Glossary
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Allograft – biologic tissue from a cadaver (deceased person) that is used to replace damaged tissue Alternative Medicine – a wide spectrum of treatments, not considered standards of practice because they lack scientific evidence Analgesic – pain reliever Ankylosing Spondylitis – inflammatory condition that produces stiffness and pain Ankylosis – stiffness of the joints typically observed with end-stage arthritic conditions Annulus Fibrosis – the outer ring of fibrous material surrounding the intervertebral disc Anterior – front Anterior interbody fusion (AIF) – a surgical procedure that involves the replacement of some or all of the disc with a bony graft from an anterior (front) approach; this can be performed in the upper or lower spine Arthritis – inflammation of the joints Artificial Disc Replacement – a surgical procedure that replaces diseased or dysfunctional discs with man-made discs Atlas- the first cervical vertebra C1 Autograft – a bone graft taken from a patient and used for a fusion procedure; typically bone is taken from the pelvis and iliac crest (the hip) and used in the spine Axis – the second cervical vertebra C2 Basal Metabolic Rate – the rate an individual burns calories Biomechanics – the study of forces applied to the body and their relationship to stability and motion Bisphosphonates – a class of medications that inhibits bone resorption (the digestion of bone); used to treat osteoporosis (ex: Boniva, Fosamax, Actonel) BMP – bone morphogenetic protein; a biologic material that enhances the growth of bone Bone Densitometry – a procedure used to detect osteopenia; see Dual energy x-ray or DEXA scan Bone Graft – bone used in fusion surgery (either autograft , allograft or BMP) Bone Growth Stimulator – an electromagnetic device that is worn to promote bone growth and enhance fusion Bone Scan – a study used to identify fractures, infections or tumors in the bone by injecting a radioisotope that is taken up by lesions in the bone; also called bone scintigraphy Burst Fracture – a compression fracture of the vertebra that involves posterior (towards the back) displacement of a bone fragment often into the spinal canal C#- the letter C followed by a number identifies the vertebra of the cervical spine (neck); For example C4 is the 4th vertebra in the cervical spine Cauda Equina- the nerve roots of the lower lumbar spine that come off the end of the spinal cord and travel to the lower extremities and the bowel and bladder Cauda Equina Syndrome – loss of bowel or bladder control, numbness in the pelvic region and weakness in the lower extremities; associated with pressure on the nerve roots of the lower spine Cartilage – a cellular tissue specific to joints Cerebral Spinal Fluid (CSF) – a fluid that acts as a shock absorber to cushion and protect the brain and the spine Cervical lordosis – forward curvature of the cervical spine Cervical Spine – the neck region of the spine CNS - central nervous system Coccyx – bottom most bone of the spine Compression Fracture – type of fracture where a bone collapses on another bone CT scan or CAT scan– computerized tomography that uses x-rays to view the bone, boney structures and fractures. The x-ray tube is rotated 360° around the patient, and the computer converts these images into a two-dimensional axial image that allows for cross-sectional imaging. Corticosteroids - Cortisone-like medicines that are used to provide relief for inflamed areas of the body. They lessen swelling, redness, itching, and allergic reactions. Often used for a number of other diseases such as asthma or other auto immune diseases. Crepitus - A grating or grinding sound Decompression - Surgical removal of pressure from nerve roots or spinal cord Degenerative disc disease (DDD): A catch-all term to describe degenerative changes in the disc(s) caused by aging or wear and tear. Degenerative joint disease (DJD) - Deterioration of the cartilage that lines a joint resulting in narrowing of the joint space and pain; also referred to as osteoarthritis Delayed union - A delay in normal healing; not necessarily a pathologic process Disc – The intervertebral (between the vertebrae of the spine) disc is a combination of strong connective tissues which hold one vertebra to the next, and acts as a cushion between the vertebrae. It is made of a tough outer layer called the "annulus fibrosus" and a gel-like center called the "nucleus pulposus." Discectomy - Surgical procedure in which part of a herniated disc is removed. The goal of the surgery is to make the herniated disc stop pressing on and irritating the nerves which cause pain and weakness. Discography - Discography involves the injection of dye into the nucleus of an intervertebral disc. During the injection, the physician performing the procedure asks the patient if the injection causes pain similar to his/her "usual pain." Typically, a CT scan follows this procedure to help to identify the source of the patient’s pain Discitis – inflammation of the disc Deep venous thrombosis (DVT) – a venous blood clot typically occurring in a deep vein of the lower leg or thigh caused by immobilization, hypercoagulation, obstructed venous flow, or endothelial injury, among others. The clot can break loose and travel to the brain, heart or lung resulting in catastrophic consequences including pulmonary embolism, stroke or death Dual-energy x-ray absorptiometry (DEXA or DXA) - A diagnostic imaging technology that uses x-rays to assess bone mineral density; typically measurements taken at the hip and lower spine to determine presence or risk of osteoporosis; see bone densitometry Electrocardiogram (EKG) - A non-invasive recording of electrical currents that flow through the heart Electromyography (EMG) - A test used to determine the function of the