Spine and Brain

Question 1

List traumatic injuries common in the cervical spine

Answer 1

• Stable or unstable (based on displacement of vertebral body)
• C1-C2 and C6-C7 are the most injured levels of C-spine (more rotational forces or torque)
• Lower cervical injuries more common in adults, and higher-level injuries are more common in children.
• SCIWORA – spinal cord injury without radiographic abnormalities (more common in children)

Question 2

List degenerative diseases of the cervical spine

Answer 2

• Degenerative disk disease results in spondylosis (common 40+)
• Degenerative joint disease
• Foraminal encroachment

Question 3

List order of diagnostic imaging of the spine

Answer 3

• X-ray (first choice)
• CT scan (high risk trauma)
• MRI (spinal cord, ligaments, soft tissue, neuro deficits not explained by other imaging)
• Chest X-ray can detect cardiomegaly (large heart)

Question 4

What procedure is frequently done for degenerative joint disease?

Answer 4

spinal fusion

Question 5

What type of diagnostic imaging can detect cardiomegaly (enlarged heart)?

Answer 5

X- ray

Question 6

Most injuries occur where in the spine?

Answer 6

• Most injuries occur in cervical – thoracic or thoracolumbar regions due to the transitional areas between fixed and moveable anatomy.

Question 7

Compression fractures and dislocations occur with the highest frequency at what spinal levels?

Answer 7

• Compression fractures and dislocations occur with the highest frequency at T12 and L1
• 15-20% of these result in neurological injury – majority in elderly women

Question 8

What is the most common spinal fracture detectable by x-ray in all age groups.

Answer 8

• Anterior compression fractures of vertebral bodies

Question 9

List the common pathologies of the thoracic spine

Answer 9

• Osteoporosis is more common in women and most common in general
• Scoliosis (people with tethered cord are likely to develop scoliosis)
• Scheuermann’s disease (kyphosis)
• Spinal tuberculosis (becoming more common)

Question 10

What section of the spine is most commonly injured?

Answer 10

Thoracolumbar spine

Question 11

What is Spondylosis?

Answer 11

• Spondylosis – stress fracture in the pars interarticularis (intervertebral arch) – common in lumbar spine due to lordotic arch

Question 12

List common lumbar spine pathologies

Answer 12

• Spondylolisthesis (forward slipping of vertebrae)
• Spinal stenosis
• intervertebral disc herniation

Question 13

List common imaging techniques for the brain

Answer 13

• PET scans – positron emission tomography – inject a contrast :
• use the chemical interaction of the tracer with abnormal tissue.
• Can see the abnormal tissue (cancer)
• Can do dynamic imaging
• Will do an MRI after if there is abnormal activity on the PET scan
• MRI- soft tissue – can see tumors/masses
• FMRI- can see activity in the brain during the scan
• CT scan – suspected brain bleed – dark blotch on scan