Glossary of Spine Terminology

-A-

Acute: Suddenly occurring.

Allograft: Tissue transplant between non-identical individuals. In the case of spine surgery, usually bone. Allografts are processed bone from cadaver donors.

Annulus fibrosis: The outer portion of the intervertebral disc, made of layers of collagen fibers that lie in circumferential layers around the nucleus pulposus.

Anterior: Front. Being in front, frontal. Anterior approach in spine surgery refers to an approach to the spine from the front.

Arthroplasty: The operative procedure of repairing or reconstructing a diseased joint. This may be done to alleviate pain, and/or to permit (restore) normal function of the joint.

Autograft: A bone graft taken from the patient and used for fusion in that patient.

-B-

Biomechanics: The application of mechanical forces to living organisms, and the investigation of the affects of the interaction of force and the body or system. Includes forces that arise from within or outside the body. (see: Kinesiology)

Bone Graft: Bone used in fusion surgery (either autograft of allograft) to promote spinal fusion.

-C-

C-Spine: Cervical spine (neck).

Cervical: Neck. Related to the neck.

Chronic: Persistent or lasting a long time, and in the case of back pain, typically referring to conditions lasting longer than 3 months.

CNS: Central nervous system.

CSF: Cerebrospinal fluid is the clear fluid filling the dural sac and providing nourishment to the neural elements in the spinal canal and brain cavities.

CT: Computerized tomography. A diagnostic imaging test. In CT scanning, x-rays are employed to generate cross sectional images. The high resolution CT scan provides excellent viewing of bones and bone spaces. CT scanning does not image soft tissues as well. Also commonly known as CAT scan.

-D-

Decompression: In spine procedures, refers to surgical removal of bone or tissue to remove pressure on adjacent nerve roots or spinal cord.

Degenerative Disc Disease (DDD): A catch-all term to describe degenerative changes in the disc(s) due to aging or wear-and-tear.

Disc: The intervertebral disc is a combination of strong connective tissues which hold one vertebra to the next, and acts as a cushion between the vertebrae. It is made of a tough outer layer called the annulus fibrosis and a gel-like center called the nucleus pulposus.

Discectomy: Surgical procedure in which part or all of a herniated disc is removed. The goal of this procedure is typically to make the herniated disc stop pressing on and irritating the adjacent nerves which are causing pain and weakness. These procedures may be done as an open procedure, with a microscope, or in a minimally-invasive method.

Discitis: Inflammation of the disc.

Discography: Utilizes the injection of dye into the nucleus of an intervertebral disc. During the injection, the physician performing the procedure asks the patient if the injection generates pain similar to their "usual pain." Discography images are generated from plain radiographs and computed tomography (CT) scanning.

DJD: Degenerative joint disease.

DRG: Dorsal root ganglion. Clump of nerve cells at the spinal canal outlet of lumbar nerve roots.

DX: Diagnosis.

-E-

Electromyography (EMG): A test used to determine the function of the peripheral nerves and nerve roots, involving placement of tiny needles in muscles and providing an electrical stimulus that can be monitored for changes that reflect the function of the connection between the nerve and muscle. This test is usually performed in conjunction with a nerve conduction velocity study (NCV).

Epidural Steroid Injections: Injection of corticosteroid medications into the epidural space (the area around the spinal nerves) to reduce painful inflammation of the nerve and disc.

-F-

Facet Joints: The bones of the spine are connected in the front of the spine by intervertebral discs, and in the back of the spine by paired joints which are commonly called "facet joints," "zygapophyseal joints," or just "z-joints."

Facet Injection: Injections of steroids and local anesthetic into the facet joints to determine if they are the source of pain, or to reduce pain and inflammation in the area of the facet joints.

FDA: Food and Drug Administration. U.S. government consumer protection agency that promotes and protects public health by helping safe and effective products reach the market in a timely way, and by monitoring products for continued safety after they are in use.

Fluoroscopic Guidance: Use of radiologic imaging to assist in the placement of instrumentation for invasive diagnositic or for surgical procedures.

Fusion: A surgical procedure performed to eliminate movement at painful or unstable spinal segments. Spinal fusion is often used to treat degenerative disc disease, but is also used to treat scoliosis, kyphosis, spinal fractures, and tumors. Bone is grafted across a section of the spine where it grows together - thereby fusing the area.

-G-

GI: Gastrointestinal.

GU: Genito-urinary.

GYN: Gynecological.

