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Quizzes > Quizzes for Business > Healthcare

Take the Spinal Surgery Knowledge Assessment Quiz

Evaluate Your Expertise in Spinal Surgery Basics

Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art representing a Spinal Surgery Knowledge Assessment Quiz.

Discover how your surgical knowledge stacks up with this comprehensive Spinal Surgery Knowledge Assessment Quiz. Ideal for med students, residents, and practicing surgeons seeking a quick skills check in spinal procedures, it covers anatomy, indications, approaches, and complication management. With our customizable editor, it can be freely modified to match your learning goals. Explore more quizzes or revisit related topics like Spine Surgery Knowledge Assessment and Knowledge Assessment Quiz for varied practice.

Which ligament prevents hyperextension of the spine by running along the anterior surface of the vertebral bodies?
Anterior longitudinal ligament
Interspinous ligament
Ligamentum flavum
Posterior longitudinal ligament
The anterior longitudinal ligament runs along the front of the vertebral bodies and resists hyperextension. The posterior longitudinal ligament lies within the canal and restrains flexion. Ligamentum flavum and interspinous ligaments serve other stabilizing roles.
How many cervical vertebrae are present in a normal human spine?
8
5
12
7
The human cervical spine consists of seven vertebrae (C1 - C7). This distinguishes it from the thoracic (12) and lumbar (5) regions. There are no eight cervical vertebrae.
What is the most common indication for performing a lumbar discectomy?
Degenerative spondylolisthesis
Idiopathic scoliosis
Spinal infection
Lumbar disc herniation with radiculopathy
Lumbar discectomy is most commonly indicated for herniated nucleus pulposus causing nerve root compression and radicular pain. Scoliosis and spondylolisthesis may require different surgical interventions. Infections typically need debridement and antibiotics first.
Which of the following is a contraindication to elective spinal fusion surgery?
Active systemic infection
Mild, stable osteoporosis
Patient age over 65
Presence of a non-compressive benign spinal cyst
Active systemic infection increases the risk of spreading infection to the implant site and is a contraindication. Osteoporosis and advanced age are considerations but not absolute contraindications. A non-compressive cyst does not preclude surgery.
In posterior spinal fusion, bone graft material is most commonly placed between which structures?
Spinous processes
Transverse processes
Lamina
Facet joints
During posterior fusion, autograft or allograft is packed between the decorticated transverse processes to promote bony bridging. Spinous processes and facet joints are not primary graft beds. The lamina is typically not used for graft placement.
Which surgical approach provides direct access to ventral spinal pathology at the cervical level?
Transforaminal lumbar approach
Posterior cervical approach
Lateral thoracic approach
Anterior cervical approach
The anterior cervical approach gives direct access to ventral structures like discs and vertebral bodies. The posterior approach accesses the posterior elements. Lateral thoracic and transforaminal lumbar approaches target different regions.
What is the primary goal of intraoperative neuromonitoring during spinal surgery?
Evaluate anesthetic depth
Measure blood loss
Guide hardware placement radiographically
Detect impending neurological injury
Intraoperative neuromonitoring assesses spinal cord and nerve root function in real time to detect potential injury. It does not directly measure bleeding or anesthetic depth, nor does it replace imaging guidance for hardware.
Which antibiotic is most commonly used for prophylaxis before spinal instrumentation procedures?
Metronidazole
Clindamycin
Cefazolin
Vancomycin
Cefazolin is the first-line prophylactic antibiotic for most spine surgeries due to its coverage of skin flora. Vancomycin is reserved for MRSA risk or penicillin allergy. Clindamycin and metronidazole have narrower or anaerobic coverage.
What is a primary advantage of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) compared to an open TLIF?
Reduced paraspinal muscle disruption
Wider exposure of neural elements
Increased operative time
Greater blood loss
MIS-TLIF limits muscle retraction and dissection, reducing disruption and postoperative pain. It typically has shorter operative time and less blood loss. Exposure is more targeted, not wider.
In the perioperative period, what is the main goal of DVT prophylaxis in spinal surgery patients?
Minimize blood loss
Prevent venous thromboembolism
