Acquired
condition |
A
disorder that a person develops over time that is
not genetic, but may occur from the influence of
the environment or unknown internal processes. |
| Acupuncture |
A 4000-year-old medical technique
from the Far East which involves inserting needles
into selected sites in the body to promote healing
without the use of medication or surgery. |
| Anesthetic |
A pain
killing agent applied topically (over skin), locally
(injected directly around a nerve supplying a painful
area in nerve root blocks), or regionally (as part
of a surgical procedure). |
Annulus
fibrosus |
Outer
fibrous layers of the intervertebral disc consisting
of overlapping collagen fibers. Also called .annulusê. |
Anterior
longitudinal ligament |
A
strong ligament running along the front of the spine
that binds the vertebrae and vertebral disks together
into a columnar unit. |
Arthrodesis |
Fusion
of diseased or damaged vertebrae with bone graft
to strengthen and stabilize the spine. |
Arthroscopic
discectomy |
Removal
of an intervertebral disc by arthroscopy. |
Arthroscopy |
A
procedure using several small incisions for insertion
of a visualization scope and instruments in the diagnosis
and treatment of a joint condition. |
Articular
process |
A
bony projection, part of which has a small smooth
surface known as a facet. In the spine there are
4 articular processes off the back of each vertebrae,
two upper and two lower that comprise the facet joints. |
Atlas |
First
cervical vertebra of the spinal column, located just
beneath the skull. Supports the head. |
Axis |
Second
cervical vertebra of the spinal column, located below
the atlas vertebra. Allows rotation of the neck.
Has a bony protrusion called the dens, or odontoid
process, which projects upward and within the atlas. |
Biofeedback |
Mind-body
technique using knowledge of heart rate, blood pressure,
or skin temperature to control symptoms such as pain
or anxiety. |
Body
asymmetry |
A
state when opposite sides of the body do not correspond
in appearance and/or function. |
Bridging
osteophytes |
New
vertical bone that forms between vertebral bodies,
associated with degenerative disease. |
| Calcification |
The growth
of calcium within a tissue or structure, altering
its natural structure or nature. |
Cauda
equina syndrome |
Compression
on the lower aspect of the spinal cord (caudal sac),
usually by a large herniated disc, that affects nerves
on both sides of the cord.¾ Signs: low back
pain, weakness and/or tingling in both legs, and bowel
and bladder incontinence.¾
Requires immediate surgical decompression for recovery. |
Cervical |
Refers
to the neck or cervical curve of the spine; the top
most curve that includes the neck area. |
Cervical
vertebrae |
The
upper 7 vertebral bones of the spinal column that
form the neck, and provide and support rotation for
the head and neck. |
| Charleston bending
brace |
A treatment
brace that over-corrects the bend of the scoliotic
curve and does not allow for upright standing. It
is used only at night-time. |
Chronic
low back pain |
Pain
in the lower back that lasts beyond the course of
an acute disease or an injury, or pain that persists
for months or years. |
Claudication |
Symptoms
of leg pain or weakness and limping that are present
when walking but absent at rest. |
| Cobb angle |
The measure
of the magnitude of a scoliotic curve.¾ The
angle is formed by the intersection of two perpendicular
lines, each of which is parallel to the top and bottom
vertebra of the scoliotic curve, respectively. |
| Cobb method |
A technique
to measure the degree of curvature (Cobb angle) of
a scoliotic curve on an X-ray |
Coccyx |
The
lowest 4 bones of the spinal column that are fused
in the shape of a triangle. |
Compression
fractures |
A
fracture of the inner aspect of bone caused by the
impact of a heavy load. |
Congenital
condition |
A
disorder present at birth which may or may not be
genetic, or inherited. |
Congenital
scoliosis |
Scoliosis
caused by abnormal vertebral development from birth,
such as failure of normal vertebral formation or
segmentation. |
Congenital
spinal abnormalities |
A
condition of the spine since birth, for example,
an excessively narrowed spinal canal. |
Contained
disc herniation |
Outer
annular fibers are intact, although stretched over
the protruding disc material. |
Contrast
agent |
A
liquid given orally or intravenously for imaging tests
that improves the contrast and therefore¾
the visibility of structures. |
| Contrast enhanced
MRI |
MRI used
with a nontoxic dye injected into an arm vein through
a small needle to differentiate between tissue structures
more accurately. More commonly applied in patients
with recalcitrant pain who have had previous spinal
surgery. |
Degenerative
disc disease |
Condition
where the spinal disc loses structural integrity
from wear and tear, aging, or trauma. Consequences
may be: disc space narrowing, osteophyte formation,
disc bulging, or herniation. |
Degenerative
spondylolisthesis |
Forward
displacement of a vertebra from the vertebra below
due to degenerative changes in the facet joints.¾ A
Frequent cause of low back and leg pain. |
Dens |
An
element of the -axis" vertebra which projects
upward, articulating with the -atlas" vertebra.
