Prairie Spine Glossary

Patient Resource Guide

Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A abbott method For scoliosis of the spine, traction is applied to produce overcorrection, followed by casting. abdominal muscles Important for support of the spine, these muscles are the rectus abdominis, external oblique, internal oblique, and transversus.

implanted in the brain and connected to a pulse generator that is implanted near the collarbone. Stimulation level can be adjusted to get the most possible tremor control with minimal side effects. acupuncture A traditional Chinese healing technique that involves the insertion of fine needles into particular points along the body, called meridians, with the aim of balancing vital energies. acute Severe, for a short time.

abduction Movement away from midline of body in frontal plane; applied to hip, shoulder, fingers, thumb, and foot.

acute pain Pain that occurs immediately after illness or injury and resolves after healing

abrasion Any superficial scraping of skin tissue or mucous membrane mechanically or through injury.

adenocarcinoma Cancer arising from secretory cells, often in a gland.

Breast and pancreatic cancers are usually adenocarcinomas.

abscess Localized collection of pus in a cavity that may form in any tissue.

adenoma A benign growth formed of glandular tissue.

achondroplastic stenosis Increased vertebral thickness, marked concavity of the vertebral body, and shortened pedicles. acoustic neurinomas Benign tumor of the hearing nerve (eighth nerve). A progressively enlarging, benign tumor, usually within the internal auditory canal or hearing nerve. acromegaly Disorder marked by progressive enlargement of the head, face, hands, feet, and thorax, due to the excessive secretion of growth hormone. action tremor A type of tremor that occurs during voluntary movements, such as lifting a cup to one’s mouth. activa tremor control therapy Therapy that uses an implanted device to deliver mild electrical stimulation to block the brain signals that cause tremor. Stimulates the target nuclei in the thalamus by an insulated wire lead with electrodes that are surgically

adolescent scoliosis Lateral curvature of the spine occurring during adolescence. adult scoliosis Scoliosis occurring after skeletal maturity. aebi, etter, and cosica Anterior approach to inferior C-2 to fractured dens with screws.

AEDs Antiepileptic drugs. afferent neuron Transmitting impulses to the central nervous system. agnosia Absence of the ability to recognize the form and nature of persons and things. agraphia Loss of the power of writing due either to muscular incoordination or to an inability to phrase thought.

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Patient Resource Guide

Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

alar dysgenesis Abnormality in development of the sacroiliac joint. albee Fusion of the spine using grafts across the spinous processes in spondylolisthesis.

anesthesis Literally means “without feeling.” A lack of feeling, such as numbness, that may be natural or induced by drugs. anesthesiologist A medical doctor who specializes in anesthesia

alexander technique Postural training that can reduce pain.

anesthetic A medication that causes a lack of sensation.

ALIF See anterior lumbar interbody fusion.

aneurysm Dilation of an artery, formed by a circumscribed enlargement of its wall.

Saccular (berry) aneurysm - sac-like bulging on one side of an artery usually arising at an arterial branching.

allodynia Pain created by a stimulus that is not typically painful and below the normal threshold. allograft bone Sterile bone derived from another human used for grafting procedures. amaurosis Loss of vision without discoverable lesion in the eye structures or optic nerve.

Amaurosis fugax - temporary blindness occurring in short periods. amnesia Loss of memory caused by brain damage or by severe emotional trauma. analgesia Loss of sensibility to pain, loss of response to a painful stimulus. A medical term for a medication that relieves pain. anaplasia In the case of a body cell, a reversion to a more primitive condition. A term used to denote the alteration in cell character that constitutes malignancy. anastomosis A communication, direct or indirect, a joining. In the nervous system a jointing of nerves or blood vessels. anencephaly Absence of the greater part of the brain, often with skull deformity.

angiogram A study that shows the blood vessels leading to and in the brain by injecting a dye or contrast substance through a catheter placed in the artery in the leg. angioma A tumor whose cells tend to form blood vessels (hemangioma) or lymph vessels (lymphangioma). angiography Radiography of blood vessels using the injection of material opaque to x-rays to give better definition to the vessels. anisospondyly Different abnormal shapes of the vertebral bodies. ankylosing spinal hyperostosis Arthritic disorder in which bridgingosteophytes located anteriorly and posteriorly on the vertebral body bind two or more vertebrae together; Forestier disease. ankylosing spondylitis Stiffening or fixation of the vertebra; an inflammatory joint disease mainly affecting the spine hips, and pelvis. annulus fibrosus The outer, fibrous, ring-like portion of an intervertebral disc. anorexia Loss of appetite; a condition marked by loss of appetite leading to weight loss.

