Khanna Spine

Question 1

Patellar reflex?

What is L5 reflex?

Answer 1

• L4 patellar reflex
  Dermatome L1/2/3 Prox/middle/distal thigh
  There is NO L5 nerve root

Question 2

What is the best to determine PVNS versus synovial chondromatosis?

Answer 2

Gradient echo MR

Question 3

To evaluate for non-displaced occult fracture of femoral neck?

Answer 3

STIR sequence of MRI

Question 4

Tumors respect the disk because?

Answer 4

They do NOT have hyallluranidase- cannot digest the disk- infection can

Question 5

SLACLine

Answer 5

Sympathetic chain, longus coli, atery, cervical nerve root, lateral masse (anterior to posterior)

Question 6

Horners syndrome injury

Answer 6

• Inferior ganlgion of sympathetic chain

Question 7

Carotid sheath contents and relationship

Answer 7

Artery (most anteior and medial, IJ, vagus N.

Question 8

What is at risk with the C1-2 transarticular screw?

Answer 8

C2 nerve root

- Posterior arch of C1 (1.5 cm worry about VA, 2.5cm until you HIT VArtery

Question 9

Which side does the artery of Adamkiewize arise from?

Answer 9

Lower thoracic spine , LEFT side

Question 10

ALIF risks L/4/5 or L5S1

Answer 10

• L4/5 ililumbar vein
  L5/S1- symphatetic chain
  Also genitofemoral nerve

Question 11

Powers ratio

Answer 11

BC/AB- only good for ANTERIOR AOdislocation

Question 12

Type II Odontoid

Answer 12

Displacement>angulation
Odontoid screw(only 1) OR PSF C1/2

Question 13

Type II Odontoid

Answer 13

Displacement>angulation
Odontoid screw(only 1) OR PSF C1/2

Question 14

What is a hangmans fracture?

Answer 14

Is a fracture between the anterior and posterior elements of C2
- Type I- no angulation/translation
- Type II- angulation and translation- closed, traction, extension
IIA- need COMPRESSION HALO
III- vertical fracture with unilateral or bilateral facet dislocations (highest neuro compromise)

Question 15

What levels increase risk of dysphagia in ACDF?

Answer 15

the Higher you GO, higher dysphagia

• Lower you GO higher risk of RLN injury
• More levels, higher airway comp, higher non-union

Question 16

Rheumatoid Spine

Answer 16

• ligament instability, pannus formation

- neurocompromise

Question 17

Rheumatoid spine

Answer 17

Autoimmune response, ligaments are getting lex, pannus formation
- <135 cervicomedullary angle
- subaxial subluxation
- AA instability
- basilar invagination
AA instability(first)–>then leads to late stage subaxial subluxation

Question 18

IF you have a burst fracture WITH a lamina fracture what approach?

Answer 18

you will have to go from the bac due to high association with injury dural tears

Question 19

GSW to spine?

Answer 19

Hollow organ injury- possible surgical intervention
No hollow- observe
If bullet IN canal at t10 or ABOV you LEAVE IT (ODD)

Question 20

Treatment for neurgenic shock?

Answer 20

Hypotensive and bradycardia

Fluids THEN pressors

Question 21

Which of the chord syndroms has the worst prognosis?

Answer 21

Anteiror cord

- Best prognosis is BS