Spine Disorders — MCQs

Spine Disorders Indian Medical PG Practice Questions and MCQs

Question 201: Pott's spine is most common at which specific region of the spine?

A. Sacral
B. Cervical
C. Lumbosacral
D. Thoracolumbar (T12-L1) (Correct Answer)

Explanation: **Thoracolumbar (T12-L1)** - The **thoracolumbar junction (T12-L1)** is the most common site for Pott's spine due to its biomechanical stress and vascular supply, making it a frequent location for spinal tuberculosis. - This region is susceptible to **compression fractures** and bone destruction, leading to kyphotic deformity (gibbus) in advanced cases. *Sacral* - While spinal tuberculosis can affect any part of the spine, the **sacral region** is considerably less common than the thoracolumbar junction. - Infections in the sacrum are often associated with other pelvic involvement or direct extension from adjacent sites. *Cervical* - Tuberculosis of the **cervical spine** can occur but is not as frequent as in the thoracolumbar region. - Clinical manifestations can include **neck stiffness, dysphagia**, and neurological deficits affecting the upper limbs. *Lumbosacral* - The **lumbosacral region** (L5-S1) can be affected by Pott's spine, but it is less common than the thoracolumbar junction. - Involvement here can lead to specific neurological symptoms like **foot drop** or radicular pain in the lower extremities.

Question 202: A right-sided disc herniation at the L5-S1 level typically may cause:

A. Low back pain and right-sided sciatica (Correct Answer)
B. Normal ankle jerk reflex.
C. Weakness of dorsiflexion of the right foot.
D. Diminished sensation over the medial aspect of the foot.

Explanation: ***Low back pain and right-sided sciatica*** - A right-sided disc herniation at the L5-S1 level typically compresses the **S1 nerve root** on the right side. - This compression leads to **sciatica**, which presents as radiating pain along the S1 dermatome (back of the leg and sole of the foot), often accompanied by localized **low back pain**. *Weakness of dorsiflexion of the right foot* - **Dorsiflexion weakness** is primarily associated with compression of the **L4 or L5 nerve roots**, not S1. - The muscles responsible for dorsiflexion (e.g., tibialis anterior) are predominantly innervated by L4 and L5. *Normal ankle jerk reflex* - The **ankle jerk reflex** is mediated by the **S1 nerve root**. - Therefore, compression of the S1 nerve root would typically lead to a **diminished or absent ankle jerk reflex**, not a normal one. *Diminished sensation over the medial aspect of the foot* - **Diminished sensation** over the **medial aspect of the foot** corresponds to the **L4 dermatome**. - A herniation at L5-S1 primarily affects the S1 dermatome, which involves the **lateral aspect of the foot** and sole.

Question 203: What type of spinal injury is characterized by vertical fragmentation of the vertebrae due to axial loading?

A. Burst fracture (Correct Answer)
B. Compression fracture
C. Flexion-rotation injury
D. Extension injury

Explanation: ***Burst fracture*** - A **burst fracture** results from severe axial loading, causing the vertebral body to **fragment vertically**. - Fragments can retropulse into the **spinal canal**, potentially leading to neurological deficits. *Compression fracture* - A **compression fracture** typically occurs from flexion or axial loading, causing the **anterior portion of the vertebral body to collapse** but without significant fragmentation or retropulsion. - The posterior wall of the vertebra usually remains intact, making it relatively stable. *Flexion-rotation injury* - This type of injury involves forces that combine **flexion and rotation**, often causing significant ligamentous and bony disruption, including facet joint dislocation or fracture-dislocation. - It does not primarily lead to vertical fragmentation but rather rotational instability and dislocation. *Extension injury* - An **extension injury** occurs when the spine is forced into excessive extension, often damaging the posterior elements of the vertebrae or causing anterior disc or ligamentous avulsion. - It contrasts with axial loading and fragmentation, typically affecting the posterior vertebral structures.

Practice by Chapter

Cervical Spine Disorders

Practice Questions

Thoracic Spine Disorders

Practice Questions

Lumbar Spine Disorders

Practice Questions

Intervertebral Disc Disease

Practice Questions

Spinal Stenosis

Practice Questions

Spondylolisthesis

Practice Questions

Spinal Deformities

Practice Questions

Spinal Infections

Practice Questions

Spinal Tumors

Practice Questions

Spinal Cord Injuries

Practice Questions

Minimally Invasive Spine Surgery

Practice Questions

Rehabilitation of Spine Conditions

Practice Questions

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