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Patient Resource Guide

Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

anosmic Without the sense of smell.

anterolateral Situated or occurring in front of and to the side.

anoxia Total lack of oxygen supply.

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.

anterior Front of the body or situated nearer the front of the body. 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.

anti-coagulant A medication that prevents coagulation of the blood. antidepressant A medication used to treat depression and sometimes pain on a short-term basis.

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.

antidiuretic An agent that reduces the output of urine. Antidiuretic hormone (ADH) is formed in the hypothalamus and stored in the posterior pituitary gland. Its secretion reduces urine output.

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).

ao fixateur interne A posteriorly placed spinal fixation device.

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 intervertable 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.

aphasia Difficulty with, or loss of use of language, in any of several ways including reading, writing or speaking.

Failure of understanding of the written, printed, or spoken word not related to intelligence, but to specific lesions in the brain. apnea Cessation of respiration; inability to get one’s breath. apoplexy A sudden event. Often used as equivalent to stroke. arachnoid Middle layer of membranes covering the brain and spinal cord. arachnoiditis Inflammation of the arachnoid membrane, most commonly seen within the spinal cord around the spinal cord and cauda equina.

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Patient Resource Guide

Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

area - (cortical) A part of the brain having a special function as in Motor - The cortical portion of the brain controlling movement. Sensory - The cortical portion, controlling sensation.

Arnold-Chiari malformation A condition in which there is displacement of the medulla and cerebellum into the opening in the basilar part of the occipital bone. It is one of the causes of hydrocephalus and is usually accompanied by spina bifida and menigomyelocele. arteriography See angiography. arteriosclerosis Thickening and calcification of the arterial wall with loss of elasticity and contractility. arteriovenous Relating to both arteries and veins. arteriovenous malformation Collection of blood vessels with one or several abnormal communications between arteries and veins that may cause hemorrhage or seizures. artery of adamkiewicz An important source of blood supply to the lower portion of the spine, usually occurring at T-9 to T-11 level; however, not the only blood supply to the cord at that level. arthralgia Pain in a joint, usually due to arthritis or arthropathy. arthritis Inflammation of a joint usually characterized by swelling, pain and restriction of motion. arthrodesis The fusion of bones across a joint space, thereby limiting or eliminating movement. It may occur spontaneously or because of a surgical procedure, such as fusion of the spine. arthropathy Any disease or disorder involving a joint.

arthroplasty The surgical remodeling of a diseased or damaged joint. arthroscope An instrument inserted into its joint cavity to view the interior of a joint and correct certain abnormalities. An arthroscope is an endoscope for use in a joint. arthroscopy The procedure of visualizing the inside of a joint by means of an arthroscope. articular Pertaining to a joint. astrocyte Cell that supports the nerve cells (neurons) of the brain and spinal cord. astrocytoma Tumor within the substance of the brain or spinal cord made up of astrocytes - often classified from Grade I (slow-growing) to Grade III (rapid-growing). ataxia A loss of muscular coordination, abnormal clumsiness. athetosis A condition in which there is a succession of slow, writhing, involuntary movements of the fingers and hands, and sometimes of the toes and feet. atlanto-axial Pertaining to the atlas and the axis; denoting the joint between the first two cervical vertebrae. atlanto-epistrphic See atlanto-axial. atlanto-occipital Relating to the atlas and the occipital bone. atlanto-odontoid Relating to the atlas and the dens of the axis. atlas First cervical vertebrae, articulating with the occipital bone and rotating around the dens of the axis.

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Patient Resource Guide

Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

atonic seizure Seizures that are characterized by a sudden loss of muscle tone, causing the individual to instantly drop to the floor, commonly known as drop attacks. atrophy A wasting of the tissues of a body part. aura Warning sign that people with epilepsy often experience prior to the onset of a seizure, this may consist of a strange taste, bad feeling, or tingling sensation. autogenous bone Bone originating from the same individual; an individual”s own bone. autograft bone Bone transplanted from one part to another part of the body in the same individual. autologus A graft in which the donor and recipient area are in the same individual. autonomic nervous system The portion of the nervous system that regulates involuntary body functions, including those of the heart and intestine. Controls blood flow, digestion, and temperature regulation. avascular Non-vascular, not provided with blood vessels.

AVM See arteriovenous malformation. 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 baastrup d. (kissing spine) False joint formed by wide posterior spinous processes of the lumbar spine. This may become a source of pain. backbone See spine. back pain Nonspecific term used to describe pain below the cervical spine. bactericidal Causing the death of bacteria. bacteriostatic Inhibiting or retarding the growth of bacteria.

