CAISS Spine Injuries 5 — Questions and Answers
Question 1: In pediatric patients under age 8, spinal cord injury without radiographic abnormality (SCIWORA) occurs more frequently than in adults primarily because:
- Children have stronger ligaments reducing fracture risk
- The pediatric spine is more elastic, allowing cord injury without bony disruption (Correct answer)
- Children sustain less force in crashes
- Pediatric vertebrae are fused and rigid
Correct answer: The pediatric spine is more elastic, allowing cord injury without bony disruption
The pediatric spine's hypermobility and elasticity allow significant cord stretch and injury without detectable fracture or dislocation on imaging.
Question 2: When coding a hangman's fracture (traumatic spondylolisthesis of C2), the AIS coder must determine severity primarily based on:
- Patient's GCS score
- Degree of displacement and presence of neurological deficit (Correct answer)
- Mechanism of injury (hanging vs. MVA)
- Time to treatment
Correct answer: Degree of displacement and presence of neurological deficit
Fracture displacement and neurological status are the primary determinants of AIS severity for C2 traumatic spondylolisthesis.
Question 3: The AAAM AIS 2005 Spine chapter codes injuries with cord contusion and complete neurological deficit at which level?
- AIS 3
- AIS 4
- AIS 5
- AIS 6 (Correct answer)
Correct answer: AIS 6
Complete neurological deficit from cord injury represents maximum neurological devastation and is coded AIS 6 in the AIS 2005 spine chapter.
Question 4: A patient involved in a rear-end collision presents with neck pain, muscle spasm, and limited range of motion but no fracture on imaging. AIS coding of this soft-tissue cervical injury is most likely:
- AIS 0 (no injury)
- AIS 1 (Correct answer)
- AIS 2
- AIS 3
Correct answer: AIS 1
Soft-tissue cervical sprains/strains (whiplash-associated disorders Grade I-II) without fracture or neurological deficit are coded AIS 1 in the spine region.
Question 5: In the context of CAISS certification, 'abbreviated' in the Abbreviated Injury Scale primarily refers to:
- The scale being a short proxy for comprehensive injury description (Correct answer)
- The use of abbreviations in medical terminology
- Abbreviated hospital stays
- The shortening of injury recovery time
Correct answer: The scale being a short proxy for comprehensive injury description
The AIS provides a brief, standardized severity rating as a proxy for detailed clinical description, enabling efficient epidemiological data collection.
Question 6: Which of the following best describes an AIS spine code of '650202.3' in AIS 2005 format?
- The final digit after the decimal indicates the AIS severity score
- The code indicates an injury in the abdomen region
- All digits before the decimal represent the injury type and location
- Both A and C are correct (Correct answer)
Correct answer: Both A and C are correct
In AIS pre-dot code format, digits encode body region, chapter, and specific injury descriptor, while the post-decimal digit is the severity score.
Question 7: A trauma registry receives a case coded with two spine injuries: AIS 3 (T8 burst fracture) and AIS 4 (T8 fracture with incomplete paraplegia). Which coding principle applies?
- Both codes should be retained to represent the full injury
- Only AIS 3 is coded since it has no neurological deficit
- Only one code for the same injury location should be used — select the more severe descriptor (Correct answer)
- Average the two scores to AIS 3.5
Correct answer: Only one code for the same injury location should be used — select the more severe descriptor
AIS coding rules require selecting the single most accurate and severe code that best characterizes an injury at a given location, avoiding duplicate coding of the same injury.
CAISS Spine Injuries 5
In pediatric patients under age 8, spinal cord injury without radiographic abnormality (SCIWORA) occurs more frequently than in adults primarily because: