Cervical Spine Orthopedics I Practice Exam

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• What imaging and clinical clues suggest a cervical spine tumor or metastasis?
• In cervical trauma, which combination of findings indicates the need for surgical stabilization?
• ACDF is described as what procedure and what is its typical indication?
• What is a potential complication of posterior cervical fusion?
• Which radiographic measure specifically assesses cervical sagittal balance by evaluating the offset of the head relative to the C2 vertebra?
• Which combination of changes is most commonly seen as a secondary result of cervical spondylosis?
• What is foraminal stenosis in the cervical spine, and which levels are commonly affected?
• What is adjacent segment disease in the context of cervical fusion?
• What is the typical nonoperative management for acute whiplash injuries?
• Foraminal stenosis causes radicular symptoms by compressing which structure?
• Which imaging modality is most effective for evaluating bony overgrowth in cervical osteoarthritis that contributes to stenosis?
• Why must cervical manipulations be approached with caution in clinical practice?
• Which imaging modality is best for assessing soft tissue in the cervical region?
• C2/C3 facet syndrome refers to which region?
• Radiculopathy presents how, typically?
• What radiographic measurement is used to screen for cervical canal stenosis on plain radiographs, and what threshold suggests stenosis?
• In cervical trauma, translational instability on imaging indicates the need for surgical stabilization. Which finding best represents translational instability?
• What is the role of cervical traction in radiculopathy management?
• Foraminal stenosis is defined as which of the following and what symptoms does it cause?
• What is the mnemonic used for VBAI?
• Which structure is primarily involved in facet syndrome?
• Which statement about laminoplasty and laminectomy is true?
• Which odontoid fracture type extends into the C2 body?
• Which set of tests is recommended initially for a patient with neck pain and radicular symptoms to support a diagnosis of spondylosis with radiculopathy?
• What cervical curvature is quantified by the C2–C7 Cobb angle?
• What does the Pavlov ratio compare, and what threshold suggests canal stenosis?
• Which odontoid fracture type is more stable and often treated with immobilization?
• In adults, an ADI greater than 3 mm is considered abnormal. True or False?
• In acute cervical trauma, what is the primary purpose of MRI?
• Which measure quantifies cervical lordosis?
• Which option lists signs typical of anterior cord compression?
• What is the quality of pain seen with radicular symptoms?
• On dynamic flexion-extension imaging, what findings indicate cervical instability?
• Odontoid Type II fractures are often managed nonoperatively with halo immobilization when surgery is not urgent. Which statement is true?
• After cervical fusion, what is the biomechanical consequence on adjacent levels?
• Myelopathy presents how, typically?
• Which maneuver among the initial four tests is included for suspected cervical radiculopathy?
• What is the typical purpose of a rigid cervical collar after surgery or after an acute injury?
• C4/C5 facet syndrome refers to which region?
• Which grade describes a complete tear with full laxity and no endpoint?
• PEACE corresponds to which stage of whiplash management?
• Which finding is a sign of cervical myelopathy on exam?
• What is the most significant contributor to disc injuries in the cervical spine?
• Why is restoring cervical lordosis during fusion surgery important?
• What is the specific term for nonunion at a fusion site in cervical spine surgery?
• Ossification of the posterior longitudinal ligament (OPLL) most specifically affects which region of the spine in this context?
• Which orthopedic test is typically provocative for facet syndrome?
• In the mnemonic LEO, which feature corresponds to the letter O?
• In cervical spine imaging for trauma, when is MRI typically indicated?
• Describe a Jefferson fracture and its mechanism.
• Degenerative cervical radiculopathy most often affects which level?
• Name a common cervical disc herniation level and the typical corresponding nerve root affected.
• Which procedure decompresses the exiting nerve root in foraminal stenosis without directly addressing the disc?
• Explain the Sharp-Purser test and what a positive result indicates.
• Which structures contribute most to anterior column compromise in degenerative cervical stenosis?
• Hangman fracture classically involves fracture of which part of the axis?
• In odontoid fractures, what characterizes a Type II fracture and its prognosis?
• In rheumatoid arthritis, what instability is of greatest concern in the cervical spine?
• Which grade of cervical sprain/strain has an endpoint during laxity testing?
• Which of the following is a red flag symptom warranting urgent imaging in neck pain?
