A

ANKYLOSING SPONDYLITIS – Stiffening or fixation of the vertebra; an inflammatory joint disease mainly affecting the spine, hips, and pelvis.

ANKYLOSING SPINAL HYPEROSTOSIS – Arthritic disorder in which bridging osteophytes located anteriorly and posteriorly on the vertebral body bind two or more vertebrae together; Forestier disease.

ANNULUS FIBROSIS – The outer, fibrous, ring-like portion of an intervertebral disc.

ANTERIOR APPROACH – When used to approach the cervical, cervicodorsal, dorsal, and lumbar spines, it is designed to provide sufficient surface for multiple segmental spinal fusions; Hodgson, Roaf. For specific cervical spinal explorations and fusions; Southwick and Robinson, Bailey and Badgley, Whitesides and Kelly, Henry (to vertebral artery).

ANTERIOR CERVICAL DISCECTOMY – An operation where the cervical spine is reached through a small incision in the front of your neck. After the soft tissues of the neck are separated, the intervertebral disc and bone spurs are removed.

ANTERIOR CERVICAL DISCECTOMY WITH FUSION – An operation performed on the upper spine to relieve pressure on one or more nerve roots, or on the spinal cord. The term is derived from the words anterior (front), cervical (neck), and fusion (joining the vertebrae with a bone graft).

ANTERIOR DISPLACEMENT – Forward movement of the superior segment on the inferior one.

ANTERIOR LUMBAR INTERBODY FUSION (ALIF) – Operation where the lumbar spine is approached through an incision in the abdomen. A portion of the affected disc space is removed from the spine and replaced with an implant.

ANTERIOR SPINAL FUSION – Approaching the spine from the front, the intervertebral disc and/or vertebral body is removed and bone graft is inserted. Some variations of this procedure include the Smith-Robinson, Cloward, and dowel procedures.

ANTERIOR SPURRING – Ligament turning to bone on anterior side of vertebral body.

ANTEROLATERAL APPROACH – An approach to the dorsal spine by rib resection to explore the spine anteriorly and, in some cases to do spinal fusions and decompressions spinal cord.

ARTHRALGIA – Joint pain.

ATLANTO-AXIAL – Pertaining to the atlas and the axis; denoting the joint between the first two cervical vertebrae.

ATLANTO-OCCIPITAL – Relating to the atlas and the occipital bone.

ATLAS – First cervical vertebrae, articulating with the occipital bone and rotating around the dens of the axis.

ATROPHY – A wasting of the tissues of a body part.

AVASCULAR – Non-vascular, not provided with blood vessels.

AXIS – The vertebral column. The second cervical vertebra, about which the first cervical vertebra rotates, allowing head movement.

AXON – The part of a nerve cell that usually sends signals to other nerves or structures.

B

BACK PAIN – nonspecific term used to describe pain below the cervical spine

BONE – The hard tissue that provides structural support to the body. It is primarily composed of hydroxyapatite crystals and collagen. Individual bones may be classed as long, short, or flat.

BONE GRAFT – Bone which is harvested from one location in an individual and placed in another individual (allograft bone) or in a different location in the same individual (autogenous bone).

BROWN-SEQUARD’S SYNDROME – Loss of sensation of touch, position sense, and movement on the side of a spinal cord lesion, with loss of pain sensation on the other side. It is caused by a lesion limited to one side of spinal cord.

C

CADAVERIC – A tissue or organ transplanted from a cadaver (deceased donor)

CARCINOMA – Cancer, a malignant growth of epithelial or gland cells.

CAROTID ARTERY – Large artery on either side of the neck which supplies blood to most of the cerebral hemisphere. Main artery to the head that divides into external and internal carotid arteries.

CARPAL TUNNEL – Space under a ligament in wrist through which the median nerve enters the palm of the hand.

CARPAL TUNNEL SYNDROME – A condition caused by compression of the median nerve in the carpal tunnel, characterized especially by discomfort and disturbances of sensation in the hand.

CARTILAGE – The hard, thin layer of white glossy tissue that covers the end of bone at a joint. This tissue allows motion to take place with a minimum amount of friction.

CARTILAGE SPACE NARROWING – Narrowing of any cartilage space; also called disc space narrowing.

CATHETER – A small tube used to inject a dye to see the blood vessels, similar to that used for looking at vessels in the heart.

CAUDA EQUINA – The bundle of spinal nerve roots arising from the end of the spinal cord and filling the lower part of the spinal canal (from approximately the thoraco-lumbar junction down).

CAUDA EQUINA SYNDROME – Sufficient pressure on the nerves in the low back to produce multiple nerve root irritation and commonly loss of bowel and bladder control.

CENTRAL CORD SYNDROME – Most common of the incomplete traumatic spinal cord syndromes characterized by motor impairment that is proportionately greater in the upper limbs than in the lower, with bladder dysfunction and a variable degree of sensory loss below the level of the cord lesion.

CENTRUM – The body of a vertebra.

CEREBROSPINAL FLUID (CSF) – Water-like fluid produced in the brain that circulates and protects the brain and spinal cord, known as CSF.

CERVICAL – Of or relating to the neck.

CERVICAL PLEXUS – Plexus of nerves that supply the neck muscles with branches named by muscles supplied, a portion which is called the ansa cervicalis.

CERVICAL RIB – Rib-like structure in the seventh cervical vertebra that may cause nerve root irritation.

CERVICAL SPINAL FUSION – Spinal fusion involving the seven cervical segments. This may include the base of the skull, the occiput, and the first thoracic spine.

CHEMONUCLEOLYSIS – A treatment of an intervertebral disc that consists of an injection of chymopapain, a drug that dissolves part of the disc.

COCCYALGIA – Pain in the coccyx region; coccygodynia, coccyodynia, coccydynia.