peripheral nerves and nerve roots. It involves placement of tiny needles in muscles and an electrical stimulus that reflects the function of the connection between the nerve and muscle (muscle contraction). This test is usually performed in conjunction with a nerve conduction velocity study (NCV); see Nerve Conduction Study Epidural hematoma - A blood clot located outside the dura mater Epidural steroid injection (ESI) - Injection of corticosteroid medications into the epidural space (the area around the spinal nerves) to reduce inflammation of the nerve and disc. Facet joints - The bones of the spine are connected in the front of the spine by intervertebral discs and in the back by paired joints. These paired joints are commonly called "facet joints". Facet injection - Injections of steroids and local anesthetic into the facet joints to determine if it is a source of pain or to reduce pain and inflammation. Fluoroscopic guidance - Use of radiologic imaging (x-ray) to assist in diagnostic and surgical procedures. Fusion - A surgical procedure performed to eliminate movement over painful or unstable spinal segments. Spinal fusion may be used to treat degenerative disc disease but is also used to treat scoliosis, kyphosis, fractures and tumors. Bone is grafted across a section of the spine where it grows together fusing the area. Food Guide Pyramid - A guide to daily food choices presented by the US government that includes food from five groups that provide essential nutrients. Foramen - The space between two adjacent vertebrae where the nerve root exits. Gout - An inflammatory arthritis associated with the collection of urate around the joint; the big toes are the most common location for gout Herniated disc - With age, the center of vertebral discs may start to lose water content, making the disc less effective as a cushion, causing displacement of the disc’s center (herniated or ruptured disc) through a crack or tear in the outer layer (the annulus). A herniated disc can press on a nerve root in the spine and may cause back pain or pain, numbness, tingling or weakness of the leg called “sciatica.” Also known as a protruded, slipped or ruptured disc, or herniated nucleus pulposus (HNP). Holistic medicine – treatment of the whole person, from a physical, emotional, spiritual and mental aspects Interbody fusion - Grafting bone in the space between discs for the purpose of fusing two vertebrae together Intervertebral disk - A fibrocartilaginous disk located between the bodies of each of the vertebrae; made up of the nucleus pulposus and annulus fibrosus Interbody or intervertebral device or cage – a synthetic device place between the vertebrae in the disc space to promote fusion. Kyphosis - A curve in the spine that points to the back of the body. A hunchback is one example of kyphosis L# - The letter L followed by a number identifies a specific vertebra in the lumbar spine. For example, L4 is the 4th vertebra in the lumbar spine.L3-4 would refer to the disc between the L3 and L4 vertebrae. Laminectomy - A surgical decompression procedure in which part of the posterior arch of a vertebra is removed; allows access to the disk and relieves pressure on the spinal cord and the nerve roots. Lateral view - A view that passes from side to side Lordosis - Curve in the spine that points to the front of the body Lumbar - Lower back Lumbosacral – pertaining to the lumbar and sacral regions of the body Manipulation – adjustments of a body part Methylprednisolone or Corticosteroid- A drug (steroid) that lessens inflammation. Used to reduce inflammation of the joints or used to potentially lessen the damage of a spinal cord injury. MRI - Magnetic resonance imaging is a diagnostic test that does not involve exposure to X-ray. MRI images soft tissues such as the intervertebral disc and nerves as well as bones. A very sensitive and specific spinal test, it is useful in diagnosing soft-tissue injury, tumors, stress fractures and infection. Myelitis - Spinal cord inflammation. Myelography - A radiographic imaging study in which contrast is injected into the subarachnoid space (the space around the spinal cord) Used to assess the spinal cord, nerves and nerve roots in detail. Typically, a CT scan is performed following myelography to better assess spinal anatomy Myelopathy - Spinal cord disorder resulting in weakness of upper and lower extremities due to compression or other disease of the spine. Typical conditions resulting in myelopathy include spinal stenosis or an injury to the spinal cord. Myofascial Pain – pain caused by a group of muscles Nerve conduction studies - Studies that test the speed by which nerves transmit impulses; see Electromyography or EMG Nerve Root Block - Injection of corticosteroids (anti-inflammatory) and a local anesthetic onto the nerve root sleeve surrounding a nerve root. Neuropathic pain – pain resulting from a dysfunction in the nervous system Nonunion - Failure of healing of a fracture or surgical fusion. NSAIDs - Nonsteroidal antiinflammatory drugs. Medications used to reduce swelling and inflammation. Examples of NSAIDs are aspirin, ibuprofen, naproxen and a variety of prescription drugs. There are different classes of NSAID medications, including COX-1 and COX-2 inhibitors. Nucleus pulposus - A region of the intervertebral disk that functions as a shock absorber Opioids - Drugs that treat pain without treating the underlying cause. These medications affect pain perception only. Osteoarthritis (OA) - A deterioration of the weightbearing surface; distinguished by destruction of cartilage and narrowing at the joint space. Osteomyelitis - Infection of bone Osteonecrosis - The death of bone, often as a result of obstruction of its blood supply Osteopenia – Fragile bones Osteophytes - Bone spurs Osteoporosis - Deterioration of bone tissue resulting in an