-H-

Herniated Disc (HD): With age, the nucleus (gelatinous center) of vertebral discs may start to lose water content, thereby making the disc less effective as a cushion between the bones of the spine, often leading to displacement of the disc's center (herniated or ruptured disc) through a crack in the outer layer. Most disc herniations occur in the bottom two discs of the lumbar spine, at or just below the waist. A herniated disc can press on a nerve root in the spine, and may cause back pain, or pain, numbness, tingling or weakness of the leg called "sciatica." (also known as a slipped or ruptured disc, or herniated nucleus pulposus (HNP). Can also occur in the neck, but rarely in the thoracic portion of the spine.

HMO: Health maintenance organization.

Herniated Nuclleus Pulposus (HNP): See Herniated Disc.

Hx: History.

-I-

Instability: When vertebrae move beyond their normal range of motion.

Interbody Fusion: Grafting bone in the space between discs for the purpose of fusing two vertebral segments.

-J-

-K-

Kinesiology: The study of muscles and body movement. (see: biomechanics)

Kyphosis: Exaggeration or angulation of normal posterior curve of the spine. May give rise to condition commonly known as humpback, hunchback, or Pott's curvature. Also refers to excessive curvature of the spine with convexity backward.

-L-

L#: The letter L followed by a number identifies a specific vertebra in the lumbar spine. For example, L3 is the 3rd vertebra in the lumbar spine. L3-4 would refer to the disc (or disc space) between the L3 and L4 vertebrae.

Laminectomy: Surgical procedure removing the shingle-like portions on the back of a vertebra to relieve pressure on the underlying spinal cord and nerve roots.

Laminotomy: Surgical procedure removing a small portion of the shingle-like elements (lamina) that protect the spinal cord and nerve roots, to relieve pressure on the nerve roots.

LBP: Low back pain. Also known as Lumbar back pain.

Lordosis: Curve in the spine that points to the front of the body.

Lumbar: Lower back.

-M-

MD: Medical Doctor.

Methylprednisolone: A drug (steroid) that lessens inflammation. Used to reduce inflammation of the joints or commonly used to lessen the damage of a spinal cord injury.

Microdiscectomy: A surgical removal of the disc, or a herniated portion of the disc, performed with a microscope for precise visualization during the procedure.

Minimally Invasive Surgery (MIS): Surgery done through multiple small incisions, rather than through a large, open procedure.

M & M: Morbidity and mortality.

MRI: Magnetic resonance imaging. A diagnostic imaging test. MRI clearly images soft tissues (such as the intervertebral discs, and nerve tissue) as well as bones. A very sensitive and specific spinal imaging test.

Myelitis: Spinal cord inflammation.

Myelopathy: Spinal cord disorder which commonly causes weakness in the lower extremities, and spasticity in the upper extremities, which may be the consequence of spinal stenosis, particularly in the cervical spine, or of an injury to the spinal cord.

-N-

NASS: North American Spine Society. A multidisciplinary organization for spine care professionals and researchers hat advances quality spine care through education, research and advocacy.

Neoplasm: Tumor.

Nerve Root Block: Injection of corticosteroids (anti-inflammatories) and a local anesthetic onto the nerve root sleeve surrounding a nerve root.

NIH: National Institutes of Health. One of the U.S. Department of Health and Human Services Public Services Agencies. The NIH is the federal base for medical research in the United States.

NSAIDs: Non-steroidal anti-inflammatory drugs. Medications used to reduce swelling and inflammation. Examples of NSAIDs are: aspirin, iuprofen, naproxen, and a variety of prescription drugs. There are also different classes of NSAID medications, including COX-1 and COX-2 inhibitors.

-O-

Opoids: Drugs that treat pain by affecting pain perception without treating the underlying cause(s). These medications affect pain perception only, and do not treat the underlying pathologic condition.

Osteophytes: Bone spurs.

Osteoporosis: A condition in which the bones become more porous and prone to fracture, usually age-related.

Orthosis: Brace.

-P-

PDR: Physician's Desk Reference. Guide to drugs available in the U.S.

Pedicle: Projection of bone from the back of the vertera that helps form the ring around the spinal canal.

Percutaneous: Passage through the skin, by needle or other object.

Percutaneous Lumbar Discectomy (PLD): The removal of bulging disc material percutaneously through a large bore needle inserted into the disc space. The disc material is removed using laser, cutting instruments, suction, or laser appliances. Also known as percutaneous microdiscectomy.

