spine

Question 1

Sub- axial C spine injury and classification system (SLICS)

Answer 1

Injury morph: none-0; compression-1; Burst- 2; Distraction-3, Translation-4 Disclig complex: intact-0; Indeterminate-1, disrupted- 2 Neuro status- intact-0; root injury- 1; complete- 2; incomplete- 3 <3= non-op 4= either 5= operative

Question 2

Complications of post. upper cervical approach

Answer 2

1. C5 neurapraxia 2. Vertebral a. injury- C1-2 transarticular screw (start point inferomed quad of lateral mass to 30deg cranial and 20deg lateral quad) 3. Transverse sinus injury- keep instrumentation inferior to superior nuchal line

Question 3

TLICS

Answer 3

1. Morphology-
   
   1. Compression=1
   2. Burst=2
   3. Translational=3
   4. Distraction=4
2. Neuro-
   
   1. Root injury=2
   2. cord/ conus medullaris (incomplete=3, complete=2)
   3. cauda= 3
3. Post-lig complex-
   
   1. intact=0
   2. injury suspected=2
   3. injured=3

3= non-op 4= surgeon preference 5= operative

Question 4

L spine anterior anatomy

Answer 4

1. Lumbar segmental vessels
2. Sympathetic chain- exits into the retroperitoneal space at L2 and runs medial to psoas muscle
3. Genitofemoral N.
4. Psoas muscle
5. Left renal vein

Gt vessels bifurcate at L4 vertebral body

Question 5

Stages of epidural hematoma

Answer 5

1. Hyperacute
   
   1. <24 hrs
   2. oxyHgb
   3. Hypo T1, hyper T2
2. Acute
   
   1. 1-3 days
   2. deoxyHgb
   3. iso T1&2
3. Subacute
   
   1. 3 days- 2 weeks
   2. metHgb
   3. hyper T1
4. chronic
   
   1. >2 weeks
   2. hemosiderrin
   3. hypo T1&2

Question 6

Lateral L spine anatomy

Answer 6