Banks-Dervin rod For scoliosis fixation; a multiple level rod that is fixed with oblique spinous process to contralateral lamina screws. behavioral therapy A psychological and social treatment strategy that aims to change unhealthy behavior that may contribute to pain.

Bell’s palsy Paralysis of facial muscles (usually one side) due to facial nerve dysfunction of unknown cause. benign Not cancerous; does not invade nearby tissue or spread to other parts of the body. bioabsorbable polymer A substance, such as some plastics, which the human body can break down and absorb. biocompatibility A characteristic of some materials that when they are inserted into the body, they do not produce a significant rejection or immune response. biodegradation The breakdown of organic materials into simple chemicals commonly found in the body.

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Patient Resource Guide

Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

biopsy Removal of a small portion of tissue, usually for making a diagnosis. blood-brain-barrier The barrier that exists between the blood and the cerebrospinal fluid and prevents the passage of various substances from the bloodstream to the brain.

BMP See bone morphogenetic protein-2 (BMP-2) BMP-like products Proteins that enhance mineralization, which can increase bone formation. bohman Posterior triple spinous process wiring technique in the cervical spine to secure bone graft. 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 derivative One of the substances extracted from bone, such as bone morphogenic proteins (BMP). bone graft Bone that 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). bone harvesting The removal of bone for transplantation to another site.

The most common sources are the iliac crests because these bones contain a large amount of cancellous bone, the inner spongy part, which is useful for getting grafts to take. bone marrow The tissue contained within the internal cavities of the bones. A major function of this tissue is to produce red blood cells.

bone morphogenetic protein-2 (BMP-2) One of a family of BMPs, chemicals occurring naturally in the body, which play a major role in bone growth.

BMP-like products: proteins that enhance mineralization, which can increase bone formation. bone plate Usually a relatively thin metal device that is affixed to bone via screws. Bone plates are used to immobilize bones or bone fragments such that healing can occur. bone scan A test using a radioactive agent to identify injured or damaged areas of bone. Often used to identify fractures or tumors that may not be visible on an x-ray. bone screw A threaded metal device inserted into bone. The functions of bone screws are to immobilize bones or bone fragments or to affix other medical devices, such as metal bone plates, to bones.

Bosworth A fusion using an H-shaped bone graft in spondylolisthesis. bovine bone extract A BMP derived from the bones of bovines brachial Relating to the arm.

Bradford For kyphoscoliosis deformity; staged anterior and posterior approach for interbody fusion and correction of deformity. bradycardia Slowness of the heart rate. bradykinesia Slowness in movement. brattstrom Use of acrylic cement for C-1 to C-2 fusion. breakthrough pain A sudden, intense increase or flare-up in pain levels.

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Patient Resource Guide

Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Brooks and Jenkins Loops of wire around lamina of C-1 and C-2 to hold bone graft between lamina.

capner Draining of thoracic spinal abscess through an anterolateral approach.

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. Caused by a lesion limited to one side of spinal cord.

carcinoma Cancer, a malignant growth of epithelial or gland cells.

burr An electrical drilling tool for enlarging atrephine (circular) hole in the cranium. bursa A fluid-containing sac near or involving a joint or bony prominence that reduces friction between a tendon and a bone, or between your bone and your skin during movement.

C cadaver A term generally applied to a dead human body preserved for anatomical study. cadaveric A tissue or organ transplanted from a cadaver (deceased donor) Callahan Individual wire fixation of a strut bone graft to involved facets. callosum The great commisure of the brain between the cerebral hemispheres. camptocormia Severe forward flexion of upper torso, usually an excessive psychologic reaction to back pain. cancellous bone The spongy or honeycomb structure of some bone tissue typically found at the ends of long bones.

carotid artery Large artery on either side of the neck that supplies blood to most of the cerebral hemisphere. Main artery to the head that divides into external and internal carotid arteries. carotid sinus Slight dilatation on the common carotid artery at its bifurcation containing nerve cells sensitive to blood pressure. Stimulation can cause slowing of the heart, vasodilatation and a fall in blood pressure. carotid tubercle Prominence of the transverse process of C-6 felt on the lateral side of the neck. 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. carrier A material or device used to deliver a therapy to a site in or on the body. 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 vessles, similar to that used for looking at vessels in the heart.