Also called the odontoid process |
Disc
bulge |
General
pushing out of a spinal disc, extending the disc
from its normal position. Considered a normal occurrence
with age. |
Disc
herniation |
Focal
abnormality of a disc associated with disc disease.¾ Involves
the breakdown of the outer disc structure with the
inner s partially or completely pushing through the
outer fibrous layers and subsequent encroachment of
the epidural space, spinal cord, and nerves. |
Dura
mater |
The
outermost and toughest membrane surrounding the brain
and continuing as part of the sac surrounding the spinal
cord.¾ Also called the dura. |
| Electromyography |
Diagnostic
test for conditions involving the nerves and muscles
of the spine and neuromuscular function. |
Epidural
injections |
Technique
whereby a liquid mechanism (steroid, anesthetic)
is injected clinically into the epidural space surrounding
the spinal cord and spinal nerves. |
Epidural
space |
Space
between the spinal cord and the walls of the vertebral
canal, on or over the dura. |
| Epidural steroid
injections |
Technique
whereby a liquid (steroid, anesthetic) is injected
clinically into the epidural space surrounding the
spinal cord and spinal nerves |
Erector
spinae muscles |
The
most important extensor muscle group of the back.
Responsible for returning the back to an erect position
following motion. The erector spinae muscles secondarily
contribute to lateral bending, rotation of the spine,
and movement of the head. Another name for this muscle
group is the sacrospinal muscle group. |
External
oblique abdominal muscles |
One
of the powerful rotator muscles of the spine whose
fibers run obliquely to the long axis of the body.
Contribute to spinal movement by compressing the
stomach organs and flexing the spine. |
Extruded
disc herniations |
Condition
where the nucleus material of a disc has passed through
a defect of an adjacent ligament (the posterior longitudinal
ligament) but remains in continuity with the
disc. |
Facet
arthritis |
Degeneration
of facet joint cartilage and hypertrophy of the bone
forming the joint. |
Facet
arthrosis |
Chronic
degeneration of the facet joint cartilage and enlargement
of the bony aspects (articular processes) of the
joint |
Facet
joint capsule |
Collagen
membrane that encloses the facet joint |
Facet
joints |
Joints
of the spine that connect all of the vertebrae and
allow coordinated movement of the vertebral column. |
| Facet syndrome |
A condition
where pain emanates from the facet joints. Pain is
typically brought on suddenly by certain body positions
and relieved by others. |
Facetectomy |
Excision
or removal of the facet joints of the vertebrae. |
Fibrocartilage
tissue |
A
dense strong cartilage found in intervertebral discs,
the knee joint, and at the attachments of tendons
and ligaments to bone. |
Fluoroscopy |
A
radiology technique that allows still or moving images
of internal structures on a monitor or TV screen;
alternative to conventional X-ray. |
| Gait |
The activity
of walking, stepping, or running. The smoothness
or abnormalities of a personês gait can provide
information for diagnosis of spinal disorders. |
Halo
cast |
A
metal frame apparatus for immobilizing the neck or
cervical spine. Applied under local or general anesthesia. |
Herniated
disc |
A
condition where the center (nucleus pulposus) of the
intervertebral disc is protruding through the outer
fibrous layer (annulus fibrosus) of the disc. A frequent
cause of low back and leg pain.¾ Distinguish
from a disc bulge. |
| Herniation |
Protrusion
of part of a disc through its outer layers or the
whole disc through a defect or natural opening of
muscle or bone. |
| Hyperreflexia |
A condition
of very strong reflexes, often occurring in patients
with cervical myelopathy. |
Hypertrophy |
Enlargement
or overgrowth of a tissue, organ, or structure in
the body. |
Hypertrophic
arthritis |
A
