Advanced Imaging

Question 1

Appropriate used of CT imaging - Spine (5)

Answer 1

• Fxs
• Osseous congenital anomalies
• Central/ IVF stenosis
• Degen
• Disc herns (better than MRI)

Question 2

Appropriat use of MRI scan- Spine (4)

Answer 2

• Multiple lvls of degen
• Neurological conditions (Adrnold chiari etc)
• Congenital anomalies
• Discitis and infections

Question 3

What are the 4 disc herniation points + m/c

Answer 3

Central
Subarticular (m/c)
Foraminal
Extraforaminal

Question 4

3 major classifications of Disc lesiona

Answer 4

1. Dehydrated/ disiccated disc
2. Bulging disc
3. Herniated disc

Question 5

3 major classifications of disc lessions

Answer 5

• Protrusion (contained within annular fibres+PLL)
• Extrusion- Extruded beyond the annular fibred but still attached

Sequestration- Extruded and migrated away from parent disc

Question 6

Classification of a disc bulge

Answer 6

• Commonly seen in degenerative disc
• -More than 25% of the disc margin is outside the boundry of the adjacent vert body

—Usually no clinical sig

Question 7

2 types of disc bulges

Answer 7

circumferential

asymetric

Question 8

What is a protrusion disc herniation and where is it mc seen

Answer 8

<25% of the disc margin
-herniated material has a broad base

-mc seen in subarticular herniation

Question 9

What is a extrusion disc herniation

Answer 9

<25% of the disc margin

-The base is narrower than the extruded material

Question 10

What is a sequestration disc herniation

Answer 10

form of disc extrusion

-free fragemnt of disc material has no connection and can migrate up or down

Question 11

If you have a L4-5 subarticular disc hern what nerve root will be affected

Answer 11

L5

Question 12

If you have a L4-5 foraminal disc hern what nerve root will be affected

Answer 12

L4

Question 13

Where are cervical disc herns mc

Answer 13

1. C5-6
2. C6-7
3. C4-5

Question 14

What type of herniation is mc

Answer 14

Subarticular herniations

Question 15

What nerve root is affected in cervical disc herniations

Answer 15

Always afffecting IvF@ the herniation level

Question 16

If you have a C6-7 herniation what nerve root does it typically target

Answer 16

Usually C7 nerve root

Question 17

Cervical diameter measurement for absolute/relative stenosis

Answer 17

Absolute- less than 10mm

relative- 10-12mm

Question 18

Lumbar diameter measurement for stenosis

Answer 18

Less than 12mm

Question 19

Mc causes of cervical spine stenosis (4)

Answer 19

disc herns
post vert body osteophytes
facet hypertrophy
-OPLL

Question 20

mc causes of lumbar spine stenosis(4)

Answer 20

• Disc herns
• lig flavum hypertrophy
• facet hypertrophy
• degenerative spondylolisthesis

Question 21

What causes lateral recess entrapment (3), where mc

Answer 21

Facet arthrosis
hypertrophy of lig flavum
disc bulges/herns

-M/c at L4-5, L5-S1

Question 22

what is the mc cause of spinal cord dysfunction in adults >55

Answer 22

CSM

Question 23

What are the s+s of CSM

Answer 23

• Weakness, numbness and clumbniness in UE
• Altered walking ability
• Painful/stiff neck
• mm wasting
• • lhermittes phenom