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Glossary of Terms

  • A

  • AcuteOccurs suddenly.
  • Allograft boneSterile bone derived from another human and is used for grafting procedures.
  • Annulus fibrosusThe outer, fibrous ringlike portion of an intervertebral disk.
  • AnteriorThe front portion of the body. It is often used to describe the position of one structure compared with another.
  • Anterior interbody fusionA surgical procedure that replaces some of or the entire disk with a bony graft through an anterior approach. This technique is used commonly in the cervical spine to treat degenerative disk disease and herniated nucleus pulposus. This technique also is used in the lumbar spine for many fusions.
  • AnterolateralIn front and to the side
  • Apical vertebraThe most rotated vertebra in a curve; the most deviated vertebra from the patient's vertical axis.
  • ArachnoiditisInflammation of the arachnoid membrane -- the coverings of the spinal cord and brain. This can lead to scarring. This condition may be identified after surgery in some patients who have persistent pain.
  • ArthritisInflammation of a joint usually characterized by swelling, pain and restriction of motion.
  • Arthrodesis The fusion of bones across a joint space that limits or eliminates movement. It may occur spontaneously or because of a surgical procedure, such as spine fusion.
  • Arthropathy Any disease or disorder involving a joint.
  • Arthroplasty The surgical remodeling of a diseased or damaged joint.
  • Arthroscope An instrument inserted into a joint cavity to view the interior of a joint and correct some abnormalities. An arthroscope is an endoscope for use in a joint.
  • Arthroscopy The procedure of seeing the inside of a joint with an arthroscope.
  • Articular Concerning a joint.
  • Autogenous bone A person's own bone.
  • Autograft bone Bone transplanted from one part to another part of the body in the same person.
  • B

  • Bone The hard tissue that provides structural support to the body. It is primarily composed of hydroxyapatite crystals and collagen. Bones may be classed as long, short or flat.
  • Bone graft Bone that is harvested from one location in a person and placed in another person (allograft bone) or in another location in the same person (autogenous bone).
  • Bone growth stimulator An electromagnetic device worn or implanted to promote bone growth with fractures or surgery. It may be used to enhance the fusion in patients at higher risk for difficult-healing fusion, such as smokers.
  • Bone marrow The tissue in the internal cavities of the bones. An important function of this tissue is to produce red blood cells.
  • Bone morphogenetic protein Biologic material that enhances bone growth.
  • Bone plate Usually a thin metal device that is fastened to bone with screws to immobilize bones or bone fragments so healing can occur.
  • Bone screw A threaded metal device that is inserted into bone. The functions of bone screws are to immobilize bones or bone fragments or to fasten other medical devices, such as metal bone plates, to bones.
  • C

  • Cancellous bone The spongy or honeycomb structure of some bone tissue typically found at the ends of long bones.
  • 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 little friction.
  • Cauda equina This consists of the nerve roots in the lumbar spine that come off the end of the spinal cord and travel to the lower extremities, bowel and bladder.
  • Cauda equina syndrome Loss of bowel and bladder control, and numbness in the groin and saddle area of the pelvis. This condition is associated with weakness of the lower extremities. It can be caused by abnormal pressure on the lowest portion of the spinal canal and spinal nerve roots, and it is related to either bony stenosis or a large herniated disk.
  • Centrum The body of a vertebra.
  • Cerebrospinal fluid Fluid filling the dural sac and provides nourishment to the neural elements in the spinal canal and brain cavities.
  • Cervical The neck region of the spine containing the first seven vertebrae.
  • Chemonucleolysis A treatment of an intervertebral disk that consists of an injection of a drug that dissolves part of the disk.
  • Chronic Persistent or long-lasting. With back pain, it refers to conditions lasting longer than three months.
  • Claudication Intermittent limping because of pinching on the nerves in the lumbar spine and a decrease in the blood supply to nerves or muscles.
  • Cobb Angle Measurement Calculated by selecting the upper- and lower-end vertebrae in a curved spine and extending perpendicular lines to their transverse axes. At the point of intersection, the angle is measured to determine the curve's angle.
  • Coccyx The region of the spine below the sacrum. It also is called the tailbone.
  • Collagen A fibrous protein that is a constituent of connective tissue, such as skin, tendons, ligaments, cartilage and bones.
  • Comminuted fracture A fracture in which a bone is broken into more than two pieces. Often internal or external fixation devices are used to maintain proper alignment of the fragments.
  • Compensatory curve A curve, which can be structural, above or below a major curve that can maintain normal body alignment.
  • Compression The act of pressing together. It refers to the loss of vertebral body height either anteriorly, posteriorly or both.
  • Computed tomography (CT) This diagnostic-imaging test provides high-resolution cross-sectional images of bones and bone spaces. CT scanning does not image soft tissues. It is also known as a CAT scan.
  • Congenital Present at and existing since birth.
  • Coronal Refers to a section that divides the body into anterior and posterior portions.
  • Cortical bone Bone tissue that has been depleted of its minerals (calcium and phosphorous).
  • D