Improve spinal stability
Reduce surgical site infection
DVT prophylaxis aims to prevent deep vein thrombosis and pulmonary embolism. It does not directly affect infection rates, blood loss, or mechanical stability of the spine.
Which late complication after spinal fusion is defined by failure of the bone to fuse?
Epidural fibrosis
Adjacent segment disease
Pseudarthrosis
Hardware failure
Pseudarthrosis refers to a lack of solid bony fusion following arthrodesis, resulting in a false joint. Hardware failure may coexist but is a separate mechanical issue. Adjacent segment disease and fibrosis are different complications.
A dural tear during laminectomy can lead to which immediate postoperative issue?
Deep vein thrombosis
Hardware malposition
Postural headache from CSF leak
Wound dehiscence
Dural tears allow CSF to leak, causing low-pressure headaches that worsen when upright. DVT, wound problems, and hardware concerns are unrelated to dural integrity.
Which clinical sign is most indicative of cervical myelopathy during physical exam?
Hoffmann's sign
Straight leg raise
Patellar reflex loss
Kernig's sign
A positive Hoffmann's sign suggests upper motor neuron dysfunction consistent with cervical spinal cord compression. Straight leg raise tests lumbar nerve roots. Patellar reflex loss and Kernig's sign are not specific for cervical myelopathy.
Which imaging modality best characterizes bony detail when planning spinal instrumentation?
MRI
CT scan
Plain radiograph
Ultrasound
CT scans provide high-resolution detail of bone morphology and are ideal for surgical planning and screw trajectory assessment. MRI is superior for soft tissue. Plain radiographs offer limited detail, and ultrasound is not used.
The ASA physical status classification system evaluates which aspect of a patient before spinal surgery?
Risk of surgical site infection
Patient pain tolerance
Degree of spinal cord compression
Overall preoperative systemic disease severity
The ASA classification grades a patient's systemic health and comorbidities to estimate perioperative risk. It does not measure neurological compression, infection risk, or subjective pain tolerance.
In a patient with degenerative scoliosis and multilevel stenosis, which strategy best balances neural decompression and spinal alignment?
Decompression alone without fusion
Long segment fusion with selective decompression
Osteotomy alone for correction
Short segment fusion only
Long segment fusion with targeted decompression addresses both alignment and neural element clearance in multilevel degenerative scoliosis. Short fusion or decompression alone may fail to correct sagittal balance. Osteotomy without fusion offers little lasting stability.
What biomechanical advantage do pedicle screws provide in posterior spinal instrumentation?
Three-column spinal stability
Primary load bearing through anterior column
Limited rotational control
Increased facet joint mobility
Pedicle screws engage all three spinal columns, offering rigid fixation and control of translation and rotation. They do not shift load preferentially to the anterior column, nor increase facet mobility.
In a late-onset postoperative spinal infection with solid fusion mass, what is the recommended hardware management?
Retention of hardware with single irrigation
Lifelong antibiotic suppression without debridement
Immediate hardware exchange and debridement
Removal of instrumentation after confirming solid fusion
When fusion is solid, hardware can be removed safely to control infection. Exchanging instrumentation risks further contamination. Suppression without surgery often fails, and single irrigation without removal is inadequate.
When planning sagittal balance correction, which parameter is most critical to match lumbar lordosis?
Pelvic incidence minus lumbar lordosis mismatch
Cervical lordosis measurement
Sacral slope only
Thoracic kyphosis angle alone
Pelvic incidence-lumbar lordosis mismatch is the key parameter guiding lordotic restoration for balanced posture. Thoracic kyphosis and sacral slope are less directly instructive alone, and cervical measurements are separate.
Adjacent segment disease after lumbar fusion is primarily caused by what mechanism?
Residual infection spreading to neighboring levels
Hardware corrosion affecting adjacent vertebrae
Metastatic seeding at adjacent segments
Altered load distribution accelerating degeneration
Fusion changes biomechanics, increasing stress on adjacent levels that accelerates disc and facet degeneration. Infection, corrosion, or metastasis are unlikely mechanisms for adjacent segment disease.
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Learning Outcomes