COCCYGEAL – Remaining three or four, somewhat fixed, fused segments at the end of the spine (tailbone) that articulate with sacrum above.

COCCYGECTOMY – Excision of the coccyx (tailbone).

COCCYGOTOMY – Incision into the coccyx (tailbone).

COCCYX – The small bone at the end of the spinal column, formed by the fusion of four rudimentary vertebrae. The three, and sometimes four, segments of bone just below the sacrum; referred to as the tailbone.

COLLAGEN – A fibrous protein which is a major constituent of connective tissue. Such as skin, tendons, ligaments, cartilage, and bones.

COMPRESSION – A squeezing together; the exertion of pressure on a body in such a way as to tend to increase its density; the decrease in a dimension of a body under the action of two external forces directed toward one another in the same straight line.

COMPRESSION of NERVE ROOT – Mechanical process resulting from a tumor, fracture, or herniated disc; the resulting irritation is called radiculitis if there is actual inflammation around the nerve. Pain from this type of disorder is called radicular pain.

COMPUTED TOMOGRAPHY (CT) SCAN – A diagnostic imaging technique in which a computer reads x-rays to creae a three-dimensional map of soft tissue or bone.

CONCUSSION – A disruption, usually temporary, of neurological function resulting from a blow or violent shaking.

CONGENITAL SCOLIOSIS – Scoliosis due to bony abnormalities present at birth involving either failure of formation of a vertebra or separation of adjacent vertebrae. Corrective scoliosis surgery may be needed.

CONSTITUTIONAL STENOSIS – Normal-statured individuals with congenital variance in vertebral structure leadng to a narrow canal.

CONTUSION – A bruise; an area in which blood that has leaked out of blood vessels is mixed with brain tissue.

CORDOTOMY – Transverse incision into the spinal cord.

COSTO – Combining form denoting relation to ribs.

COSTOCHONDRAL JUNCTION – Junction of the rib into cartilage in the anterior chest. NOTE: Most of the ribs have attachments to the cartilage rather than a direct junction with the breast bone.

COSTOVERTEBRAL ANGLE – Juncture of tissue inferior and lateral to the twelfth rib and vertebral body.

COSTOVERTEBRAL JOINT – Junction of the rib with the thoracic spine.

CT SCAN – (computed tomography scan): A diagnostic imaging technique in which a computer reads x-rays to create a three-dimensional map of soft tissue or bone.

D

DECOMPRESSION – In relation to the spine, this procedure is carried out to relieve pressure on the spinal cord or nerve roots.

DECOMPRESSIVE LAMINECTOMY – A decompression done by removing the lamina and spinous process.

DEGENERATIVE- The lesion results from inter-segmental instability of long duration.

DEGENERATIVE DISC DISEASE– Gradual or rapid deterioration of the chemical composition and physical properties of the disc space.

DEGENERATIVE STENOSIS – Gradual hypertrophy of the vertebral body margin, facet joints, and ligamentum flavum leading to stenosis.

DERMATOME – Refers to the distribution of sensory nerves near the skin that are responsible for pain, tingling, and other sensations (or lack of).

DIFFUSE AXONAL INJURY – Damage to the axons of many nerve cells that lie in different parts of the brain.

DIPLOPIA – Double vision, due usually to weakness or paralysis of one or more of the extra-ocular muscles.

DISC – The intervertebral disc, a cartilaginous cushion found between the vertebrae of the spinal column. It may bulge beyond the vertebral body and compress the nearby nerve root, causing pain. The terms “slipped disc”, “ruptured disc” and “herniated disc” are often used interchangeably even though there are subtle differences.

DISC DEGENERATION – The loss of the structural and functional integrity of the disc.

DISCECTOMY – Surgical removal of part or all of an intervertebral disc material placing pressure on neural elements.

DISCITIS – Non-bacterial inflammation of an intervertebral disc or disc space.

DISC SPACE INFECTION – Infection in the space normally occupied by an intervertebral disc.

DISKOGRAM – The graphic record, usually radiographic, of diskography.

DISKOGRAPHY – Radiographic demonstration of intervertebral disc by injection of contrast media into the nucleus.

DISLOCATION – Displacement of an organ or any part; specifically disturbance or disarrangement of the normal relation of the bones entering the formation of a joint.

DORSAL COLUMN – The main, normal sensory tract to the brain.

DORSAL LATERAL COLUMN – The main tract of position and tone to the brain.

E

EDEMA – An excessive accumulation of fluid in the body’s tissues. It usually occurs in the feet, ankles, and legs, but can involve your entire body.

EGGSHELL – Excavation of vertebral body for correction of deformity that is combined with spinal fusion.

ELECTROMYOGRAPHY (EMG) – A method of recording the electrical currents generated in a muscle during its contraction.

EPIDURAL – Immediately outside the dura mater. Same as extra-dural.

EXCISION – Removal by cutting away material.

EXTRADURAL – On the outer side of the dura mater.

EXTENSION – The act of bringing the distal portion of a joint in continuity (though only parallel) with the long axis of the proximal portion.

EXTRUSION – Displaced material reaches the spinal canal through fibers of the annulus, but remains connected to the central disc material.

F

FACET – a flat, plate-like surface that acts as part of a joint; as seen in the vertebrae of the spine and in the subtalar joint of the ankle. Each vertebra has two superior and two inferior facets.

FACET ARTHROPATHY – a degenerative disease affecting the facet joint.

FACECTOMY – Excision of an articular facet of a vertebra.

FACET TROPISM – Asymmetrical orientation of the facets comparing right to left side.

FAILURE of SEGMENTATION – Failure of a portion or all of two or more adjoining vertebrae to separate into normal units.