• Which cervical fracture is an avulsion fracture of the anteroinferior corner of a vertebral body often associated with instability?
• Which description best defines the Spurling maneuver and a positive result?
• What mechanism commonly causes a burst fracture of the cervical spine?
• What provocative test reproduces radicular symptoms by applying axial load and foraminal compression to the cervical spine?
• Which radiographic feature is commonly seen in cervical spondylosis on plain X-ray?
• How might pseudarthrosis present clinically after cervical fusion?
• Whiplash associated disorder (WAD) is commonly described as which cervical condition?
• Which pediatric cervical spine anomaly should you consider with limited neck motion and a short neck?
• What MRI finding is most specific for cervical spondylotic myelopathy?
• What materials are commonly used for interbody cages in ACDF?
• Which cervical fracture is defined by fracture of the pars interarticularis in the region of C2?
• What is the most common level for cervical disc herniation causing radiculopathy?
• Which mnemonic is used to recall imaging findings characteristic of cervical spondylosis?
• Which of the following best describes signs when there are overlapping areas of the spinal cord involvement?
• C6/C7 facet syndrome refers pain to which region?
• Which option lists signs typical of posterior cord compression in myelopathy?
• Which dens fracture type is rare and stable?
• How does rheumatoid arthritis affect the cervical spine and what is a dangerous complication?
• For a Type II odontoid fracture, why is surgical stabilization often considered?
• Which statement correctly matches C5 motor and C5 dermatomes?
• Describe a grade I sprain/strain.
• Which cervical levels are most commonly affected by spondylosis?
• Cervical spondylosis is caused by degenerative changes in which structures?
• Which statement correctly pairs C5 motor with its muscle?
• C3/C4 facet syndrome refers to which region?
• How does laminoplasty differ from laminectomy in multilevel cervical stenosis?
• Irritation and/or degeneration of one or more facet joints manifesting as axial neck pain is best described as which condition?
• Which joint is most associated with facet syndrome?
• C5-C6 facet syndrome refers to which region?
• Which ligament prevents cervical flexion and provides anterior stability along the vertebral bodies?
• Which odontoid fracture type has the highest risk for nonunion?
• Which imaging modality provides the most comprehensive view for both degenerative changes and soft tissue structures in the cervical spine?
• Which hypertrophic change can contribute to degenerative cervical stenosis?
• Which movement pattern best describes the cervical facet joints orientation?
• In sclerotogenous facet pain, which structures are involved?
• LOVE corresponds to which stage of whiplash management?
• X-ray is the preferred imaging method for which scenario?
• Laminoplasty is favored over laminectomy for multilevel cervical stenosis when preserving posterior elements and reducing risk of postoperative kyphosis is desirable, such as in rheumatoid arthritis or good bone quality. Which scenario best describes this?
• What is the initial change seen in cervical spondylosis?
• C7 dermatomes correspond to which digit?
• A Jefferson fracture involves fracture of which structure and by what mechanism?
• How is a Teardrop fracture classified in terms of stability and management?
• In the mnemonic LEO, which feature corresponds to the letter L?
• Which imaging findings best support cervical osteoarthritis as a cause of stenosis?
• What is the typical quality of pain described in cervical spondylosis?
• Which structure wraps around the dens and prevents anterior translation of C1 on C2?
• Which radiographic view specifically visualizes the odontoid process?
• Which finding is typically absent in facet syndrome?
• Which statement correctly pairs C6 motor with the corresponding muscle?
• What are two common complications of ACDF?
• Which imaging modality is preferred to assess the extent of degenerative changes in the cervical spine?
• Which modality pairing is often complementary in suspected cervical spine injury?
• Which red flag in neck pain raises suspicion for cancer or infection?
• Which anatomical structure forms the fixed pivot for cervical rotation?
• Facet syndrome pain is typically provoked by which movement pattern?
• Which postoperative strategy helps monitor and mitigate adjacent segment changes after cervical fusion?
• Describe a grade III sprain/strain.
• What is the atlanto-dental interval (ADI) and what value is abnormal in adults?
• What is the most common site for degenerative foraminal stenosis in the cervical spine?
• VBAI stands for which of the following?
• Nondisplaced Jefferson fracture typically managed by:
• What is the Lhermitte phenomenon, and what does it suggest?
