Cervical Spine

Question 1

Signs of Vertebrobasilar Artery(VBA) Dissection

Answer 1

Unsteadiness/ataxia 67%
Dysphagia/dysarthria/aphasia 44%
Lower limb weakness 41%
Upper limb weakness 33%
Nausea/vomiting 26%
Facial palsy 22%
Dizziness/loss of equilibrium 20%
Loss of consciousness 15%

Question 2

Signs of Internal Carotid Artery (ICA) Dissection

Answer 2

Ptosis 60-80%
Upper limb weakness 65%
Facial palsy 60%
Lower limb weakness 50%
Dysphagia/dysarthira/aphasia 45%
Unsteadiness/ataxia 40%
Nausea/vomiting 30%
Loss of consciousness 20%

Question 3

NDI outcome measure MDC?

Answer 3

5/50 for uncomplicated neck pain;
up to 10/50 for cervical radiculopathy

Question 4

NDI outcome measure CID(clinically important difference)

Answer 4

varies from 5/50 to 19/50 across studies

Question 5

Canadian C-Spine Rule

Answer 5

Pt should get X-ray if
1) Any high risk factor MOI=yes
2) Low risk factor MOI=no
3) Able to actively rotate 45* R and L=no

not applicable in certain populations, injury type, presentation

Question 6

Nexus Criteria for C-spine Imaging

Answer 6

Imaging indicated if any of the following present:
1) focal neuro deficit
2) midline spine tenderness
3) altered LOC present
4) intoxication present
5) distracting injury present

Question 7

Predictors for moderate/severe disability at 12 months after WAD

Answer 7

age 35+, NDI 40%+, hyperarousal symptoms 6+ on subscale of PTSD scale

Question 8

predictors for full recovery after WAD

Answer 8

age <35, NDI scores <=32%
-majority of recovery takes place in first 3 months

Question 9

Cook et al cluster to diagnose cervical myelopathy

Answer 9

-age >45
-positive babinski sign
-positive supinator sign