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Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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. caudate nucleus Part of the basal ganglia that lie deep in the brain. causalgia A syndrome of sustained burning pain, allodynia, and hyperpathia after a traumatic nerve lesion. central nervous system Part of the nervous system which consists of the brain and spinal cord, to which sensory impulses are transmitted and from which motor impulses pass out, and which supervises and coordinates the activity of the entire nervous system. central pain Pain initiated or caused by a primary lesion or dysfunction in the central nervous system. centrum The body of a vertebra. cerebellum The lower part of the brain that is beneath the posterior portion of the cerebrum and regulates unconscious coordination of movement. cerebral Relating to the brain or intellect. cerebral cortex Surface layer of gray matter of the cerebrum that functions chiefly in coordination of higher nervous activity; called also pallium. cerebral palsy Disability resulting from damage to the brain before or during birth and outwardly manifested by muscular incoordination and speech disturbances.

cerebrospinal fluid (CSF) Water-like fluid produced in the brain that circulates and protects the brain and spinal cord, known as CSF. cerebrum The principal portion of the brain, which occupies the major portion of the interior of the skull and controls conscious movement, sensation and thought. 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 that 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. chiasm (optic) Crossing of visual fibers as they head toward the opposite side of the brain. For each optic nerve most of the visual fibers cross to the opposite side, some run directly backward on each side without crossing. chiropractor A specialist in the function of the spine and nervous system who manipulates the skeleton and often treats back pain. chorea A disorder, usually of childhood, characterized by irregular, spasmodic involuntary movements of the limbs or facial muscles.

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Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

choroid plexus A vascular structure in the ventricles of the brain that produces cerebrospinal fluid. chronic pain Pain that persists beyond the time for normal healing and can last from a few months to many years. Can result from disease, such as arthritis, or from an injury or surgery.

Also can occur without a known injury or disease. cingulate gyrus A long, curved convolution of the medial surface of the cortical hemisphere. cingulotomy Electronic destruction of the anterior cingulate gyrus and callosum. clinical studies A process of strictly controlled evaluations involving patients. Some of these studies are required by the FDA prior to general release of a device or compound for use in humans.

coccyx The small bone at the end of the spinal column in man, 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. cognitive therapy A psychological treatment that seeks to recognize and reverse negative, unhealthy thought patterns and change them to positive healthy patterns. collagen A fibrous protein that is a major constituent of connective tissue. Such as skin, tendons, ligaments, cartilage, and bones. collar A band, usually denoting one encircling the neck. coma A state of profound unconsciousness from which one cannot be roused.

coagulation The process of clotting.

combined stenosis For congenital or developmental reasons, the midsagittal diameter is decreased.

cobalt-chrome A term that is used in referring to cobalt-chromiummolybdenum alloy, a mixture of metals used in many surgical implants.

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.

coccyalgia Pain in the coccyx region5 Also called coccygodynia, coccyodynia, coccydynia.

commissural myelorrhapy A longitudinal division of the spinal cord to sever crossing fibers.

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

compensatory curve A curve located above or below a rigid structural curve to maintain normal overall body alignment.

coccygectomy Excision of the coccyx (tailbone). coccygotomy Incision into the coccyx (tailbone).

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.

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Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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. computerized tomography An x-ray technique that uses a computer to construct cross-sectional images of the body. Also called CT scan and formerly known as CAT scan. 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. constitutional stenosis Normal-statured individuals with congenital variance in vertebral structure leading to a narrow canal. contract To shorten; to become reduced in size; in the case of muscle, either to shorten or to undergo an increase in tension. contrast medium Any material (usually opaque to x-rays) employed to delineate or define a structure during a radiologic procedure. 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. coronal suture The line of junction of the frontal bones and the parietal bones of the skull. corpectomy Excision of vertebral body usually combined with interpostion of prosthesis or bone graft.

corpus callosum The greatest commissure of the brain between the cerebral hemispheres. cortex The external layer of gray matter covering the hemispheres of the cerebrum and cerebellum. cortical Pertaining to the cortex. cortical bone The dense bone that forms the outer surface of bone. corticosteroids Anti-inflammatory drugs created from or based on a naturally occurring hormone produced by the cortex of the adrenal glands (cortisone). cortisone A naturally occurring hormone produced by the cortex of the adrenal glands. Decreases inflammation. 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 attachment to the cartilage rather than a direct junction with the breastbone. 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. cotrel-dubousset Posterior fixation device for spinal deformity, fracture, tumor, and degenerative conditions. cramp A painful muscle spasm caused by prolonged tetanic contraction. cranium The part of the skull that holds the brain.

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Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

craniectomy Opening of skull and removal of a portion of it. craniopharyngioma Congenital tumor arising from the embryonic duct between the brain and pharynx. cranioplasty The operative repair of a defect of the skull. craniostenosis Premature closure of cranial sutures, limiting or distorting the growth of the skull. craniosynostosis Premature closure of cranial sutures, limiting or distorting the growth of the skull. craniotomy Opening of the skull, usually by creating a flap of bone. crankshaft phenomenon Progressions of a spinal curve due to continued growth of the unfused anterior aspect of the spine following a posterior spine fusion for scoliosis in children. cricoid ring Cartilage ring above the tranchea and below the thyroid cartilage, the first cricoid ring is at the level of C-6.