condition occurring with osteoarthritis where reactive
new bone formation occurs around joints and the joint
bones become larger. |
| Idiopathic
scoliosis |
Scoliosis,
or lateral curvature of the spine, the cause of which
cannot be determined. |
Iliocostalis
muscle |
A
division of the erector spinae muscle group which
help to extend the spine (bend backwards). |
Implants |
Metal
devices, also called instrumentation, that are used
in spinal surgery for fusion of vertebrae and to
increase stability of the spine. |
Internal
oblique abdominal muscles |
One
of the rotator muscles of the spine whose fibers
run obliquely to the long axis of the body. Contribute
to spinal movement by compressing the stomach organs
and flexing the spine. |
Intertransverse
ligaments |
Ligaments
which travel between the tips of the transverse processes
on vertebrae, contribute to spinal stability. |
Intervertebral
disc joint |
The
articulation between two vertebrae provided by a
fibrocartilage disc; joint of the vertebral column. |
Intravenously |
A
technique whereby fluids are introduced to the body
through a tube placed within a vein. |
Isthmic spondylolisthesis |
Forward
displacement of a vertebra due to bony defects between
the upper and lower facet joints of a single vertebrae
(posterior arch).¾ Frequent cause of low back
and leg pain. |
Laminae |
Flat
pieces of the vertebral arch extending from the vertebral
pedicles that form the back wall of the spinal canal. |
Laminectomy |
Removal
of the lamina of one or more vertebrae to inspect
the spinal cord or to provide decompression of the
cord. |
Laminoplasty |
Operation
to create a more spacious spinal canal by elevating
the laminae over the back of the spinal cord. |
Latissimus
dorsi muscle |
Muscles
that participate in bending forward (flexion), shoulder
or head movements, or arm movement.¾ |
| Lidocaine |
Anesthetic,
sometimes given in conjunction with a facet block
diagnostic test. |
Ligamenta
flava |
Bands
of elastic ligament that connect the laminae and
fuse with the facet joint capsules. |
Limited
lumbar laminotomy |
A
surgically created opening in one or more laminae. |
Longissimus
muscles |
A
division of the erector spinae muscles which helps
to extend the spine (bend backwards) and flex it
to one side. |
Lumbar |
Refers
to the lower back and that area of the spinal column
called the .lumbar curveê. Consists of 5 vertebrae. |
Lumbar
arachnoiditis |
Inflammation
of the arachnoid lining of the spinal cord that can
lead to scarring and compression of the nerve roots. |
Lumbar
puncture |
Procedure
whereby a needle is placed within the spinal canal
to take samples of cerebrospinal fluid for diagnosis
or to deliver medication, contrast agents, or anesthesia. |
Lumbar
spinal stenosis |
A
narrowing of the spinal canal due to degenerative
changes in the lumbar spine. |
Lumbar
vertebrae |
Have
facet joint positions that virtually prevent rotation
in the lower back, but they allow for a large amount
of forward and backward bending (flexion and extension). |
| Lumbosacral junction |
Lower
back region where the lumbar and sacral vertebrae
meet. |
| Marcaine |
Anesthetic
sometimes given in conjunction with a facet block
diagnostic test. |
Microdiscectomy |
Surgical
removal of a herniated disc fragment using microscopic
techniques of magnification and illumination. |
| Milwaukee brace |
A brace
used to treat scoliosis utilizing stabilization of
the chin and base of the head. |
| Monoradiculopathy |
Disease
or disorder involving a single nerve root on one
side of the spine. |
Motion
segment |
A
segmental model of spinal function consisting of
two adjacent vertebrae, three joints (two posterior
facet joints and the intervertebral disk joint),
and the associated ligaments. |
MRI
(closed/open) |
Magnetic
resonance imaging. A noninvasive imaging technology
that uses magnets and radiofrequency waves to image
the body.