FIBROSIS – The replacement of normal tissue with scar tissue.

FIBROMYOSITIS – Chronic inflammation of a muscle with an overgrowth, or hyperplasia, of the connective tissue.

FLATTENING of NORMAL LUMBAR CURVE – Condition in which the hollow of the back becomes shallow or even straight.

FLEXION – The act of flexing or bending; bending of a joint so as to approximate the parts it connects.

FORAMEN – A natural opening or passage in bone. An opening allowing for the egress of spinal nerve roots from between two vertebrae.

FORAMINOTOMY – Surgical opening or enlargement of the bony opening traversed by a nerve root as it leaves the spinal canal. A procedure carried out alone or in conjunction with disc surgery.

FRACTURE- A disruption of the normal continuity of bone.

FRACTURE-DISLOCATION – Fracture of a bone that is also dislocated from its normal position in a joint.

FUNCTIONAL SCOLIOSIS – Any scoliosis that is caused by leg length or other functional disorder and not by a primary curvature of the spine.

FUSION – Union or healing of bone.

G

GETTY – For decompression of lumbar spinal stenosis; excision of lamina and portion of facet.

GILL – Removal of the posterior spinal arch in spondylolisthesis.

GILL, MANNING, and WHITE – A procedure sometimes combined with posterolateral spinal fusion.

GLENOHUMERAL – Relating to the glenoid cavity and the humerus.

GLIA (Also termed neuroglia) – The major support cells of the brain. These cells are involved in the nutrition and maintenance of the nerve cells.

GOLDSTEIN – For scoliosis deformity graft incorporating posterior elements, including facet joints and ribs.

GRAFT – Any free (unattached) tissue or organ for transplantation.

H

HALIFAX – Clamp across lamina of C-1 and C-2.

HARRINGTON ROD – An instrumentation and fusion using a straight, stiff rod for distraction or compression; associated with a posterior spinal fusion in the thoracic or thoracolumbar spine for scoliosis or trauma.

HEADACHE – Pain in various parts of the head, not confined to the area of distribution of any nerve.

HEMILAMINECTOMY – The excision of only one side of the lamina (right or left) relative to other spinous process.

HERNIATED INTERVERTEBRAL DISC (HID)- Extrusion of part of the nucleus pulposus material through a defect in the annulus fibrosus. Outward pouching of a disc.

HERNIATED NUCLEUS PULPOSUS (HNP) – Extrusion of the central portion of an intervertebral disc through the outer cartilaginous ring. The material can compress the spinal cord or nerves in or exiting the spinal canal.

HERNIATION – Formation of a protrusion.

HETEROTOPIC BONE FORMATION – The occurrence of bone growth in an abnormal location.

HUMERUS – The bone of the arm, articulating with the scapula above and the radius and ulna below.

HYOID BONE – Small, vertically oriented bones lateral to trachea, located at the level of C-3.

HYPER- Excessive, above normal.

HYPEREXTENSION – Extension of a limb or part beyond the normal limit.

HYPERFLEXION – Flexion of a limb or part beyond the normal limit.

HYPERLORDOSIS – Increase in the normal anterior concavity of the cervical or lumbar spine.

I

IDIOPATHIC SCOLIOSIS – Structural lateral curvature of an unknown cause. Corrective scoliosis surgery may be needed.

ILIAC BONE – A part of the pelvic bone that is above the hip joint and from which autogenous bone grafts prominent portion of the pelvic bone at the belt line of the body.

ILIOPSOAS MUSCLE – Large muscles starting at L-1 and becoming wider as it picks up segments from the lower lumbar spine; combines with the iliacus muscle before attaching to the lesser trochanter of the hip.

INSTRUMENTATION – the use of instruments such as metal screws or braces during a surgical procedure to support bone as it heals.

INTERBODY – between the bodies of two adjacent vertebrae

INTERCOSTALS – The muscles between the ribs.

INTERNAL FIXATION – The immobilization of bone fragments or joints with implants in order to promote healing or fusion.

INTERSPINOUS LIGAMENT – Ligament between each of the spinous processes.

INTERSPINOUS PSEUDARTHROSIS – Formation of a false joint between two spinous processes.

INTERVERTEBRAL DISC – See Disc (Intervertebral).

INTERVERTEBRAL DISC NARROWING – Narrowing of the space between any two vertebral bodies.

INTRINSIC – Situated entirely within or pertaining exclusively to a part.

IN VITRO – Describing biological phenomena that are made to occur outside the living body traditionally in a test tube. In vitro is Latin for in glass.

INFORMED CONSENT – Consent of the patient who has received sufficient information to have surgery, receive medication, or participate in a clinical study.

ISOMETRIC – Of equal dimensions. In physiology, denoting the condition when the ends of a contracting muscle are held fixed so that contraction produces increased tension at a constant overall length.

ISOTONIC – Relating to isotonicity or isotonia. Having equal tension; denoting solutions possessing the same osmotic pressure; more specifically, limited to situations in which cells can neither swell nor shrink.

ISTHMIC – The lesion is in the pars interarticularis. Three types occur: lytic, fatigue fracture of the pars interarticularis; elongated but intact pars interarticularis; and acute fracture of the pars interarticularis.

J

JACOBS LOCKING HOOK – Thick, threaded rods for fixation of various spinal deformities.

JARCHO-LEVIN SYNDROME – Extensive defects of the spine with associated defects in the ribs leading to a small, stiff thorax and pulmonary compromise.

JOINT – The junction or articulation of two or more bones that permits varying degrees of motion between the bones.

JOINTS of LUSCHKA (uncovertebral joints) – Unique to the cervical spine, these joint-like structures are formed by the apposition of posterolateral portions of adjacent vertebral bodies; these joints form the anterior portion of the canal where nerves pass through.