D dance therapy The use of dance as restorative therapy.

DBM See demineralized bone matrix deafferentation A loss of sensation created by the severing or destruction of sensory nerves, which is more or less permanent. de Andrade and Macnab Anterior approach for cervical occipital fusion. 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.

CSF shunt A bypass or diversion of accumulations of cerebrospinal fluid to an absorbing or excreting system.

deep brain stimulation A tremor control therapy for patients with Parkinson’s Disease or essential tremors, who do not respond effectively to medications. It is a surgical reversible procedure that involves implanting a device to deliver mild electrical stimulation to block the brain signals that cause tremor. degenerative The lesion results from intersegmental instability of long duration.

CT scan An x-ray type technique that uses computer technology to provide very detailed information.

degenerative disc disease Gradual or rapid deterioration of the chemical composition and physical properties of the disc space.

cytology Study of cells.

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

CSF Cerebrospinal Fluid.

demineralized bone Bone tissue which has been depleted of its minerals; e.g., calcium and phosphorous.

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Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

demineralized bone matrix (DBM) A source of BMP and is derived from pulverized bone specimens that are demineralized with an acid solution.

It is used as a bone grafting material, but DMB has produced disappointing results in clinical studies, probably due to low concentrations of BMP that can also vary from batch to batch. dendrite A nerve cell process that transmits impulses toward the cell body. depressed skull fracture A break in the bones of the head in which some bone is pushed inward, possibly pushing on or cutting into the brain. depression An emotional state characterized by lack of interest in all formerly pleasurable outlets such as sex, food, friends, hobbies, and entertainment, ranging from mild to severe. dermatome The sensory segmental supply to the skin and subcutaneous tissue. diabetes insipidus Excretion of large amounts of urine of low specific gravity. The inability to concentrate urine. diaphragm The muscle between the abdomen and thorax; main muscle of normal breathing. diastematomyelia Congenital defect associated with spina bifida in which the spinal cord is split in half by bony spicules or fibrous bands, each half being surrounded by a dural sac. diathermy The generation of heat in tissue by electrical currents for medical or surgical purposes. diffuse axonal injury Damage to the axons of many nerve cells that lie in different parts of the brain.

diffuse brain injury Damage to the brain that can affect many parts of the brain, often in a subtle fashion; examples include diffuse axonal injury and inadequate blood flow. diphenylhydantoin Dilantin; a medication used to control seizures. diplopia Double vision, due usually to weakness or paralysis of one or more of the extra-ocular muscles. disability or “handicap” A disadvantage resulting from impairment of functional limitations that prevents the fulfillment of a role that is normal for that individual, given age, sex, social, and cultural factors. disc The intervertebral disc - 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 Nonbacertial inflammation of an intervertebral disc or disc space. disc space infection Infection in the space normally occupied by an intervertebral disc. diskogram or discogram The graphic record, usually radiographic, of discography.

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Glossary A-D A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

diskography or discography Radiographic demonstration of intervertebral disc by injection of contrast media into the nucleus of the pulposus.

drug tolerance The point at which doses of some drug lose their effectiveness, when the dose must be increased to achieve a similar result.

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.

Dunn For myelomeningocele spinal deformity; use of contouring L-rod for posterior stabilization.

distal Situated away from the center of the body. dome The round balloon like portion of the aneurysm that usually arises from the artery from a smaller portion called the neck of the aneurysm. doppler A non-invasive study that uses sound waves to show the flow in a blood vessel and can be used to determine the degree of narrowing (percent stenosis) of the vessel.

A wand is placed on the skin over the vessel to be imaged. This study has no risks and is not painful. dorsal column The main, normal sensory tract to the brain. dorsal lateral column The main tract of position and tone to the brain. dorsolateral An approach to the dorsal spine by costotransversectomy, usually done for fractures and other affections of the spinal cord. double curve Two lateral curves in a single spine; double major curve is two lateral curves of equal magnitude, and double thoracic curve is two thoracic curves. drug addiction Both a physical and psychological dependence on a habitforming substance, such as a narcotic drug. drug dependence A physical dependence on the effects of a particular habit-forming drug, and one that does not have a component of psychological need.

dura See dura mater. dural Pertaining to the dura. dura mater A tough fibrous membrane that covers the brain and spinal cord, separated from them by a small space.

