Neck and Back Pain

In the evaluation of neck pain, this sign or maneuver happens when the patient flexes his neck where his chin meets the anterior chest and a sharp pain originates from his nape towards both arms. What sign is this?

• Spurling's Sign

• Lhermitte's Sign

• Hoffman's Sign

• Abduction Relief Sign

In a patient with neck pain, if you are entertaining a C8-T1 root lesion, on PE your patient could be:

• Eliciting tenderness over the brachial plexus at Erb’s point.

• Having tenderness over the ulnar nerve at the elbow.

• Aching in the myotome distribution to the chest, axilla, or triceps; or numbness or tingling in the middle finger.

• Eliciting a positive Babinski’s sign.

When do you recommend doing a Cervical Spine MRI to an ER patient presenting with neck pain?

• Chronic neck pain with neurologic signs or symptoms regardless of the plain radiographic findings.

• There is no cervical instability.

• When malignancy is confirmed.

• The plain radiographs don't reveal bone or disk margin destruction.

Most common levels for cervical disk herniation?

• C4-C5

• C5-C6

• C6-C7

• C7-T1

Cervical spondylosis is a degenerative disk disease resulting in a loss of cervical flexibility causing pain, it happens commonly in what level?

• C4-C5

• C5-C6

• C6-C7

• C7-T1

The symptoms of this low back pain usually begins in the sixth decade. It includes low back pain that is aggravated by prolonged standing and spinal extension and is relieved by rest and forward flexion.

• Disk herniation

• Ankylosing spondylitis

• Transverse myelitis

• Spinal stenosis

This is an autoimmune arthritis that primarily affects the spine and pelvis. Commonly occurs in patients <40 years old with a 3:1 male predilection. Patients complain of awakening with low back pain and stiffness that improves throughout the day with mild activity.

• Disk herniation

• Transverse myelitis

• Ankylosing spondylitis

• Spinal stenosis

Epidural compression syndrome is a collective term encompassing spinal cord compression, cauda equina syndrome, and conus medullaris syndrome. The following are the common causes, EXCEPT for one:

• Spinal canal hemorrhage with hematoma

• Spine or epidural space malignancy

• Spinal epidural abscess

• Transverse myelitis

Which of the following is most common finding of a patient with low back pain suffering from epidural compression syndrome?

• Sciatica both legs

• Urinary retention

• Saddle anesthesia

• Gait difficulty

Which of the following shows radiographic abnormalities of bony destruction, irregularity of vertebral end plates, and disk space narrowing?

• Vertebral Osteomyelitis

• Spinal Epidural Abscess

• Discitis

• Transverse Myelitis