JUVENILE SCOLIOSIS – Begins between the ages of 3 and 10 years of age. Corrective scoliosis may be needed.

K

KANEDA – An anteriorly placed fixation device for spinal deformities.

KINETIC – Relating to motion or movement.

KNODT DISTRACTION ROD – For distraction stabilization of thoracic and lumbar spine.

KOSTUICK-HARRINGTON – Anteriorly placed device for spinal deformity correction.

KYPHECTOMY – For kyphotic deformity in myelodysplasia; excision of kyphotic portion of lumbar spine combined with spinal fixation.

KYPHOSCOLIOSIS – Lateral curvature of the spine associated with forward inclination of the spine.

KYPHOSIS – An abnormal increase in the normal kyphotic curvature of the thoracic spine. Round shoulder deformity, humpback, dorsal kyphotic curvature; may refer to any forward-bending area or deformity of the spine.

L

LAMINA – The flattened or arched part of the vertebral arch, forming the roof of the spinal canal. The posterior part of the spinal ring that covers the spinal cord or nerves.

LAMINECTOMY – Excision of one or more lamina of the vertebrae. Removal of the lamina, the bony element covering the posterior portion of the spinal canal.

LAMINOPLASTY – Procedure where the lamina are hinged laterally opened like a door and secured in their new position with suture or bone to enlarge the spinal canal.

LAMINOTOMY – Procedure where an opening is made in a lamina. Formation of a hole in the lamina without disrupting the continuity of the entire lamina to approach the intervertebral disc or neural structures.

LATERAL – Situated away from the midline of the body.

LIGAMENT – A band of flexible, fibrous connective tissue that is attached at the end of a bone near a joint. The main function of a ligament is to attach bones to one another, to provide stability of a joint, and to prevent or limit some joint motion.

LIGAMENTOUS- Relating to or of the form or structure of a ligament.

LIGAMENTUM FLAVUM – A band of yellow elastic tissue that runs between the lamina from the axis to the sacrum; it assists in maintaining or regaining erect position and serves to close in the spaces between the arches.

LIPOMA – A benign fatty tumor, usually composed of mature fat cells.

LOCALIO – For sacral tumor; a method for partial excision of the sacrum.

LOCALIZATION – Limitation to a definite area. The reference of a sensation to its point of origin.

LONGISSIMUS COLLI – Long muscle immediately anterior to the cervical spine.

LORDOSIS – Curvature of the spine with the convexity forward. Not a disease state, but the normal anterior concavity of the neck or low back.

LUMBAGO – A non-medical term signifying pain in the lumbar region. Archaic term meaning back pain.

LUMBAR – The lower part of the spine between the thoracic region and the sacrum. The lumbar spine consists of five vertebrae. The five moveable spinal segments of the lower back and largest of the spinal segments.

LUMBAR CURVE – Curve with apex between the first and the fourth lumbar vertebrae.

LUMBAR DRAIN – A device (usually a long, thin, flexible tube) inserted through the skin into the cerebrospinal fluid space of the lower back; provides a method of draining cerebrospinal fluid.

LUMBARIZATION – Partial or complete formation of a free-moving first sacral segment so that it looks like a lumbar vertebra.

LUMBAR KYPHOSIS – Reverse of the normal curve of the low back.

LUMBAR LORDOSIS – Angle made by lines drawn from the superior surface of the first and fifth lumbar vertebra.

LUMBAR MICRODISCECTOMY – an operation on the lumbar spine performed using a surgical microscope and microsurgical techniques.

LUMBOSACRAL CURVE – A lateral curve with its aspect at or between the fifth lumbar vertebra.

LUMBOSACRAL JOINT ANGLE – Angle between the inferior surface of the fifth lumbar vertebra and the top of the sacrum.

LUQUE INSTRUMENTATION – A posterior method of fixation.

LUQUE ISF – For posterolateral fusion fixation; a pedicle screw and plate device.

M

MACCARTHY PROCEDURE – For sacral tumor; a method of excision of the sacrum.

MAGERL – Transarticular facet screw fusion for posterior C-1 on C-2 with the use of bilateral screws directed from inferior posterior lateral mass to anterior superior C-1.

MAGNETIC RESONANCE IMAGING (MRI) – Diagnostic test that produces three-dimensional images of body structures using powerful magnets and computer technology rather than x-rays. Scanning technique for views of the brain or spinal cord. No radiation is involved, but rather, pulsed magnetic waves are used to delineate the structures within the brain.

MALIGNANT- Resistant to treatment; occurring in severe form, and frequently fatal; tending to become worse.

MARGINAL OSTEOPHYTES – Excess bone formation at the margin of the vertebral body; spondylosis.

MARIE-STRÜMPELL DISEASE – Inflammation of the spine, occurring as a rheumatoid-type disease in children.

MASSAGE – A method of manipulation of the body by rubbing, pinching, kneading, tapping, etc.

MCAFFEE – Anterior retropharyngeal approach to upper cervical spine; often used for fusion, allowing excision of tumor.

MEDIAN NERVE – The nerve formed from the brachial plexus that supplies muscles in the anterior forearm and thumb, as well as sensation of the hand. It may be compressed or trapped at the wrist in carpal tunnel syndrome.

MEDIAL – Situated closer to the midline of the body.

MEYER – For C-1 to C-2 instability, posterior fusion using vertical strut grafts and wires.

MODIFIED FRANKEL CLASSIFICATION – Scale for spinal cord damage due to any cause.

MINIMAL ACCESS DISCECTOMY – An operation performed on the upper spine to relieve pressure on one or more nerve roots.

MINIMALLY INVASIVE LUMBAR LAMINECTOMY/DISCECTOMY – An operation performed on the lower spine to relieve pressure on one or more nerve roots. The term is derived from the words lumbar (low back), and discectomy (remove a portion of the intervertebral disc).