Closed: Patient is placed in long tube for MRI procedure. Can
uncomfortable physically or stressful for children
or patients with claustrophobia.
Open: MRI is open on the sides and therefore more comfortable. |
Multifidus
muscle |
A
back muscle whose fibers extend to each region of
the spine, from sacral to cervical. Contributes to
extension and lateral rotation of the spine. |
Muscle
strains |
A
painful muscle condition, usually a result of muscle
overuse from prolonged exercise or extremes of physical
activity. Frequent cause of low back and leg pain. |
| Myelogram |
An X-ray
study of the spinal canal and spinal cord. |
Myelography |
Radiographic
study of the spinal canal with the introduction of
a dye substance into the spinal fluid to facilitate
the image of the nerve tissues. Usually followed
immediately by a CT scan. |
| Myelopathy |
Damage
to the spinal cord from disease and/or compression. |
Narrowing
of the disc space |
A
complication of degenerative disc disease where the
height between vertebrae has become less than normal. |
| Nerve conduction
studies |
Diagnostic
test to measure the rate at which a nerve (sensory
or motor) conducts an impulse. |
Nerve
foramina |
Small
openings in the bony vertebrae that provide for the
passage of spinal cord nerves to body tissues and
organs. |
Nerve
root avulsion |
A
tearing away or separation of the nerve root from
its normal position as it exits the spinal cord. |
Nerve
root blocks |
A
diagnostic procedure used to identify the nerve or
nerves responsible for symptoms and a technique to
block pain using an injection of anesthetic around
the nerve supplying the painful area. |
Nerve
root impingement |
Pressure
on a nearby nerve root and surrounding soft tissues
by displaced structure or tissue, such as a herniated
intervertebral disc or abnormal bone growth; or by
entrapment against bone with movement. |
Neural
arch |
Posterior
aspect of a vertebra formed by the laminae and pedicles
and forming the posterior wall and side walls of
the spinal canal |
Noncontained
disc herniation |
A
condition where disc material has broken through
the annulus fibrosus, or outer layers, thus creating
the potential for greater nerve root impingement. |
| Noninvasive imaging
technology |
Diagnostic
imaging technology that does not impact tissues adversely
or involve the use of instruments which enter the
human body. |
Nonspecific
back pain |
Pain
that may be due to a single type of soft tissue injury,
such as a muscle strain, or to a combination of soft
tissue injuries (muscle, ligament, and other connective
tissues). |
| NSAID |
Nonsteroidal
anti-inflammatory drug. Aspirin-like medicines used
to treat pain and inflammation. |
Nucleus
pulposus |
The
soft and gelatinous center of an intervertebral disc
which has a high water in younger persons. |
Oscilloscope |
Diagnostic
instrument that displays images of electrical impulses
on a monitor (cathode-ray tube). |
Osteoarthritis |
Noninflammatory
degenerative joint disease occurring mainly in older
persons. |
Osteophytes |
A
small abnormal outgrowth of bone in the region of
the spinal joints or on the edge of vertebrae adjacent
to the intervertebral spinal discs. |
| Pacemakers |
Therapeutic
technology that controls the heart rhythm. Patients
with pacemakers should not have MRI scans taken as
the magnetic field could interfere with the pacemakerês
function |
Paralytic
curves |
Scoliosis
(lateral curvature of the spine) due to a neuromuscular
condition such as cerebral palsy or a spinal cord injury
with paraplegia. |
Paraspinal
muscles¾ |
Back
muscles that attach to the spine and play a major role
in posture and gait.¾ Their function is the
extension of the spine in reaction to gravity and body
weight (includes the multifidus and longissimus dorsi). |
Paresthesias |
Abnormal
burning or -pins and needles" sensation without
any specific stimulation applied to skin. |
Pars
defect |
Bony
defect in the back of the vertebrae sometimes responsible
for pain, instability of the spine, and slippage
(spondylolisthesis) |
Pars
interarticularis |
Is
a narrow area (an isthmus) of bone between the upper
and lower articular processes |
