MSC SPINE COMPREHENSIVE EXAM UPDATED QUESTIONS
AND ANSWERS GRADED A+
✔✔Burst fracture involves what portion of vertebral body? - ✔✔Anterior and posterior
✔✔Image 5 - ✔✔Orange- ALL
Purple- PLL
Blue- Flavum
Yellow- Supraspinous
Green- Interspinous
✔✔Where does 80% of biomechanical load transfer thru? - ✔✔anterior column
✔✔Advgts of DLIF/LLIF/XLIF
- direct decompression
- excellent disc height restoration
- large graft
- avoids posterior muscles/ dissection of posterior elements
- better anterior column support
- expand apophyseal ring
- better deal w a spondy/reduce spondy by using large graft - ✔✔- indirect
decompression
- excellent disc height restoration
- large graft
- avoids posterior muscles/ dissection of posterior elements
- better anterior column support
- expand apophyseal ring
- better deal w a spondy/reduce spondy by using large graft
✔✔Two most common post op issue with trans-psoas approach?
- infection
- Anterior thigh pain (quad)
- Tibialis weakness - ✔✔- Anterior thigh pain (quad)
- Tibialis weakness
✔✔Most common lvl for ALIF procedure - ✔✔L5-S1
✔✔At what lvl do the venacava and aorta bifurcate? - ✔✔L4-L5
✔✔Dilators are used for ___ in DLIF procedure...
- doc on lateral aspect of disc
- sequentially dilate to help dilate soft tissues, less tissue disruption and not cutting thru
psoas
- use retractor system to place over dilators - ✔✔Paragraph question (all apply)
, ✔✔What is another term for present at birth? - ✔✔Congenital
✔✔TLIF, why is this more ideal than a PLIF? - ✔✔Saves time in OR
Less chance of neural injury b/c less retraction and distraction
Less passage of instruments
✔✔What anatomical elements do we have to resect on a TLIF procedure? - ✔✔Facet
(facetectomy) Transforaminal approach
✔✔Two approaches that rely solely on indirect decompression? - ✔✔ALIF and DLIF
✔✔What is traditional ALIF construct? - ✔✔Plates and Screws
✔✔If doing an ALIF 360, is the patient prone? - ✔✔No, Placed supine, doing
retroperitoneal approach, break scrub, flip patient, then put prone, drape, ioband stocker
and put in perc pedicle screws or facet screws or interspinous plate
✔✔Primary curve in deformity is the original curve? T/F
More or less ridged? - ✔✔True, more ridged
✔✔In DLIF technique, we can address what planes in terms of deformity? - ✔✔Coronal
and Sagittal deformities
✔✔Image 6 (hunch-back) - ✔✔Pathology: Sherman's kyphosis
Hyper kyphosis, wedged vertebral bodies
✔✔What is the minimum amount of segments required to be Sherman's kyphosis? -
✔✔3
✔✔Image 7 - ✔✔Pathology: L5-S1, collapsed disc space, sclerotic bone
✔✔Image 8 - ✔✔Hypertrophy ligament (ligamentum Flavum)
✔✔Image 9 - ✔✔Retropulsion
✔✔What is the most popular type of pedicle screw?
Most common type for spondys?
Addresses osteoporosis
Considered MIS? - ✔✔Polyaxially
Reduction
Fenestrated
Percutaneous
✔✔Image (interbody w three screws)
AND ANSWERS GRADED A+
✔✔Burst fracture involves what portion of vertebral body? - ✔✔Anterior and posterior
✔✔Image 5 - ✔✔Orange- ALL
Purple- PLL
Blue- Flavum
Yellow- Supraspinous
Green- Interspinous
✔✔Where does 80% of biomechanical load transfer thru? - ✔✔anterior column
✔✔Advgts of DLIF/LLIF/XLIF
- direct decompression
- excellent disc height restoration
- large graft
- avoids posterior muscles/ dissection of posterior elements
- better anterior column support
- expand apophyseal ring
- better deal w a spondy/reduce spondy by using large graft - ✔✔- indirect
decompression
- excellent disc height restoration
- large graft
- avoids posterior muscles/ dissection of posterior elements
- better anterior column support
- expand apophyseal ring
- better deal w a spondy/reduce spondy by using large graft
✔✔Two most common post op issue with trans-psoas approach?
- infection
- Anterior thigh pain (quad)
- Tibialis weakness - ✔✔- Anterior thigh pain (quad)
- Tibialis weakness
✔✔Most common lvl for ALIF procedure - ✔✔L5-S1
✔✔At what lvl do the venacava and aorta bifurcate? - ✔✔L4-L5
✔✔Dilators are used for ___ in DLIF procedure...
- doc on lateral aspect of disc
- sequentially dilate to help dilate soft tissues, less tissue disruption and not cutting thru
psoas
- use retractor system to place over dilators - ✔✔Paragraph question (all apply)
, ✔✔What is another term for present at birth? - ✔✔Congenital
✔✔TLIF, why is this more ideal than a PLIF? - ✔✔Saves time in OR
Less chance of neural injury b/c less retraction and distraction
Less passage of instruments
✔✔What anatomical elements do we have to resect on a TLIF procedure? - ✔✔Facet
(facetectomy) Transforaminal approach
✔✔Two approaches that rely solely on indirect decompression? - ✔✔ALIF and DLIF
✔✔What is traditional ALIF construct? - ✔✔Plates and Screws
✔✔If doing an ALIF 360, is the patient prone? - ✔✔No, Placed supine, doing
retroperitoneal approach, break scrub, flip patient, then put prone, drape, ioband stocker
and put in perc pedicle screws or facet screws or interspinous plate
✔✔Primary curve in deformity is the original curve? T/F
More or less ridged? - ✔✔True, more ridged
✔✔In DLIF technique, we can address what planes in terms of deformity? - ✔✔Coronal
and Sagittal deformities
✔✔Image 6 (hunch-back) - ✔✔Pathology: Sherman's kyphosis
Hyper kyphosis, wedged vertebral bodies
✔✔What is the minimum amount of segments required to be Sherman's kyphosis? -
✔✔3
✔✔Image 7 - ✔✔Pathology: L5-S1, collapsed disc space, sclerotic bone
✔✔Image 8 - ✔✔Hypertrophy ligament (ligamentum Flavum)
✔✔Image 9 - ✔✔Retropulsion
✔✔What is the most popular type of pedicle screw?
Most common type for spondys?
Addresses osteoporosis
Considered MIS? - ✔✔Polyaxially
Reduction
Fenestrated
Percutaneous
✔✔Image (interbody w three screws)