Dwyer Anteriorly placed screws and band device for correction of spinal deformities.

Dwyer-Hartsill For failed lumbar degenerative disc disease; pedicle screws wired to a rectangular frame along with posterolateral fusion. dysesthesia An abnormal and painful sensation that can occur spontaneously or in response to a particular stimulus. dysphasia Difficulty in the use of language due to a brain lesion without mental impairment. dysplastic Congenital abnormalities of the arch of the sacrum or the arch of L-5 that permit the slipping to occur. dysraphism Any failure of closure of the primary neural tube. This general category would include the disorder myelomeningocele. dystonia musculorm deformans An affliction occurring especially in children, marked by muscular contractions producing distortions of the spin and hips.

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Patient Resource Guide

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E

enkephalins Naturally occurring molecules in the brain. Enkephalins attach to special receptors in the brain and spinal cord to stop pain messages. They also affect other function within the brain and nervous system.

edema A medical term for swelling. eggshell Excavation of vertebral body for correction of deformity that is combined with spinal fusion. electroencephalopgrahy (EEG) The study of the electrical currents set up by brain actions; the record made is called an electroencephalogram. electromyography (EMG) A test designed to evaluate the function of nerves and muscles and to detect diseases or injury to either. encephalocele Protrusion of the brain through a cranial fissure. endorphins Natural chemical substances that relieve pain. endarterectomy Removal of fatty or cholesterol plaques and calcified deposits from the internal wall of an artery. endocrine gland A gland which furnishes an internal secretion, usually having an effect on another organ. endocrinopathy Any disease due to abnormality of quantity or quality in one or more of the internal glandular secretions. endogenous Arising within or derived from the body. endoscope A medical device for viewing internal portions of the body. It is usually comprised of fiber optic tubes and video display instruments. endoscopy Inspection of internal body structures or cavities using an endoscope.

ependyma The membrane lining the cerebral ventricles of the brain and central canal of the spinal cord. ependymoma A growth in the brain or spinal cord arising from ependymal tissue. Tumor of the spinal cord. epidural Immediately outside the dura mater. Same as extradural. epidural anesthetic Drugs injected between the middle and lower back to deaden sensation in nerves that lead to the chest and lower part of the body. epidural hematoma A blood clot between the dura mater and the inside of the skull. epilepsy Disorder characterized by abnormal electrical discharges in the brain, causing abnormal sensation, movement or level of consciousness. esophagus Portion of the gut between the mouth and stomach in the anterior neck. euphoria A happy mood of well-being or buoyant self-confidence. excision Removal by cutting away material. extradural On the outer side of the dura mater. exogenous Originating outside of the body.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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

fatigue That state, following a period of mental or bodily activity; characterized by a lessened capacity for work and reduced efficiency of accomplishment, usually accompanied by a feeling of weariness, sleepiness, or irritability. fatigue fracture A fracture that occurs in bone or in other materials.

Including metal, because of repeated stress as opposed to a single injury.

FDA See Food and Drug Administration.

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. falx (cerebri) An extension of dura between the right and left hemispheres of the brain. family doctor A medical doctor usually referred to as a general practitioner, family practitioner, or internist. May prescribe medications and other treatments to help manage pain, or they may refer to other medical doctors who specialize in particular areas.

fenestration (of cyst) Surgical creation of window-like opening. fibrosis The replacement of normal tissue with scar tissue. fibromyositis Chronic inflammation of a muscle with an overgrowth, or hyperplasia, of the connective tissue. field block injection A procedure used to relax a muscle or to reduce muscle pain and inflammation. The targeted muscle is injected with a local anesthetic and corticosteroid. Also called trigger point injection. fissure A groove or natural division, deep furrow in the brain. 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. fontanelle Normal openings in he skull of infants; the largest of these is the anterior fontanel or “soft spot” in the middle of the head. fontanelles “Soft spots” of the infant’s head, normal unossified areas in the infant skull.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Food and Drug Administration (FDA) The Federal government agency that has regulatory authority over the manufacture, distribution, and labeling of drugs, medical devices, and foods. 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. functional stereotactic neurosurgery Surgery intended to improve the function of the central nervous system. A stereotactic head frame is used along with imaging techniques to map the brain and localize the surgical target. fusiform aneurysm A sausage-like enlargement of the vessel fusion Union or healing of bone (see arthrodesis).