Pedicles |
Short,
thick bony structures which project backwards from
each side of the vertebral body and are joined by
the laminae to complete the back wall of the spinal
canal. |
Percutaneous
discectomy |
Removal
of disc material using minimally invasive tools,
either through automated suction techniques or with
arthroscopic visualization. |
Laser
discectomy |
Percutaneous
discectomy using an automated laser. |
| Plain films |
An alternative
name for X-rays. |
| Polyradiculopathy |
Radiating
pain along the arm or leg due to dysfunction of a
multiple spinal nerves, often due to a herniated
discs or spinal stenosis. |
Posterior
longitudinal ligament |
(Weaker)
bind the vertebrae and vertebral disks together into
a columnar unit |
Quadratus
lumborum muscle |
Contributes
mainly to lateral bending of the lumbar spine and is
well situated for that purpose, spanning from the pelvis
and lower lumbar area to the ribs and upper lumbar
vertebrae ). Participate in flexion of the vertebral
column, shoulder or head movements, or arm movement.¾ |
Radical
discectomy (complete) |
Removal
of the entire intervertebral disc, always accompanied
by spinal fusion. |
Radicular pain |
Pain
experienced at the site of a nerve root or along
the path for which a nerve supplies function. |
| Radiculopathy |
Radiating
pain along the arm or leg due to dysfunction of a
spinal nerve, often due to a herniated disc or spinal
stenosis. |
Radiopaque
contrast medium |
A
liquid given orally or intravenously for imaging
tests that improves the contrast and therefore visibility
of structures. |
Range
of motion |
The
area through which a joint can be freely moved, actively
or passively. |
Rectus
abdominis muscle |
A
muscle that contributes to spinal movement by compressing
the stomach organs and flexing the spine. |
Reduction |
Returning
the displaced vertebra to normal anatomic alignment. |
Referred
pain |
Pain
experienced at a site that is distant from the origin
of the pain or injury. |
Regional
anesthesia |
Anesthesia
for a select region of the body produced by the injection
of anesthesia around the sensory nerves supplying
that area. |
Sacrum |
Lowermost
portion of the spinal column consisting of 3-5 fused
bones, collectively in the shape of a triangle. |
Salvage
procedure |
A
last resort surgical procedure. |
Sciatica |
A
condition defined as pain radiating down the leg,
due to irritation of the sciatic nerve and commonly
caused by a herniated disc or nerve compression from
osteophytes. |
Scoliosis |
A
significant lateral deviation in the normal vertically
straight line of the spine. Frequent cause of low
back and leg pain. |
Sequestered
disc herniation |
A
condition where a piece of herniated disc material
has separated from the body of the disc itself and
is not in direct continuity with it. |
| Somatosensory evoked
potentials |
Diagnostic
test for spinal cord injury involving the measurement
of electrical signals generated by the stimulation
of the peripheral nerves and recorded by electrodes
placed on the skin over the cerebral cortex.¾ Also
used during spine surgery to prevent neurologic injury. |
Spinal
canal |
The
space that houses the spinal cord and spinal nerves
throughout the length of the vertebral column. Provides
openings for the exit of paired spinal nerves from
the spinal cord. |
Spinal
cord |
That
part of the central nervous system that connects
all parts of the body with the brain and travels
through the spinal canal of the vertebral column. |
Spinal
cord impingement |
Pressure
placed on the spinal cord by a herniated intervertebral
disc or abnormal bone growth from degenerative joint
disease. |
Spinal
disc |
Soft
tissue structure between the vertebrae, consisting
of a soft inner material (nucleus pulposus) and a tough
outer tissue (annulus fibrosus).¾ Allows articulation
of the intervertebral joint. |
Spinal
fusion |
Surgically
created connection of two adjacent vertebrae to immobilize
one or more motion segments in an attempt to relieve
pain, correct deformity, and improve stability. |
Spinal
motion segment |
A
segmental model of spinal function consisting of
