Spine

Question 1

Cervical spine fractures usually occur following what type of injury?

Answer 1

High energy, often involving significant head trauma

Question 2

What are the majority of thoracolumbar spine injuries due to?

Answer 2

Falls from height or RTAs

Question 3

What type of fractures can occur in the spine of older people?

Answer 3

Osteoporotic ‘wedge’ fractures

Question 4

How are osteoporotic wedge fractures treated?

Answer 4

Symptomatic treatment only since they are relatively stable

Question 5

Younger patients with high energy injuries tend to have what type of spinal fractures?

Answer 5

Burst fractures

Question 6

What are chance fractures?

Answer 6

Flexion distraction fractures which involve the posterior ligaments and therefore may be unstable and may require surgery

Question 7

How are stable fractures of the thoracic spine treated?

Answer 7

Bracing

Question 8

What are some indications for surgery for spinal fractures?

Answer 8

Neurological defect or highly unstable fractures

Question 9

What is spinal shock?

Answer 9

A physiological response to injury where there is complete loss of sensory and motor function below the level of the injury

Question 10

When does spinal shock usually resolve?

Answer 10

24 hours

Question 11

The presence of spinal shock is identified with what?

Answer 11

Bulbocavernous reflex

Question 12

What is neurogenic shock?

Answer 12

Temporary shutdown of the sympathetic outflow from T1-L2

Question 13

With injuries where in the spine does neurogenic shock usually occur?

Answer 13

Cervical or upper thoracic

Question 14

What does neurogenic shock lead to? When will it resolve?

Answer 14

Hypotension and bradycardia, resolves in 24-48 hours

Question 15

What may occur in neurogenic shock due to unopposed parasympathetic innervation?

Answer 15

Priapism (prolonged erection)

Question 16

How is neurogenic shock treated?

Answer 16

IV fluid therapy

Question 17

Which type of shock is very common in trauma and is more likely to be the cause than neurogenic or spinal shock?

Answer 17

Hypovolaemic shock

Question 18

What determines a complete spinal cord injury?

Answer 18

No sensory or voluntary motor function below the level of the injury (reflexes should still be intact)

Question 19

How can you determine the level of injury in a complete spinal cord injury?

Answer 19

The most distal spinal level with partial function

Question 20

What determines an incomplete spinal cord injury?

Answer 20

Some neurological function (sensory and, or motor) below the level of the injury

Question 21

What is the prognosis for recovery from complete spinal cord injuries?

Answer 21

Poor

Question 22

In spinal cord injuries, the sparing of which area implies a good prognosis?

Answer 22

Sacrum

Question 23

What is the most common pattern of incomplete spinal cord injuries?

Answer 23

Central

Question 24

What type of injury usually causes a central incomplete spinal cord injury?

Answer 24

Hyperextension injury in a cervical spine with OA

Question 25

What function is lost in an anterior incomplete spinal cord injury?

Answer 25

Motor function and coarse touch, pain and temperature sensation

Question 26

What type of injuries tend to cause incomplete Brown-Sequard spinal cord injuries?

Answer 26

Penetrating injuries

Question 27

What type of neurological loss occurs in Brown-Sequard syndrome?

Answer 27

Motor loss on one side of the body and loss of pain/temperature and light touch on the other side of the body

Question 28

What x-ray views are required for a C-spine fracture?

Answer 28

AP, lateral, odontoid peg