PMMA: Polymethyl methacrylate. A material used as bone cement for orthopedic and spine surgery.

Posterior: Rear. On the back side. In rear position.

Posterior Lumbar Interbody Fusion(PLIF): Spinal fusion technique in which the disc is removed through the back of the spinal canal, and a bone graft is inserted in the intervertebral space also through the back.

PRN: As necessary.

Pseudarthrosis: When a solid fusion is not obtained after fusion surgery.

PT: Physical therapist or physical therapy.

PVA: Percutaneous vertebral augmentation. A procedure that helps stabilize collapsed vertebral bodies by injection of material into the collapsed area. Includes vertebroplasty and kyphoplasty.

-Q-

-R-

Radiculopathy: Impairment of a nerve root, usually causing radiating pain, numbness, tingling, or muscle weakness that corresponds to a specific nerve root.

RCT: Randomized clinical trial.

RN: Registered Nurse.

ROM: Range of motion.

Rx: Treatment.

-S-

Sacrum: Part of the tailbone just above the coccyx and below the lumbar spine.

Sciatica: Pain, numbness, tingling in the distribution of the sciatic nerve, which travels from deep in he buttock down to the foot.

Scoliosis: Abnormal curve of the spine.

SI: Sacroilliac. The joints (one on each side) between the sacrum at the midline and the iliac wings, which form part of the pelvic ring. Often a site of referred pain, and may be a source of pain.

SPECT Scan: Single photon emission computed tomography. A diagnostic imaging test.

Spina Bifida: Congnital defect of the spinal column, where a hole in the vertebra leave the spinal cord and nerves exposed. This condition is usually identified at birth and may be treated early in life.

Spina Bifida Occula: A congenital defect of the spinal column where the lamina fail to come together completely at the midline. In thi form, there are no exposed neural elements, therefore, this is usually an incidental finding without clinical findings associated.

Spinal Cord Stimulation (SCS): Electrical device implanted in the spine to control chronic pain.

Spinal Stenosis (SS): Local, segmental, or generalized narrowing of the central spinal canal by bone or soft tissue elements.

Spondylolysis: The breaking down of a vertebral structure. A fracture (crack) in the "pars interarticularis" where the vertebral body and the posterior elements, protecting the nerves are joined. In about 5 percent of the adult population, there is a developmental crack in one of the vertebrae, usually at the point at which the lower (lumbar) part of the spine (L5) joins the tailbone (sacrum).

Spondylolysis, Degenerative: When a vertebra slips forward over the vertebra below it as a result of arthritis of the small joints of the spine and degeneration of the discs.

Spondylolysis, Isthmic: When a vertebra with a crack in the "pars interarticularis" where the vertebral body and the posterior elements, protecting the nerves are joined, slips forward over the vertebra below it. Spondylolisthesis can be graded as I, II, III, or IV based on how far forward the vertebra has slipped.

Spondylolisthesis: Forward subluxation of the lower lumbar vertebrae on the sacrum.

Sx: Symptoms.

-T-

T#: The letter T followed by a number identifies a specific vertebra in the thoracic spine. For example, T3 is the 3rd vertebra in the thoracic spine.

TENS: Transcutaneous electrical nerve stimulation. A form of electrical anesthesia used to block pain perception.

Thoracic: Mid-upper back, area between the cervical (neck region) and the lumbar (low back) spine.

Traction: Traction applies intermittent or continuous force by mechanical or manual methods to elongate the spine.

Trigger Point Injections: Injection of local anesthetic, with or without corticosteroid into painful soft tissues (ie. muscles or ligaments) along the spine or over the back of the pelvis. Generally used for pain control.

Tx: Treatment.

-U-

Unremitting Low Back Pain: Another term for chronic low back pain. A condition in which the chief complaint is back pain of primarily a mechanical nature, associated with activities, but without associated spondylolysis or spondylolisthesis. To be classified as unremitting low back pain, symptoms must persist for more than 3 months, and have been unresponsive to primary care treatment recommendations.

-V-

Vertebrae: Bones tht make up the spine.

-W-

Whiplash: Also referred to as "neck sprain" or "strain." Commonly occurs in rear-ender car accidents, although symptoms may have other causes.

-Z-

Z-Joint: Zygapophyseal Joint. See Facet Joint.

Zygapophyseal Joint Injections: Injections of steroids and local anesthetic into the facet joints to determine if they are a source of pain or to reduce pain and inflammation.

Caution:
Investigational Device, limited by United States Law to Investigational Use