MINIMALLY INVASIVE SURGERY – Surgery requiring small incision(s), usually performed with endoscopic visualization.

MUSCULOSKELETAL INJURIES- Injuries affecting the muscles.

MYALGIA – Muscular pain.

MYELALGIA – Pain in the spinal cord.

MYELANALOSIS – Wasting of spinal marrow.

MYELAPOPLEXY – Loss of nerve strength caused by some disorder of the spinal cord.

MYELASTHENIA – Loss of nerve strength caused by some disorder of the spinal cord.

MYELATELIA – Imperfect development of the spinal cord.

MYELATROPHY – Atrophy (wasting away) of spinal cord because of lack of nutrition, causing it to diminish in size.

MYELAUXE – Abnormal increase in size of spinal cord.

MYELETEROSIS – Abnormal alteration of the spinal cord.

MYELIN – The fat-like substance which surrounds the axon of nerve fibers and forms an insulating material.

MYELOGRAM – An x-ray of the spinal canal following injection of a contrast material into the surrounding cerebrospinal fluid spaces.

MYELOGRAPHY – Radiography of the spinal cord and nerve roots after the injection of a contrast medium into the spinal subarachnoid space. MYELOMALACIA – Softening of the spinal cord. MYELOMENINGITIS – Inflammation of the spinal cord and meninges (spinal membranes).

MYELOMENINGOCELE – A protrusion of the spinal cord and its coverings through a defect in the vertebral column. Herniation of cord and meninges through a defect in the vertebral column.

MYELONEURITIS – Inflammation of the spinal cord and peripheral nerves.

MYELOPARALYSIS – Spinal paralysis.

MYELOPATHY – Any functional or pathologic disturbance in the spinal cord.

MYELOPHTHISIS – Wasting of the spinal cord; reduction of cell-forming function of bone marrow.

MYELOPLEGIA – Spinal paralysis.

MYELORADICULITIS – Inflammation of spinal cord and nerve roots.

MYELORADICULOPATHY – Disease of spinal cord and spinal nerve roots.

MYELORRHAGIA – Spinal hemorrhage.

MYELOSCELEROSIS – Hardening of the spinal cord.

MYELOSYPHILIS – Syphilis of the spinal cord.

MYELOTOMY – A procedure for severing tracts in the spinal cord.

MYOPATHY – Any disease of muscle.

MYOSITIS – Inflammation of the muscle.

N

NEOPLASM – Any new or abnormal growth, specifically a new growth of tissue in which the growth is uncontrolled.

NERVE – A whitish, cordlike structure composed of one or more bundles of myelinated or unmyelinated fibers, or more often, mixtures of both coursing outside of the central nervous system, together with connective tissue within the fascicle and around the neurolemma of individual fibers.

NERVE ROOT – The portion of a spinal nerve in close proximity to its origin from the spinal cord.

NEURALGIA – A paroxysmal pain extending along the course of one or more nerves.

NEURECTOMY – Excision of part of a nerve.

NEURITIS – Inflammation of a nerve; may also be used to denote non-inflammatory nerve lesions of the peripheral nervous system.

NEUROBLASTOMA – Tumor of sympathetic nervous system origin, found mostly in infants and children.

NEUROFIBROMA – A tumor of the peripheral nerves due to an abnormal collection of fibrous and insulating cells.

NEUROFIBROMATOSIS – A familial condition characterized by developmental changes in the nervous system, muscles, and skin, marked by numerous tumors affecting these organ system.

NEUROPATHIC PAIN – Pain caused by damage to nerve tissue. It is often felt as a burning or stabbing pain. One example of neuropathic pain is a “pinched nerve.”

NEUROPATHY – Any functional or pathologic disturbance in the peripheral nervous system.

NEUROSTIMULATION – Surgical placement of a medical device under the skin to send mild electrical impulses to the spinal cord. The electrical impulses travel through a lead (a special medical wire) that is also surgically placed. These electrical impulses block the signal of pain from reaching the brain. Peripheral nerve stimulation, a form of neurostimulation, works in a similar way. For this treatment, the lead is placed at the site of the specific nerve that is causing pain rather than near the spinal cord. Because neurostimulation works in the area where

pain signals travel (the spinal cord or specific nerve), electrical impulses (which are felt as tingling) can be directed to cover the specific sites where a patient is feeling pain.

NEUROSTIMULATOR – A device for electrical excitation of the central or peripheral nervous system.

NEUROSURGERY – The surgical specialty involved in the treatment of disorders of the brain, spinal cord, and peripheral nerves.

NEWMAN – C-1 to C-2 posterior fusion without fixation.

NOCICEPTIVE PAIN – Pain caused by an injury or disease outside the nervous system. It is often an on-going dull ache or pressure, rather than the sharper, trauma-like pain more characteristic of neuropathic pain. One example of nociceptive pain is arthritis pain.

NON-UNION – Failure of the fragments of a fractured bone to heal or to obtain bony fusion following an arthrodesis.

NUCHAL LIGAMENT – Large posterior midline ligament in the neck from the base of the skull to the seventh cervical vertebra.

NUCLEUS PULPOSUS – The semi-gelatinous tissue in the center of an intervertebral disc. It is surrounded and contained by the annulus fibrosus which prevents this material from protruding outside the disc space.

NURICK SCALE – Classification scale for spinal cord compression due to spondylosis.

NYSTAGMUS – Involuntary rapid movement of the eyes in the horizontal, vertical or rotary planes of the eyeball.

O

OCCIPITAL NERVE – Nerve from the back of the neck that supplies motor function and sensation to the forehead. Contains two parts—greater and lesser occipital nerve.