  • Discectomy A surgical procedure to remove part of a herniated disk. The goal of the surgery is to keep the herniated disk from pressing on and irritating the nerves that cause pain and weakness. This may be done as an open procedure with a microscope or with a minimally invasive method.
  • Discitis Inflammation of the disk.
  • Discography Injecting dye into the nucleus of an intervertebral disk. During the injection, the physician performing the procedure asks the patient if the injection generates pain similar to his or her usual pain. Discographic images are generated from plain X-rays and computed tomography scanning.
  • Disk (intervertebral) The intervertebral disk is a combination of strong connective tissues that hold one vertebra to the next and is 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.
  • Disk degenerationThe loss of the structural and functional integrity of the disk.
  • Distal Away from the center of the body.
  • Distraction Excessive space between fracture fragments or vertebral segments because of interposed tissue or, most often, axial forces.
  • E

  • Electromyography A test to determine the function of the peripheral nerves and nerve roots. It involves placing tiny needles in muscles. An electric stimulus then is monitored for changes that reflect the function of the connection between the nerve and muscle. This test is usually performed with a nerve conduction-velocity study.
  • End vertebra In a curved spine, the vertebra that is closest to the head whose superior surface tilts toward the concavity of the curve, and the vertebra closest to the coccyx whose inferior surface tilts toward the concavity of the curve.
  • Endogenous Arising in or derived from the body.
  • Endoscope A medical device for viewing internal portions of the body. It is usually composed of fiberoptic tubes and video-display instruments.
  • Endoscopy Inspection of internal body structures or cavities using an endoscope.
  • Epidural Outside the thin, tough, dural membrane that surrounds the brain and spinal cord.
  • Excision Removal by cutting away material.
  • Exogenous Originating outside the body.
  • F

  • Facet A posterior structure of a vertebra that articulates with a facet of an adjacent vertebra to form a facet joint. This allows motion in the spinal column. Each vertebra has two superior and two inferior facets.
  • Facet injection Injections of steroids and local anesthetic into the facet joints can be used to determine whether it is a source of pain or to reduce pain and inflammation. See also zygapophysial joint injections.
  • Facetectomy Excision of a facet.
  • Fatigue fracture A fracture that occurs in bone or in other materials, including metal, because of repeated stress versus a single injury.
  • Fibrosis The replacement of normal tissue with scar tissue.
  • Foramen A natural opening or passage in bone.
  • Fracture A disruption of the continuity of bone.
  • Fusion Union or healing of bone.
  • G

  • Gibbus A sharply angular kyphos.
  • H

  • Herniated disk Displacement of the disks center through a crack in the outer layer. Most disk herniations occur in the bottom two disks of the lumbar spine, at and just below the waist. A herniated disk can press on a nerve root in the spine and may cause back pain or pain, numbness, tingling or weakness in the leg (sciatica). This condition also is called a slipped or ruptured disk, or herniated nucleus pulposus. It also can occur in the neck and rarely in the thoracic portion of the spine.
  • Heterotopic bone formation Bone growth in an abnormal location.
  • Hook A metallic medical device used to connect spinal structures to a rod.
  • Hydroxyapatite The latticelike structure of bone composed of calcium and phosphorous crystals that deposit on collagen to provide the rigid structure of bone.
  • I

  • Iatrogenic Occurring without a known cause; self-originating.
  • Iliac bone A part of the pelvic bone that is above the hip joint and from which autogenous bone grafts are frequently obtained.
  • Iliac crest The large, prominent portion of the pelvic bone at the body's belt line.
  • Immobilization Limit motion or fix a body part to promote healing.
  • In vitro Describing biological phenomena that occur outside the living body, traditionally in a test tube. In vitro is Latin for "in glass."
  • In vivo In a living body. In vivo is Latin for "in life."
  • Inferior Below or directed down.
  • Instability When vertebrae move beyond their normal range of motion.
  • Interbody fusion Grafting bone in the space between disks to fuse two vertebral segments.
  • Internal fixation The immobilization of bone fragments or joints with implants to promote healing or fusion.
  • Intervertebral cage A type of instrumentation used to promote fusion during surgery.
  • Intervertebral disk See Disk.
  • J

  • Joint The junction or articulation of two or more bones that permits varying degrees of motion between the bones.
  • K

  • Kyphoplasty A procedure to repair osteoporosis fractures using a gluelike material that is injected into a balloon inserted into a collapsed vertebra.
  • Kyphosis An abnormal increase in the kyphotic curve of the thoracic spine.
  • L

