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Miller > spine > Flashcards

spine Flashcards

1
Q

biceps reflex nerve root

A

C5

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2
Q

brachioradialis tendon reflex nerve root

A

C6

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3
Q

tricpes tendon reflex nerve root

A

C7

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4
Q

wrist extension nerve root

A

C6

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5
Q

wrist flexion nerve root

A

C7

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6
Q

finger flexion nerve root

A

C8

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7
Q

achilles tendon reflex nerve root

A

S1

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8
Q

tib ant nerve root

A

L4

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9
Q

EDL nerve root

A

L5

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10
Q

what ADI indicates mechanical instability in RA?

A

> 9-10 mm

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11
Q

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

A

< 14 mm

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12
Q

most common location for degen spondy

A

L4-L5

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13
Q

most common location for isthmic spondy

A

L5-S1

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14
Q

amount of correction with Smith-Pete osteotomy

A

5-10 degrees sagittal plane

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15
Q

amount of correction with pedicle subtraction osteotomy

A

30 degrees sagittal plane

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16
Q

amount of correction with vertebral column resection

A

30-40 degrees sagittal plane

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17
Q

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

A

sagittal balance

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18
Q

GAG and collagen content in the annulus fibrosus?

A

low GAG, high collagen

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19
Q

GAG and collagen content in the nucleus pulposus?

A

high GAG, low collagen

20
Q

what happens to the aging disc?

A

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

21
Q

most sensitive imaging for isthmic spondy

A

SPECT

22
Q

what symptoms is a/w worse prognosis in myelopathy?

A

LE weakness (corticospinal tracts)

23
Q

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

A

> 3.5 mm

24
Q

safe zone for anterior halo pin placement

A

above eyebrow, middle to lateral third to avoid supraorbital nerve

25
Q

anterior cord syndrome

A

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

26
Q

brown-sequard syndrome

A

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

27
Q

posterior cord syndrome

A

loss of proprioception, vibration, deep pressure

28
Q

symptoms of autonomic dysreflexia

A

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

29
Q

which spinal cord injury syndrome has the worst prognosis?

A

anterior cord syndrome

30
Q

which spinal cord injury syndrome has the best prognosis?

A

brown-sequard

31
Q

powers ratio

A

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

32
Q

what radiographic measurement indicates transverse ligament rupture?

A

combined lateral mass displacement greater than 6.9 mm

33
Q

what does ADI > 3.5 mm indicate

A

transverse ligament damaged

34
Q

what does ADI > 5 mm indicate

A

transverse and alar ligaments damaged

35
Q

risk factors for nonunion in type 2 dens fracture

A

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

36
Q

best posterior fixation construct for C1-2

A

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

37
Q

what determines stability of a Jefferson fracture?

A

integrity of transverse ligament

38
Q

what is a jefferson fracture and what causes it

A

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

39
Q

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

A

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

40
Q

threshold that indicates pedicle breach

A

<8

41
Q

significant changes on neuromonitoring

A

50% decrease in amplitude, 10% increase in latency

42
Q

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

A

cervical kyphosis > 12 degrees and > 2 levels of compression

43
Q

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

A

MEPs

44
Q

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

A

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

45
Q

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

A

placing the plate within 5 mm of the proximal disk

46
Q

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

A

L4-L5

47
Q

order of closure of neurocentral synchondrosis

A

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

Miller (12 decks)

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