OCCIPUT – The back part of the head. The base of the skull.

ORTHOPAEDICS (also ORTHOPEDICS) – The medical specialty involved in the preservation and restoration of function of the musculoskeletal system that includes treatment of spinal disorders and peripheral nerve lesions.

ORTHOPEDIC SURGEON – A physician who treats the musculoskeletal system, extremities, and spine by operation or manipulation.

OSSIFICATION – The process of forming bone in the body.

OSTEOARTHRITIS – Arthritis characterized by erosion of articular cartilage, either primary or secondary to trauma or other conditions, which becomes soft, frayed, and thinned with eburnation of subchondral bone and outgrowths of marginal osteophytes.

OSTEOMYELITIS – Inflammation of bone due to infection, which may be localized or generalized.

OSTEOPHYTE – A bony outgrowth or protuberance.

OSTEOPOROSIS – A disorder in which bone is abnormally brittle, less dense, and is the result of a number of different diseases and abnormalities.

P

PAIN – An unpleasant sensation associated with actual or potential tissue damage, and mediated by specific nerve fibers to the brain where its conscious appreciation may be modified by various factors.

PARS INTERARTICULARS – The posterior continuation of the spinal arch from the pedicle; the superior and inferior facets are connected to each other by the pars interarticulars.

PATHOLOGIC – Generalized or localized bone disease is present.

PATHOLOGY – The study of disease states.

PEDICLE -The part of each side of the neural arch of a vertebra. It connects the lamina with thevertebral body. The first portion of the posterior spine arising from the vertebral body.

PERIOSTEUM – A fibrous membrane that covers the surface of bone except at the end of the bones where it is covered with cartilage as part of a joint. In children, periosteum is involved in forming new bone and molding the configuration of bone; and in the adult, the periosteum forms new bone secondary to injury or infection.

PHYSICAL THERAPY – The treatment consisting of exercising specific parts of the body such as the legs, arms, hands or neck, in an effort to strengthen, regain range of motion, relearn movement, and/or rehabilitate the musculoskeletal system to improve function.

PIRIFORMIS SYNDROME – A clinical diagnosis based on complaints of pain and abnormal sensations in the buttocks region with extension into the hips and posterior thigh as would be seen in sciatica.

POSTERIOR – The back of the body or situated nearer the back of the body.

POSTERIOR APPROACH – Used for laminectomies and spinal fusions at any level; Hibbs, Wagoner.

POSTERIOR CERVICAL SPINAL FUSION- Spinal fusion done from the back, using the lamina, facets, and spinous processes of the neck.

POSTERIOR LUMBAR SPINAL FUSION- Spinal fusion done from the back using the lamina, the facets, and spinous processes of the lower back.

POSTERIOR SPINAL FUSION- A fusion of the cervical, thoracic, or lumbar regions primarily fusing the lamina and sometimes the facet joints, using iliac or other bone graft.

POSTERIOR SPINAL MUSCLE SEGMENTS – Upper and lower posterior serratus m., spinalis m., semispinalis m., and rotators.

POSTEROLATERAL (P/L) – Behind and to one side, specifically to the outer side.

POSTEROLATERAL INTERBODY FUSION (PLIF)- Lumbar spine fusion that involves an interbody fusion accomplished through the posterior approach.

POSTEROLATERAL FUSION – A fusion of both the lamina and transverse process, using the iliac bone for graft, usually in the lower lumbar and first sacral segments.

POSTURE – The position of the limbs or the carriage of the body as a whole.

PROPRIOCEPTION – Sensation concerning movements of joints and position of the body in space.

PROTRUSION – Displaced nuclear material causes a discrete bulge in the annulus, but no material escapes through the annular fibers.

PROXIMAL – Nearest the center of the body.

Q

QUADRATUS LUMBORUM – A muscle lateral to the iliopsoas muscle of the spine running from the lower ribs to the ilium

QUADRIPLEGIA – Paralysis of all four limbs.

R

RACHIALGIA – Pain in the vertebral column.

RACHIOCAMPSIS – Curvature of the spine.

RACHIOCHYSIS – Effusion of fluid within the vertebral canal.

RACHIOKYPHOSIS – Humpbacked curvature of spine; kyphosis.

RACHIOMYELITIS – Inflammation of the spinal cord.

RACHIOPARALYSIS – Paralysis of the spinal muscles.

RACHIOPATHY – Any disease of the spine.

RACHIOPLEGIA – Spinal paralysis.

RACHIOSCOLIOSIS – Lateral curvature of the spine.

RACHIOTOMY – Incision into a vertebral canal for exploration.

RACHISAGRA – Pain or gout in the spine.

RACHISCHISIS – Abnormal congenital opening of the vertebral column.

RACHITOMY – Surgical or anatomic opening of the vertebral canal.

RADICULECTOMY – Excision of a rootlet or resection of spinal nerve roots.

RADICULOPATHY- Disease of the nerve roots in or near the spinal canal as a result of direct pressure from a disc, or inflammation of the nerve roots due to disc or spinal joint disease.

RADIOLOGIST – A medical doctor who has received specialized training in interpreting x-rays, CTs, MRIs and performing angiography.

RADIUS – The lateral and shorter of the two bones of the foreman.

REFERRED PAIN – Felt distant from its origin (e.g., bursitis in the shoulder produces pain in the lateral arm, and sciatic-like leg pain can be referred from the lower-back area).

REFLEX – An involuntary reaction in response to a stimulus applied to the periphery and transmitted to the nervous centers in the brain or spinal cord.

RESECTION – The surgical removal of part of a structure, such as bone.

RESORPTION – The removal of bone tissue by normal physiological process or as part of a pathological process such as an infection.

RETROLISTHESIS – Posterior displacement of the vertebra on the one below.