G gallie Wire around lamina of C-1 and spinous process of C-2. gamma knife Equipment that precisely delivers a concentrated dose of radiation to a predetermined target using gamma rays. gasserion ganglion Mass of nervous tissue lying on the sensory root of the trigeminal nerve. general anesthetic Causes lack of consciousness and is injected or inhaled, as before surgery. generalized seizures Seizures involving widespread areas on both sides of the brain at the time of onset. The generalized nature of these seizures accounts for their dramatic manifestations, which include loss of consciousness or awareness and convulsions. About 39% epileptics suffer primarily from generalized seizures.

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. glasgow coma scale The most widely used system of classifying the severity of head injuries or other neurologic diseases. glasgow outcome scale A widely used system of classifying outcome after head injury or other neurologic diseases.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

glenoid Resembling a socket; denoting the articular depression of the scapula entering the formation of the shoulder joint. 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. glioblastoma A general term for malignant forms of astrocytoma. glioma A tumor formed by glial cells. globus pallidus Part of the basal ganglia that lie deep in the brain.

Goldstein For scoliosis deformity graft incorporating posterior elements, including facet joints and ribs. graft Any free (unattached) tissue or organ for transplantation. gray matter The nerve cell bodies to muscle and sensory outflow and input, respectively. grisel syndrome Subluxation of the atlantoaxial joint from inflammatory ligamentous laxity due to infection. Can result in neurologic complications.

H

headache Pain in various parts of the head, not confined to the area of distribution of any nerve. heat A high temperature, the sensation produced by proximity to fire or an incandescent object, as opposed to cold. hemangioma A benign tumor consisting of a mass of blood vessels. hematomyelia Effusion of blood (hemorrhage) into the substance of the spinal cord. hematorrhachis Spinal apoplexy; hemorrhage into vertebral canal. hemispherectomy Excision of one cerebral hemisphere undertaken for malignant tumors, intractable epilepsy usually associated with infantile hemiplegia due to birth injury and other cerebral conditions. hematoma A blood clot. hemianopia Loss of vision of one-half of the visual field. hemiatrophy Atrophy of half of an organ or half of the body. hemilaminectomy The excision of only one side of the lamina (right or left) relative to other spinous process.

habit An act, behavioral response, practice, or custom established in one’s repertoire by frequent repetition of the same act. 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.

hemiplegia Paralysis of one side of the body. hemorrhage Bleeding due to the escape of blood from a blood vessel.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

hereditary Transmissible from parent to offspring by information encoded in the parental germ cell. heredity The transmission of characters from parent to offspring by information encoded in the parental germ cells.

Genealogy. herniated intervertbral disc (HID) Extrusion of part of the nucleus pulposus material through a defect in the annulus fibrosus. Out-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.

Hibbs spinal fusion A lumbar spinal fusion that includes fusing the spinous process, lamina, and facet for stabilization.

Hodgson Anterior approach to C-1 and C-2 area for drainage of tuberculosis abscess. hook For spinal applications, a metallic medical device used to connect spinal structures to a rod. hormone A chemical substance formed in one gland or part of the body and carried by the blood to another organ that it stimulates to functional activity. humerus The bone of the arm, articulating with the scapula above and the radius and ulna below.

hydrocephalus A condition, often congenital, marked by abnormal and excessive accumulation of cerebrospinal fluid in the cerebral ventricles. This dilates the ventricles and in infants and young children causes the head to enlarge. hydromyelia Expansion of the spinal cord due to increased size of the central canal of the cord that is filled with CSF. hydroxyapatite (HA) The lattice-like structure of bone composed of calcium and phosphorous crystals that deposits on collagen to provide the rigid structure of bone. hyoid bone Small, vertically oriented bones lateral to trachea, located at the level of C-3. hyper Excessive, above normal. hyperacusis Abnormal acuteness of hearing or auditory sensation. hyperalgesia An abnormal increase in the intensity of pain. hyperesthesia A hypersensitivity to sensation of any kind in response to a stimulus. 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. hyperpathia A syndrome in which the pain response is exaggerated beyond normal, often produced under repeated exposure to a stimulus that initially is not painful. hypertension High blood pressure.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

hypoalgesia Diminished sensitivity to noxious stimulation. hypoesthesia Diminished sensitivity to stimulation, excluding special senses. hypophysectomy Excision of the hypophysis cerebri. hypophysis cerebri A gland of internal secretion lying on the upper surface of the sphenoid (wedge shaped) bone. hypothalamus A collection of specialized nerve cells at the base of the brain that controls the anterior and posterior pituitary secretions, and is involved in other basic regulatory functions such as temperature control and attention.