  • Lamina An anatomical portion of a vertebra. For each vertebra, two laminae connect the pedicles to the spinous process as part of the neural arch.
  • Laminectomy An operation to remove part or all of the lamina of a vertebra. This procedure is commonly performed to allow the removal of an intervertebral disk protrusion or to decompress a nerve root.
  • Lateral 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 primary functions of a ligament are to attach bones to one another, provide joint stability and prevent or limit some joint motion.
  • Load sharing Structural support through grafts or implants.
  • Lordosis An abnormal increase in the lordotic curvature of the lumbar spine.
  • Lumbago A non-medical term describing pain in the lumbar region.
  • Lumbar The lower part of the spine between the thoracic region and the sacrum. The lumbar spine consists of five vertebrae.
  • M

  • Medial Closer to the midline of the body.
  • Microdiscectomy A surgical procedure performed with a microscope to remove herniated disk material.
  • Minimally invasive surgery Surgery requiring small incision(s), usually performed with endoscopic visualization.
  • Myelitis Spinal-cord inflammation.
  • Myelopathy A spinal-cord disorder that commonly causes weakness in the lower extremities and spasticity in the upper extremities. It may be the consequence of spinal stenosis, particularly in the cervical spine, or an injury to the spinal cord.
  • N

  • Nerve root The bony arch of the posterior aspect of a vertebra that surrounds the spinal cord. It also is called the vertebral arch.
  • Nerve root block An injection of corticosteroids (antiinflammatories) and a local anesthetic onto the nerve root sleeve surrounding a nerve root.
  • Neurosurgery The surgical specialty for the treatment of disorders of the brain, spinal cord and peripheral nerves.
  • Nonsteroidal antiinflammatory drugs Medicines used to reduce swelling and inflammation. Examples are aspirin, ibuprofen and naproxen. There are various classes of these medicines, including COX-1 and COX-2 inhibitors.
  • Nonunion Failure of the fragments of a fractured bone to heal or fuse after an arthrodesis.
  • Nucleus pulposus The semi-gelatinous tissue in the center of an intervertebral disk. It is surrounded and contained by the annulus fibrosus, which prevents this material from protruding outside the disk space.
  • O

  • Orthopedics The medical specialty involved in the preservation and restoration of function of the musculoskeletal system. This includes treatment of spinal disorders and peripheral nerve lesions.
  • Orthosis Brace.
  • Ossification The process of forming bone in the body.
  • Osteophytes Bone spurs.
  • Osteoporosis A disorder in which bone is abnormally brittle and less dense. It is caused by many diseases and abnormalities.
  • P

  • Pathology The study of disease states.
  • Pedicle The part of each side of the neural arch of a vertebra. It connects the lamina with the vertebral body.
  • Pelvic obliquity Deviation of the pelvis from the horizontal in the frontal plane. Fixed pelvic obliquities can be attributed to contractures either above or below the pelvis.
  • 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 helps form new bone and molds the configuration of bone. In adults, the periosteum forms new bone after injury or infection.
  • Physical therapy The treatment consisting of exercising specific parts of the body to strengthen, regain range of motion, relearn movement or rehabilitate the musculoskeletal system to improve function.
  • Physiology The science of the functioning of living organisms and their component systems or parts.
  • Posterior Behind a structure, such as the back side of the human body.
  • Posterior lumbar interbody fusion Spinal fusion technique in which the disk is removed through the back of the spinal canal and a bone graft is inserted in the invertebral space through the back.
  • PRN As necessary.
  • Prosthesis An artificial body part such as a leg or arm. The term prosthesis also describes some of the implants used in the body, such as a hip or knee replacement device.
  • Proximal Nearest the center of the body.
  • Pseudarthrosis A form of a nonunion in which a false joint forms with some cartilage covering the ends of the bones and a cavity containing fluid that resembles a normal joint.
  • Pseudoarthrosis A form of a nonunion in which a false joint forms with some cartilage covering the ends of the bones and a cavity containing fluid that resembles a normal joint.
  • R

  • Radiculopathy Impairment of a nerve root, usually causing radiating pain, numbness, tingling or muscle weakness that corresponds to a specific nerve root.
  • Resection The surgical removal of part of a structure, such as bone.
  • Resorption The removal of bone tissue by a normal physiological process or as part of a pathological process such as an infection.
  • Rhizotomy Surgical transection of a nerve root.
  • Rib hump The prominence of the ribs on the convexity of a spinal curve, usually because of vertebral rotation best exhibited when bending forward.
  • Rod A slender, metal implant used to immobilize and align the spine.
  • Rotation The movement of one vertebra to another about its coronal axis.
  • Ruptured disk See Herniated Disk.
  • S