two adjacent vertebrae, three joints (two posterior
facet joints and the intervertebral disk joint),
and the associated ligaments. |
Spinal
tap |
Procedure
whereby a needle is placed within the spinal canal
to take samples of cerebrospinal fluid for diagnosis
or to deliver medication, contrast agents, or anesthesia. |
Spinalis
muscle |
Division
of the erector spinae muscles contributing to extension
of the spine (bending backwards). |
Spinous
processes |
Bony
projections directly off the back of the spine that
provide attachments for spinal ligaments and muscles;
shape varies according to spinal region and function.¾
Progressively larger towards the lower spine to support
the increased weight from above. |
Splenius
muscles |
Muscles
which extend from the lower neck to the back of the
skull and upper cervical vertebrae to extend, rotate,
and laterally flex the neck.¾ |
Spondylolisthesis |
Forward
displacement (slippage or translation) of one vertebra
over the vertebra below. |
Spondylolysis |
A
defect (usually fracture) of the vertebral arch in
between the superior and inferior facet joints (specifically,
the pars interarticularis), occurring on one or both
sides. |
Spondyloptosis |
Over
100% forward slippage of a vertebra over the vertebra
below. |
Spondylosis |
Degenerative
disease process affecting the spine, in particular,
the intervertebral discs and the vertebral facet
joints. Frequent cause of low back and leg pain. |
Spondylosis¾ |
Degenerative
disease process affecting the spine, in particular,
the intervertebral discs and the facet joints. Frequent
cause of low back and leg pain. |
Stenosis |
A
condition where the spinal canal is sufficiently
reduced in size (diameter from a variety of causes
(nerve root impingement, osteophyte formation, disc
herniation, etc.). Frequent cause of low back and
leg pain. |
Suboccipital
muscles |
Muscles
that connect the atlas (1st cervical vertebra)
to the axis (2nd cervical vertebra) and
to the skull for rotation and extension of the head.¾ |
Supraspinous
ligaments |
Ligaments
that connect the tips of spinous processes and contribute
to spinal stability and integrity by limiting the
degree of spinal motion during movement. |
Thoracic
region |
Pertaining
to the chest or the midback region of the spine,
known as the thoracic curve and consisting of 12
vertebrae; in-between the cervical and lumbar regions
of the spine. |
Thoracic
vertebrae |
Twelve
vertebrae of the midback that allow significant rotation
of the spine. The long spinous processes of these
vertebrae (in addition to the rib cage) act to limit
the degree of motion in the midback. |
Tinnitus |
Ringing,
buzzing, clicking in the ears caused by a variety
of mechanisms, one of which can be spinal cord compression |
| TLSO |
Thoracolumbosacral
orthotic. An underarm custom-molded rigid body-jacket
type brace. The most common brace used in scoliosis.¾ |
Transverse
processes |
Bilateral
and broad flat lateral projections from each vertebral
body that function as attachments for spinal ligaments
and muscles. |
Transversospinalis
muscles |
Deep
spinal muscles whose subgroups span nearby vertebrae
to rotate the head, and also to extend and laterally
rotate the spine. |
Trapezius
muscle |
Muscle
of the upper shoulder that participates in flexion
of the vertebral column, and draws the head back
and to the side as well as braces the shoulder. |
| Trigger point injections |
Local
injection of anesthesia into painful muscle tissue
for symptomatic relief. |
Vertebral
arch |
A
partial circle of bone that is connected to the back
of the body; it is made up of the pedicles and laminae. |
Vertebral
body |
A
thick columnar-shaped bone comprising the front of
each vertebra. |
Vertebral
column |
Main
central support of the body consisting of approximately
33 vertebrae, or separate bones connected by muscles,
ligaments, and tendons. |
Vertebral
facet joints |
Joints
of the spine that connect all of the vertebrae and
allow coordinated movement of the vertebral column. |
| Whiplash |
A general
term used to describe soft tissue injury of the muscles,
ligaments, tendons, or discs associated with traumatic
injury of the neck. |
