Degen
A disc herniation can be classified as either a ____or ____
protrusion or extrusion
Discitis/osteomyelitis is infection of the disc-endplate complex.
_______ spread is the most common etiology.
Hematogeneous
Hematogeneous infection in adults starts in the endplate, and can spread to the adjacent vertebral body through the disc.
In contrast, in children, the disc is directly vascularized and can act as the nidus for infection.
What's the most common type of odontoid fx? Is it a stable fx?
2. No
Describe the idea of an abnormal unilateral pedicle
If one pedicle is abnormal and the other pedicle is normal, a lesion maybe present.
"Right on!"
David Litzau
A disc herniation should encompass less than ____ of the disc circumference.
What about a disc bulge?
90
180
The most sensitive MR imaging sign to detect spinal infection is
Paraspinal or epidural inflammatory change.
Other findings: erosion or destruction of vertebral endplates. Disc enhancement and edema across the disc space.
Frank osseous destruction in advanced cases.
Describe a what a Hangman's fx is and the mechanism of injury
Traumatic spondylolysis of C2.
Hyperextension and distraction
The most common cause of epidural lipomatosis is
Steroid adminstration.
"WOAH WOAH WOAH, you're blasting them!" when the resident forgot to collimate.
Dan Malone
Describe the terms from the medial to lateral position of a herniation?
Intravertebral herniation is also known as?
Central, Subarticular, Foraminal, Extra-foraminal
Schmorl's node
___ sequence is an extremely helpful technique to detect early epidural infection.
Fat suppresion
Given that normal epidural fat is hyperintense on T1-weighted images, fat suppression is an
extremely helpful technique to detect early epidural infection.
What's a Jefferson fracture? What's the mechanism of injury?
C1 ring fx (symmetrical fx of anterior and posterior arches)
Axial loading
Ossification of the posterior longitudinal ligament most frequently involves the ____ spine.
Cervical
Thoracic
"Hey *insert unlucky resident's name here*, you got a minute?"
Dave Hinke
Name and describe the 3 Modic type changes
Type 1: edema. Can be associated with active back pain
Type 2: fatty metaplasia
Type 3: fibrosis
Approximately ____% of patients with Pott disease have active pulmonary tuberculosis.
10
Grisel
Describe a Chance fx and the mechanism of injury
fx involving the 3 spinal column.
flexion distraction injury caused by acute forward flexion of the spine during sudden deceleration
"Hey, reopen this study. You missed this." They said gently
JJ
Where does the C8 nerve root exit relative to the adjacent vertebral body?
Below the C7 vertebral body
In the C spine, nerve roots exits above its corresponding vertebral body.
Unlike pyogenic discitis/osteo, why are the discs usually spared in Pott disease?
TB lacks the protelytic enzyme to break dow nthe disc substance.
Classically, causes wedge-shaped compression of the anterior aspect of the vertebral body, often leading to a Gibbus deformity.
Flexion tear drop fx can cause anterior cord syndrome, characterized by complete paralysis and loss of pain and temperature sensation. Touch and vibration sense are preserved.
Which tract(s) is preserved and which is destroyed?
pyramidal and anterior spinothalamic is destroyed
What's the distance for the atlanto-axial interval? for both adults and children
What about the basion-dental interval?
<2.5 mm in adults
<5mm in children
<12mm
"It's scary that you don't know what a tuft fracture looks like"
"Your seniors and attendings have failed you."
Dave Baugh