• The quality of pain in facet syndrome is typically described as which?
• Which orthopedic test provokes pain in cervical spondylosis?
• Which initial management is preferred for symptomatic cervical disc herniation at C5-6 with radiculopathy but no myelopathy?
• Which odontoid fracture type is classically considered more stable and commonly managed nonoperatively?
• In myelopathy, gait disturbances are most commonly due to compression of which portion of the spinal cord?
• If esophageal compression is suspected due to cervical spine pathology, which imaging test is indicated?
• Which initial maneuver among the four is used to relieve nerve root compression in suspected cervical radiculopathy?
• What constitutes a cervical facet dislocation, and what is its management priority?
• The primary aim of laminoplasty in multilevel stenosis is to:
• What is the typical range of normal cervical lordosis in the sagittal plane?
• Which MRI finding is most predictive of severe myelopathy and the need for decompression?
• How do Type II and Type III odontoid fractures differ in prognosis and treatment strategy?
• What is necessary to perform with all whiplash injuries?
• The Denis three-column theory is used to evaluate what aspect of cervical injuries?
• Dizziness and unsteadiness with which movement can suggest VBAI?
• Which imaging modality is most sensitive for detecting cervical cord pathology and myelopathy?
• What imaging strategy is used to assess cervical spine stability in trauma?
• Which statement accurately defines ACDF?
• C6 dermatomes include which distributions?
• In the mnemonic LEO, which feature corresponds to the letter E?
• C6/C7 facet syndrome refers pain to which region?
• What symptoms typify cervical radiculopathy?
• Which sign is commonly used to indicate upper motor neuron dysfunction in the cervical spine?
• Why is MRI preferred when cervical myelopathy with radiculopathy is suspected?
• Which is Lhermitte's sign and what does a positive sign indicate?
• In facet syndrome, which movement can provoke pain on the opposite side?
• The open-mouth radiographic view primarily assesses alignment between which structures?
• Which of the following represents key postoperative considerations after cervical fusion to optimize fusion and reduce complications?
• Which statement correctly describes the Davis series imaging views?
• Laminoplasty is particularly considered in multilevel cervical stenosis for patients with which condition?
• What is the first-line nonoperative management for cervical radiculopathy due to degenerative disease?
• For evaluating both cord compression and degenerative changes in a single study, which modality is preferred?
• What is the key difference between discectomy and foraminotomy?
• Sclerotogenous pain originates from which tissue type?
• Which MRI finding increases urgency for decompression in myelopathy?
• Which imaging modalities can reveal transverse ligament disruption suggesting atlantoaxial instability?
• Which imaging modality directly visualizes edema or myelomalacia in suspected cervical myelopathy with radiculopathy?
• For cervical spine evaluation, in which scenario is CT typically preferred over MRI?
• The teardrop fracture is caused by which mechanism?
• C4/C5 facet syndrome refers to which region?
• In evaluating a suspected cervical spine tumor, which imaging modality provides best soft tissue contrast and assessment of intracranial extension?
• Which statement is true about the described signs?
• Which finding is typical of a grade II sprain/strain but not a grade I?
• Which exam sign is commonly associated with cervical myelopathy and may indicate upper motor neuron involvement?
• What does a positive Hoffmann sign indicate?
• Which statement correctly differentiates PEACE and LOVE in cervical whiplash management?
• Dysphagia in cervical spondylosis may occur due to which mechanism?
• What is the screening procedure used for VBAI?
• Which statement correctly differentiates facet syndrome from cervical radiculopathy?
• Odontoid Type II fractures when surgery is not urgent are often immobilized with:
• Which patient factor is most strongly associated with nonunion after cervical fusion?
• Which imaging modality is used to check for cord or nerve root compression?
• What does the distraction test assess, and what does relief of radicular pain imply?
• Eburnation on imaging is equivalent to which degenerative change?
• What is the standard surgical approach for multilevel cervical discectomy and fusion?
• When is laminoplasty favored over laminectomy for multilevel cervical stenosis?
• Which fracture is associated with a flexion-distraction mechanism and results in an avulsion fragment from the anteroinferior corner of a cervical vertebral body?
• Which posterior procedure is used for multilevel disease or posterior compression and instability?
• Which imaging modality is best for evaluating bony injuries in acute cervical trauma?
