury?

Answer 43

MEPs

Question 44

activity modifications for Down syndrome patient with ADI 4.5-10 mm, >10 MM

Answer 44

4.5-10 = represents hypermobility, may participate in most activities but avoid high risk sports. >10 = instability, need surgery

Question 45

what technical factor increases the risk of adjacent segment ossification in ACDF

Answer 45

placing the plate within 5 mm of the proximal disk

Question 46

at what level are the lumber nerve roots most at risk during an MIS approach

Answer 46

L4-L5

Question 47

order of closure of neurocentral synchondrosis

Answer 47

develops between centrum and posterior neural arches. closes in cervical first, then lumbar, then thoracic last