REVERSAL of CERVICAL LORDOSIS – Change in the normal curvature of the cervical spine as seen on lateral radiograph. This is usually a straightening of the normal lordotic curve or an actual reversal and is most commonly caused by muscle spasm, indicating cervical disc abnormality.

RHEUMATOID ARTHRITIS – generalized inflammatory joint disease.

RHIZOTOMY – Division of the roots of the spinal nerves.

ROD – In spinal applications, a slender, metal implant which is used to immobilize and align the spine.

ROGER FUSION – Posterior cervical using iliac cortical and cancellous grafts.

ROGOZINSKI – A combined anteroposterior device used in correction of spinal deformities.

ROOT – The primary or beginning point of any part, as of a nerve at its origin from the brainstem or spinal cord.

ROOT SLEEVE FIBROSIS – Scar tissue surrounding a nerve in the spinal canal or neural foramen; epineural fibrosis. If it is within the nerve, it is called intraneural fibrosis.

S

SACRAL- Five fused segments of the lower spine, below the end of the spinal column, that connect to the pelvis and have four foramina on each side.

SACRAL CYST – Abnormality in the spinal fluid sac in the sacrum.

SACRALGIA- Pain in the sacrum.

SACRALIZATION- Fusion of L-5 to the first segment of the sacrum, so that the sacrum consists of six segments; with this abnormality, it is called BERTOLOTTI syndrome.

SACRALIZED TRANSVERSE PROCESS – One or both of the lumbar spinous transverse processes abnormally joining with the sacrum; sacralization.

SACROILIITIS- Inflammation of the sacroiliac joint. A very painful, often one-sided sacral area pain that follows delivery, not due to sepsis, and will subside gradually and completely; acute postpardum sacroilitis.

SACRUM – A part of the spine that is also part of the pelvis. It articulates with the ilia at the sacroiliac joints and articulates with the lumbar spine at the lumbosacral joint. The sacrum consists of five fused vertebrae that have no intervertebral discs.

SAGITTAL – Longitudinal.

SCALENUS – The deep lateral muscles of the anterior neck, including anterior scalene m. (scalenus SCHMORL’S NODES – Developmental change resulting in inferior or superior extension of the intervertebral disc into the vertebral bodies.

SCIATICA – A lay term indicating pain along the course of a sciatic nerve, especially noted in the back of the thigh and below the knee. Pain radiating down the sciatic nerve into the posterior thigh and leg; can be caused by irritation of a nerve anywhere from the back to the thigh.

SCOLIOSIS – Lateral (sideways) curvature of the spine. Corrective scoliosis surgery may be needed.

SEGMENTAL INSTABILITY – Abnormal response to applied loads characterized by motion in the motor segment beyond normal constraints.

SEQUESTRATION – Displaced material escapes as free fragment(s), which may migrate elsewhere.

SHUNT – A tube or device implanted in the body to redivert excess CSF away

SPINA BIFIDA – A congenital fissure or opening (cleft) of the spinal column with hernial protrusion of the meninges (membranes that cover the brain and spinal cord, including the arachnoid, dura mater, and pia mater) and sometimes the spinal cord.

SPINAL ACCESSORY NERVE (eleventh cranial) – The nerve from the brainstem that supplies the sternocleidomastoid muscles.

SPINAL CANAL – The bony channel that is formed by the intravertebral foramen of the vertebrae and in which contains the spinal cord and nerve roots. The space between the vertebral body anteriorly and the lamina and spinal process posteriorly.

SPINAL COLUMN – See Spine.

SPINAL CORD – The longitudinal cord of nerve tissue that is enclosed in the spinal canal. It serves not only as a pathway for nervous impulses to and from the brain, but as a center for carrying out and coordinating many reflex actions independently of the brain.

SPINAL DISC – See Disc (Intervertebral).

SPINAL FUSION – Operative method of strengthening and limiting motion of the spinal column. Can be performed with a variety of metal instruments and bone grafts, or bone grafts alone.

SPINAL STENOSIS – General term denoting narrowing of the spinal canal in the lumbar area leading to nerve root compromise; term often used for developmental abnormality that leaves a narrow, bony canal. There are four subgroups of this condition: achondroplastic stenosis, constitutional stenosis, degenerative stenosis, and combined stenosis.

SPINE – The flexible bone column extending from the base of the skull to the tailbone. It is made up of 33 bones, known as vertebrae. The first 24 vertebrae are separated by discs known as intervertebral discs, and bound together by ligaments and muscles. Five vertebrae are fused together to form the sacrum and 4 vertebrae are fused together to form the coccyx. The spine is also referred to as the vertebral column, spinal column, or backbone.

SPINOUS PROCESS – The portion of the vertebrae that protrudes posteriorly from the spinal column. The spinous processes create the “bumps” felt on the midline of the back. The most posterior extension of the spine arising from the lamina.

SPONDYLALGIA – Pain in vertebra(e).

SPONDYLARTHRITIS – Arthritis of the spine.

SPONDYLARTHROCACE – Tuberculosis of the spine; spondylocace.

SPONDYLEXARTHROSIS – Dislocation of a vertebra.

SPONDYLITIS – Inflammation of vertebrae, including types such as ankylosing, rheumatoid, traumatic, spondylitis deformans, Kümmell, and Marie-Strümpell Disease.

SPONDYLIZEMA – Depression or downward displacement of a vertebra, with destruction or softening of one below it.

SPONDYLODYNIA – Pain in vertebra(e).

SPONDYLOLISTHESIS – A defect in the construct of bone between the superior and inferior facets with varying degrees of displacement so the vertebra with the defect and the spine above that vertebra are displaced forward in relationship to the vertebrae below. It Is usually due to a developmental defect or the result of a fracture.