  • Sacroiliac The joints, one on each side, between the sacrum at the midline and the iliac wings, which form part of the pelvic ring. It is often a site of referred pain, and it may be a source of pain.
  • 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 disks.
  • Sagittal Refers to a lengthwise cut that divides the body into right and left portions.
  • Sciatica A lay term meaning pain along the course of a sciatic nerve, especially in the back of the thigh and below the knee.
  • Scoliosis A sideways curve of the spine.
  • Sepsis Tissue infection caused by disease-producing bacteria or toxins.
  • Skeleton The rigid framework of bones that gives form to the body, protects and supports the soft organs and tissues, and provides attachments for muscles.
  • Spina bifida A congenital defect of the spinal column in which a hole in the vertebra exposes the spinal cord and nerves. This condition is usually identified at birth and may be treated early in life.
  • Spina bifida occulta A congenital defect of the spinal column in which the lamina fail to come together completely at the midline. In this form, there are no exposed neural elements. Spina bifida occulta is usually an incidental finding without associated clinical findings.
  • Spinal canal The bony channel that is formed by the intravertebral foramen of the vertebrae, and it contains the spinal cord and nerve roots.
  • 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 also as a center for carrying out and coordinating many reflex actions independent of the brain.
  • Spinal disk See Disk (Intervertebral).
  • Spinal fusion A surgical procedure to permanently join bone by interconnecting two or more vertebrae to prevent motion (see Arthrodesis).
  • Spinal stenosis Reduction in the diameter of the spinal canal because of new bone formation that may cause pressure on the spinal cord or nerve roots.
  • Spinal-cord stimulation Electric device implanted in the spine to control chronic pain.
  • Spine The flexible bone column extending from the base of the skull to the tailbone. It comprises 33 bones, called vertebrae. The first 24 vertebrae are separated by disks, called intervertebral disks, and bound by ligaments and muscles. Five vertebrae are fused to form the sacrum and four vertebrae are fused to form the coccyx. The spine also is called the vertebral column, spinal column or backbone.
  • Spondylitis Inflammation of vertebrae.
  • Spondylolisthesis A defect in the construct of bone between the superior and inferior facets with varying degrees of displacement. The vertebra with the defect and the spine above that vertebra are displaced forward. It is usually because of a developmental defect or a fracture.
  • Spondylolysis
  • Stainless steel Iron-based metal containing chromium that is highly resistant to stain, rust and corrosion. Some grades of stainless steel are commonly used to make surgical implants and instruments.
  • Sterile Free from living organisms.
  • Sterilization The method used to render a material free from living organisms. Usual methods include steam under pressure, gas and ionizing radiation.
  • Superior Above or directed toward the head.
  • T

  • Tendon The fibrous band of tissue that connects muscle to bone. It is mostly composed of collagen.
  • Thoracic The chest region of the spine between the cervical and lumbar vertebrae. It consists of 12 vertebrae that are attachment points for ribs.
  • Titanium A metallic element used to make surgical implants.
  • Toxicology The study of the toxic or harmful effects of substances on the body.
  • Traction Applying intermittent or continuous force by mechanical or manual methods to elongate the spine.
  • Transcutaneous electric nerve stimulation A form of electric anesthesia used to block pain perception.
  • Translation Vertebral body displacement that can describe lateral, anterior or posterior displacement.
  • Transplant The implantation of bone tissue, as in grafting, from one part of the body to another, or from one person to another. Transplant also refers to the transfer of an organ such as a kidney or heart from one person to another.
  • Transverse A line that divides the body into superior and inferior portions.
  • Trigger-point injections Injection of local anesthetic with or without corticosteroid into painful soft tissues, such as muscles or ligaments, along the spine or over the back of the pelvis. They are usually used for pain control.
  • U

  • Unremitting low-back pain Chronic low-back pain. A condition in which the chief complaint is back pain associated with activities, but without associated spondylolysis or spondylolisthesis. To be classified as unremitting low-back pain, symptoms must persist for more than three months and be unresponsive to primary-care treatment recommendations.
  • V

  • Vertebra One of the 33 bones of the spinal column. A cervical, thoracic or lumbar vertebra has a cylindrical body anteriorly and a neural arch posteriorly. It comprises primarily the laminae, pedicles and other structures in the posterior aspect of the vertebra. The vertebrae protect the spinal cord.
  • Vertebral end-plates The superior and inferior plates of cortical bone of the vertebral body next to the intervertebral disk.
  • Vertebroplasty A procedure to repair fractures related to osteoporosis. Gluelike cement is injected into a collapsed vertebra.
  • W

  • Whiplash Commonly called "neck sprain or strain," although symptoms may have other causes. This condition is common with automobile accidents.
  • Wire Metal thread available in various diameters and various degrees of stiffness. It is used in surgery to transfix fractured bone.
  • Z

  • Zygapophysial joint See Facet Joints.
  • Zygapophysial Joint Injections Injections of steroids and local anesthetic into the facet joints to determine whether it is a source of pain or to reduce pain and inflammation.

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