• What are key clinical features of cervical spondylotic myelopathy?
• What is a Teardrop fracture of the cervical spine, and why is it clinically important?
• Which area is most commonly aggravated in facet syndrome?
• Describe a Hangman fracture and its typical mechanism.
• Which of the following best describes signs of posterior cord compression in myelopathy?
• Which option lists a VBAI manifestation related to eye movement?
• Which nerve root is most commonly affected in cervical radiculopathy, and which adjacent levels are also frequently involved?
• Which surgical approach is favored for ventral compressive pathology with radiculopathy?
• Where do osteophytes most commonly form in cervical spondylosis that can compress the esophagus leading to dysphagia?
• What imaging or finding confirms atlantoaxial instability?
• What does T2 hyperintensity within the cervical cord on MRI usually represent in the context of myelopathy?
• What is the typical orientation of the cervical facet joints, and what motion does this orientation favor?
• Odontoid fracture Type II is most likely unstable.
• Which factors are commonly considered when choosing postoperative immobilization duration after cervical fusion?
• Eburnation on imaging is equivalent to which radiographic finding?
• Which secondary changes may occur as a result of joint stresses in cervical spondylosis?
• What is the clinical significance of a positive Babinski sign in cervical pathology?
• C5-C6 facet syndrome refers to which region?
• What is pseudarthrosis in the context of cervical fusion?
• Which procedure specifically aims to remove herniated disc material?
• Describe a grade II sprain/strain.
• Which of the following findings is commonly associated with cervical spondylosis?
• Which of the following is NOT a feature included in the mnemonic LEO for spondylosis imaging?
• Are there neurological signs with facet syndrome?
• In suspected cervical radiculopathy, which sequence of neurologic examination components is most reliable?
• Which of the following is not listed as a test in the cervical myelopathy prediction rule?
• C8 dermatomes correspond to which region?
• C3/C4 facet syndrome refers to which region?
• What is the purpose of dynamic flexion/extension radiographs in cervical spine assessment?
• Which imaging modality is best for assessing soft tissue structures and the spinal cord after cervical trauma?
• Which clinical scenario most often prompts evaluation for pseudarthrosis after cervical fusion?
• What are common infectious etiologies affecting the cervical spine, and how do they typically present?
• Which is a common early postoperative complication after anterior cervical surgery?
• C2/C3 facet syndrome refers to which region?
• How does cervical osteoarthritis contribute to stenosis, and what imaging findings support this?
• The pain distribution pattern in facet syndrome is termed what?
• Which option is NOT a VBAI manifestation?
• Which cervical level is most commonly affected by degenerative cervical radiculopathy?
• In cervical spondylosis, degenerative changes involve which cervical structures?
• Which imaging modality is least useful for evaluating cord compression or nerve root compression?
• What is the primary factor guiding the choice between an anterior versus a posterior surgical approach for cervical spine pathology?
• What posterior technique is commonly used for multilevel cervical spondylotic myelopathy, and what is its goal?
• What is the primary component and initial symptom in spondylosis with myelopathy?
• Which of the following best describes signs of anterior cord compression in myelopathy?
• Which imaging modality is most sensitive for soft tissue and neural structures in the cervical spine?
• What is the role of the transverse ligament in C1-C2 stability, and what test assesses its integrity?
• According to the Denis three-column theory, instability is most likely when injuries involve two or more columns.
• What clinical sign indicates relief of radiculopathy when the patient places the hand on the head?
• Which statement about adjacent segment disease (ASD) after ACDF is true?
• In clinical assessment, what term describes what the patient reports feeling?
• The Davis series comprises seven x-ray views to evaluate injuries to which region?
• Which scenario most strongly favors a posterior approach over an anterior approach for cervical spine pathology?
• Which statement is NOT typical for cervical radiculopathy?
• Which of the following lists the complete clinical manifestations of VBAI?
• Progressive ossification of the posterior longitudinal ligament in the cervical spine is known as:
• In cervical spondylotic myelopathy, anterior discectomy and fusion (ACDF) is preferred over posterior fusion when:
• What radiographic view is best for visualizing the odontoid process and C1–C2 alignment?
• How many x-ray views are included in the Davis series for neck and spinal trauma?
• Which structures does the open-mouth radiograph view best assess and visualize?