SPONDYLOLYSIS – Displacement of one vertebrae over another with fracture of a posterior portion of the vertebra. A defect in the neural arch between the superior and inferior facets of vertebrae without separation at the defect and therefore no displacement of the vertebrae. It may be unilateral or bilateral and is usually due to a developmental defect, but may be secondary to a fracture.

SPONDYLOMALACIA – Softening of vertebrae; Kümmell disease.

SPONDYLOPATHY – Any vertebral disorder.

SPONDYLOPYOSIS – Infection in vertebra(e).

SPONDYLOSCHISIS – Congenital fissure (splitting) of vertebral arch.

SPONDYLOSIS – Ankylosis of the vertebra; often applied nonspecifically to any lesion of the spine of a degenerative nature. Bony replacement of ligaments around the disc spaces of the spine, associated with decreased mobility and eventual fusion; marginal osteophyte.

SPONDYLOSYNDESIS – Surgical immobilization or ankylosis by fusion of the vertebral bodies with a short bone graft in cases of tuberculosis of the spine;

SPONDYLOTOMY – Incision into a vertebra or vertebral column; rachiotomy.

SPRAIN- An injury to a ligament when the joint is carried through a range of motion greater than normal, but without dislocation or fracture.

STENOSIS – Reduction in the diameter of the spinal canal due to new bone formation which may result in pressure on the spinal cord or nerve roots.

STERNOCLEIDOMASTOID – Large externally visible muscle of the anterior neck, enabling the head to turn to either side.

STERNUM – The breast bone; further divided into three segments. manubrium: upper portion, proximal end; sternum: main portion; xiphoid: the dagger-like tip of the sternum, distal end.

STRABISMUS – Deviation of eye movement which prevents the two eyes from moving in a parallel fashion.

STRAIN – To injure by overuse or improper use.

STRUCTURAL CURVE – A fixed lateral curve of the spinal column.

SUBLUXATION – An incomplete luxation or dislocation. Though a relationship is altered, contact between joint surfaces remains.

SUPERIOR – Situated above or directed upward toward the head of an individual

SURGERY – The branch of medicine concerned with the treatment of disease, injury, and deformity by operation or manipulation. The performance or procedures of an operation.

SYNDROME – The aggregate of signs and symptoms associated with any morbid process, and constitution together the picture of the disease.

T

TENDON – The fibrous band of tissue that connects muscle to bone. It is mainly composed of collagen.

TENDONITIS – Inflammation of a tendon.

TENSION – The act of stretching. The condition of being stretched or tense, or a stretching or pulling force.

THORACIC – The chest level region of the spine that is located between the cervical and lumbar vertebrae. It consists of 12 vertebrae which serve as attachment points for ribs.

THORACIC CURVE – A spinal curvature with its apex between the second and eleventh thoracic vertebrae.

THORACIC OUTLET SYNDROME – Mechanical problem related to the exit of arteries and nerves at the base of the neck leading down the arm, and can also involve the vein bringing blood back from the arm.

THORACOLUMBAR CURVE – A spinal curve with its apex at the first lumbar or twelfth thoracic curve.

THORACOPLASTY – The surgical removal (resection) of rib segments.

THORAX – The chest or rib cage; also refers to the space containing the lungs and heart. There are 12 vertebral segments and ribs; the lower two are called floating ribs.

TISSUE – A collection of similar cells and the intercellular substances surrounding them.

TORTICOLLIS – A contraction, often spasmodic, of the muscles of the neck, chiefly those supplied by the spinal accessory nerve; the head is drawn to one side and usually rotated so that the chin points to the other side.

TRACTION – The act of drawing or pulling, as by an elastic or spring force. A pulling or dragging force exerted on a limb in a distal direction.

TRACTION SPUR – Bony excrescence appearing on the anterolateral surface of the vertebral body near, but not at the body margin, that arises as a result of disc degeneration.

TRACTOTOMY – Surgical section of a fiber tract of the central nervous system.

TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) – The stimulation of a nerve by passing electrical currents through the skin.

TRANSFORAMINAL LUMBAR INTERBODY FUSION (TLIF)- an operation where the lumbar spine is approached through an incision in the back. A portion of bone and disc are removed from the spine and replaced with an implant that is inserted into the disc space.

TRANSITIONAL VERTEBRA – Vertebra whose structure features some of the characteristics of the two adjacent vertebra. A common example is the fifth lumbar vertebra that has partial sacral components.

TRANSVERSE – Crosswise; lying across the long axis of the body or of a part.

TRANSVERSE PROCESS – Bony process arising from midportion of the spinal ring just posterior to the pedicle and pars interarticulars.

U | V | W | X

ULNA – The medial and the larger of the two bones of the forearm.

ULTRASOUND – The use of high-frequency sound to create images of internal body structures.

VERTEBRA – One of the 33 bones of the spinal column. A cervical, thoracic, or lumbar vertebra has a cylindrically-shaped bony anteriorly and a neural arch posteriorly (composed primarily of the lamina and pedicles as well as the other structures in the posterior aspect of the vertebra) that protects the spinal cord. The plural of vertebra is vertebrae.

VERTEBRAL BODY – From a lateral view, it is the main rectangular portion of the spine; from an overview, oval.

VERTIGO – An abnormal sensation of rotation or movement of one’s self, or the environment.

WEDGING – Deformity of vertebral body, caused by trauma or gradual collapse, resulting in wedge-shaped vertebra; can also occur congenitally.

WHIPLASH – Popular term for hyperextension-hyperflexion.

X-RAY – The ionizing electromagnetic radiation emitted from a highly evacuated tube, resulting from the excitation of the inner orbital electrons by the bombardment of the target anode with a stream of electrons from a heated cathode.