ABOS Part I Comprehensive Review - Batch 13

Question 1

A 32-year-old male presents to the emergency department after a high-speed motor vehicle collision, sustaining a bilateral C6-C7 facet dislocation. He is neurologically intact but complains of severe neck pain and inability to move his head. Which of

Accepted Answer

Hyperflexion with distraction resulting in complete disruption of the posterior ligamentous complex and often the posterior longitudinal ligament.

Question 2

A 55-year-old male falls from a ladder, sustaining a bilateral C5-C6 facet dislocation with significant anterior translation. He presents with an ASIA C incomplete spinal cord injury. The provided image illustrates the complex anatomical relationship

Accepted Answer

Posterior Ligamentous Complex (PLC)

Question 3

A 28-year-old male is brought to the trauma bay after a diving accident, presenting with a bilateral C4-C5 facet dislocation and an ASIA A complete spinal cord injury. He is intubated and sedated, making a reliable neurological examination impossible

Accepted Answer

Obtain a magnetic resonance imaging (MRI) of the cervical spine prior to any reduction attempt.

Question 4

A 40-year-old patient with a C6-C7 bilateral facet dislocation and a large traumatic disc herniation on MRI is scheduled for an anterior cervical discectomy and fusion (ACDF). During the approach, the surgeon identifies the internervous plane. Which

Accepted Answer

Between the sternocleidomastoid muscle and the carotid sheath laterally, and the strap muscles, trachea, and esophagus medially.

Question 5

A 60-year-old patient with a C5-C6 bilateral facet dislocation, without evidence of disc herniation on MRI, undergoes a posterior approach for reduction and stabilization. The surgeon plans to perform lateral mass screw fixation.Based on the provided

Accepted Answer

Starting point 1 mm medial and 1 mm cephalad to the center of the lateral mass, with a 25-degree lateral and 20-30 degree cephalad trajectory.

Question 6

A 48-year-old male undergoes an anterior cervical discectomy and fusion (ACDF) for a C5-C6 bilateral facet dislocation. Postoperatively, he develops hoarseness and difficulty swallowing. Which of the following complications is most likely responsible

Accepted Answer

Recurrent laryngeal nerve palsy and dysphagia; often transient, managed conservatively with speech therapy.

Question 7

A 22-year-old patient with an ASIA B C6 incomplete spinal cord injury following a bilateral C6-C7 facet dislocation undergoes successful surgical stabilization within 12 hours of injury. In the immediate postoperative period, what is the most critica

Accepted Answer

Maintain mean arterial pressure (MAP) greater than 85 mmHg for at least 7 days.

Question 8

A 70-year-old patient presents after a ground-level fall with a bilateral C4-C5 facet dislocation. Imaging confirms complete disruption of the posterior ligamentous complex. Neurological examination reveals an ASIA D incomplete spinal cord injury. Ba

Accepted Answer

8 points, mandating surgical stabilization.

Question 9

A patient presents with a bilateral C5-C6 facet dislocation. On lateral cervical spine radiography, which of the following findings is most characteristic of this injury type, indicating profound instability?

Accepted Answer

Significant anterior translation of the superior vertebral body, often exceeding 50% of the vertebral body width.

Question 10

The management of acute spinal cord injury (SCI) associated with bilateral cervical facet dislocation has evolved significantly. Which landmark study provided compelling evidence supporting early surgical decompression (within 24 hours of injury) for

Accepted Answer

The Surgical Timing in Acute Spinal Cord Injury Study (STASCIS).

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Key Takeaway