increased risk of fracture Osteotomy - Literally, cutting a bone. Used to describe surgical procedures in which bone is cut and realigned PA - Physician's assistant Paget disease - A condition of abnormally increased and disorganized bone remodeling Pain - A sensory and emotional reaction precipitated by actual or anticipated injury; results from damage to tissue or nerves and is made worse by pressure or inflammation Paresthesias - Abnormal sensations such as tingling, burning, or prickling Pedicle - Projection of bone from the back of the vertebra that helps form the ring around the spinal canal. Pelvis - A bony ring, consisting of the sacrum, coccyx that connects the trunk to the lower extremities, supports the abdominal contents, and allows passage of the excretory canals Posterior - Being on back side. In rear position. Posterior lumbar interbody fusion (PLIF) - Spinal fusion technique in which the disc is removed through the back of the spinal canal and a bone graft is inserted in the invertebral space. Pseudoarthrosis – When a solid fusion is not obtained after fusion surgery; A false joint produced when a fracture or arthrodesis fails to heal Psychogenic pain – physical pain caused or increased by mental, emotional or behavioral factors PT - Physical therapist. Radicular pain – pain experienced along the dermatome (sensory distribution) of a nerve due to pressure on that nerve. Radiculopathy - Impairment of a nerve root, usually caused by compression, resulting in radiating pain, numbness, tingling or muscle weakness. Reflex - Pattern of response or behavior similar for any given stimulus; does not involve a conscious action; Resting metabolic rate - A measure of the calories required for maintaining normal body functions such as respiration, cardiac function, and thermoregulation Rheumatoid arthritis - A chronic inflammatory disease that is probably triggered by an antigen-mediated inflammatory reaction against the synovium in the joint ROM - Range of motion; The amount of movement available at a joint Rx - Treatment. Sacroiliac joint - The joint formed by the sacrum and ilium Sacrum - One of the three bones (sacrum and two pelvic bones) that make up the pelvic ring; part of the tailbone Scoliosis – Abnormal lateral curvature of the spine Sciatica - Pain, numbness, tingling in the distribution of the sciatic nerve, which travels from deep in the buttock down to the foot. SI - Sacroiliac. The joints (one on each side) between the sacrum at the midline and the iliac wings, which form part of the pelvic ring. Often a site of referred pain Somatic Pain – pain caused by an injury to the skin, muscle, bone, joint or connective tissue SPECT scan - Single photon emission computed tomography. A diagnostic imaging test that involves increased resolution and is used to evaluate fracture, tumor or infection in the bone; see Bone Scan. Spinal column - Central supporting bony structure of the body; vertebral column Spinal cord - Extension of the brain, composed of virtually all the nerves carrying messages between the brain and the rest of the body. It lies inside the spinal column Spinal stenosis – Segmental or generalized narrowing of the canal housing the spinal cord Spine - Column of 33 vertebrae extending from the base of the skull to the tip of the coccyx Spinous processes - Palpable boney structure then can be felt on your back Spiral fracture - A break caused by a twisting force Spondylolisthesis- When a vertebra slips forward over the vertebra below it; typically caused by arthritis of the small joints of the spine and degeneration of the intervertebral discs or a fracture. Spondylolisthesis can be graded as I, II, III or IV based on how far forward the vertebra has slipped. (Grade IV being the worst slippage) Spondylolysis - A fracture (crack) in the “pars interarticularis” where the vertebral body and the posterior elements, protecting the nerves are joined. In about 5% of the adult population, there is a developmental crack in one of the vertebrae, usually at the point at which the lower (lumbar) part of the spine (L5) joins the tailbone (sacrum). Spondylosis- degenerative arthritis of the vertebrae of the spine Spur formation - Degenerative and age-related changes in the spine where spurs form along the vertebra to stabilize the spine Stenosis - A stricture of any canal or orifice. In the spine, a narrowing of the spinal canal secondary to a combination of disk narrowing, thickening of the ligaments, and osteophytes from arthritis of the facet joints. Subdural hematoma - A blood clot located beneath the dura mater Subluxation - when one or more bones of the spinal cord move out of position T# - The letter T followed by a number identifies a specific vertebra in the thoracic spine. For example, T4 is the 3th vertebra in the thoracic spine. TENS - Transcutaneous electrical nerve stimulation. A form of electrical anesthesia used to block pain perception. Thoracic - Mid-upper back, area between the cervical (neck region) and lumbar (low back) spine Traction - Traction applies intermittent or continuous force by mechanical or manual methods to elongate the spine. Trigger Point Injections - Injection of local anesthetic with or without corticosteroid into painful soft tissues (i.e., muscles or ligaments) along the spine or over the back of the pelvis. Generally used for pain control. Tx - Treatment. Vertebrae - Bones that make up the spine Vertebral Column - Segmented spinal column composed of 24 movable vertebrae, 5 fixed sacral vertebrae, and 4 fixed coccygeal vertebrae Vertebroplasty - Procedure to treat fractures related to osteoporosis, where glue-like cement material is injected into a collapsed vertebra. Visceral pain – pain originating from the body’s internal organs Whiplash - Commonly referred to as "neck sprain or strain"; Common in car accidents. |