  1. Analyse spinal anatomy relevant to surgical procedures
  2. Identify common indications and contraindications for spinal surgery
  3. Evaluate surgical approaches and techniques for spine interventions
  4. Apply perioperative safety protocols in spinal surgery contexts
  5. Demonstrate understanding of complication management strategies
  6. Master decision-making for spine patient assessment

Cheat Sheet

  1. Key spinal anatomy structures - Dive into the inner world of your spine to discover how vertebrae, intervertebral discs, and the spinal cord work together to keep you standing tall. Mastering these key components is like uncovering a hidden engineering marvel inside your body, and it sets the foundation for any surgical decision. PubMed: Spinal Anatomy Essentials
  2. Indications and contraindications for surgery - Explore why herniated discs and spinal stenosis often call for surgical fixes, while conditions like active infections or severe osteoporosis require a careful pause. Understanding these do's and don'ts ensures patient safety and optimal outcomes. Get ready to spot red flags like a pro surgeon-in-training! PubMed: Spine Surgery Indications
  3. Surgical approach options - From anterior to posterior to lateral, each surgical pathway offers unique angles to tackle spinal issues. Weigh the pros, cons, and potential risks to find the perfect route for every anatomy. This skill is crucial for tailoring procedures to individual patient needs. PMC: Comparing Spinal Approaches
  4. Perioperative safety and positioning - Proper patient positioning is a secret superpower that protects against nerve injuries and pressure ulcers during spine surgery. Learn the best practices for padding, supports, and alignment to keep your patient comfy and complication-free. These protocols are your backstage pass to a smooth operation. PMC: Spine Surgery Safety
  5. Complication management strategies - Blood loss and infections can turn a routine surgery into a thrilling challenge, so it's vital to know how to tackle them head-on. From precise hemostatic techniques to sterile protocols, you'll learn the toolkit for keeping complications at bay. Think of it as your superhero guide for any surgical curveball. PMC: Managing Spine Surgery Complications
  6. Decision-making in patient assessment - Combine clinical exams and imaging like a detective assembling clues to decide if and what type of spine surgery is needed. This mix of art and science ensures each treatment plan is spot-on. Hone this skill to become a master of tailored surgical strategies. PMC: Clinical & Imaging Integration
  7. Intraoperative neuromonitoring techniques - Keep an eye on nerve signals using SSEPs and MEPs to catch trouble before it becomes a big deal. Think of these tools as your high-tech alarm system alerting you to potential nerve damage during surgery. Mastering neuromonitoring is like having an extra set of expert eyes in the OR. OpenAnesthesia: Neuromonitoring in Spine Surgery
  8. Enhanced Recovery After Surgery (ERAS) protocols - Discover how ERAS protocols can turbocharge recovery, minimize pain, and shave days off hospital stays. This patient-centered approach blends multimodal pain control, early mobilization, and nutrition. Embrace ERAS to score bonus points in postoperative care. PMC: ERAS in Spinal Surgery
  9. Anesthetic considerations for spine surgery - From tight blood pressure control to multimodal pain management, anesthesia in spine cases is a delicate balancing act. Learn which drugs, dosages, and monitoring techniques keep patients safe and comfortable. Think of yourself as the conductor synchronizing every level of care. OpenAnesthesia: Anesthesia for Spine Procedures
  10. Position-related complication prevention - Each surgical position comes with its own set of risks, from eye pressure in prone to nerve stretch in lateral poses. Arm yourself with strategies like padding, repositioning, and frequent checks to keep complications away. This attention to detail can make all the difference in patient outcomes. PMC: Preventing Position-Related Risks
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