I idiopathic Coming from an unknown cause, or caused by medical treatment. idiopathic scoliosis Structural lateral curvature of an unknown cause. 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 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.

immobilization Limitation of motion or fixation of a body part usually to promote healing. impairment Any loss or abnormality of psychological, physiological, or anatomical structure or function. infantile scoliosis Lateral curvature of the spine that begins before age 3. inferior Situated below or directed downward. inflammation Defensive reaction of the body to damage, characterized by surface redness, swelling, and hypersensitivity of painsensing neurons. informed consent Consent of the patient who has received sufficient information to have surgery, receive medication, or participate in a clinical study. infratentorial Beneath the tentorium. infundibulum A stalk extending from the base of the brain to the pituitary gland. insomnia An inability to sleep, or sleep prematurely ended or interrupted, often caused by anxiety and pain.

Institutional Review Board (IRB) A committee designated by an institution, such as a hospital, to review and approve research projects; e.g., clinical studies in that institution. 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.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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. intra-aortic balloon counter pulsation device A pump that is inserted into the main vessel of the body, the aorta, to help the heart deliver blood to critical organs such as the brain or kidneys. intracerebellar Within the cerebellum. intra-arterial catheterization angiography An invasive study in which a catheter (a small tube) is placed in the artery and contrast material is injected to which makes the blood vessels visible on an X-Ray image.

The catheter is inserted in the groin into the femoral artery (the artery to the leg) through a needle, and is guided into the arteries in the neck and head. This study is associated with a very small (less than 0.05 % chance of serious complications) and requires the patient to lie in bed for approximately six hours to allow the leg vessel to heal. intracerebral Within the cerebrum.

intramedullary Refers to medullaris, marrow; (1) within the medulla oblongata of the brain, (2) within the spinal cord, and (3) within the marrow cavity of bone. intrathecal drug delivery Use of a small pump surgically placed under the skin of the abdomen to deliver morphine directly into the intrathecal space (where fluid flows around the spinal cord). The medication travels through a small tube called a catheter that is also surgically placed. The spinal cord is like a highway for pain signals on their way to the brain, where the body experiences the feeling of pain. intravenous Within or into a vein. intrinsic Situated entirely within or pertaining exclusively to a part. invasive procedure Any medical procedure in which body tissues are penetrated by an instrument that could cause discomfort or pain.

Investigational Device Exemption (IDE) A FDA regulatory status which permits the human use of an unapproved medical device for the purposes of collecting clinical data under strictly controlled conditions. 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. in vivo Within a living body. In vivo is Latin for in life.

intracerebral hematoma A blood clot within the brain.

ischemia Inadequate circulation of blood generally due to a blockage of an artery.

intracranial Within the cranium of the skull.

isola A posterior fixation device.

intracranial pressure (ICP) The overall pressure inside the skull.

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.

intraoperative cisternography Administration of a contrast dye into the ventricles, which are chambers in the brain that contain brain fluid.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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.

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.

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; forms the anterior portion of the canal where nerves pass through. jugular vein The major vein on each side of the neck draining blood from the head towards the heart. Large obvious vein in the neck. juvenile rheumatoid arthritis Generalized inflammatory joint disease in children. juvenile scoliosis Begins between the ages of 3 and 10 years of age.

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 labyrinth The internal ear, comprising the semi-circular canals, vestibule and cochlea. 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.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

laminectomy Excision of one or more laminae of the vertebrae.

Removal of the lamina, the bony element covering the posterior portion of the spinal canal. laminoplasty 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 An opening 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. laparoscopy A form of minimally invasive surgery using a type of endoscope known as a laparoscope. The technique allows surgeons to perform procedures without making major incisions that can lead to long recovery times. laser Light Amplification by Stimulated Emission of Radiation. The device that produces a focused beam of light at a defined wavelength that can vaporize tissue. In surgery, lasers can be used to operate on small areas without damaging delicate surrounding tissue. lateral Situated away from the midline of the body. lateral mass The lateral expansion of the spinal ring in the cervical spine, consisting of the facet joints and intervening bone as well as a tunnel through which the vertebral artery travels in the second through fifth cervical vertebra.

leptomeningopathy Disease of the arachnoid or pia matter of the brain and spinal cord. leukodystrophy Disturbance of the white matter of the brain. leukoencephalitis An inflammation of the white matter of the brain. 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 laminae from the axis to the sacrum; it assists in maintaining or regaining erect position and serves to close in the spaces between the arches. limbus annulare A mass of bone situated at the anterospuerior margin of a vertebra. Arises from failure of fusion of the primary and secondary ossification centers. linear accelerator Equipment that precisely delivers a concentrated dose of radiation to a predetermined target using x-rays. lipoma A benign fatty tumor usually composed of mature fat cells.

Leeds For scoliosis, segmental wiring of a contoured squareended Harrington rod.

local anesthetic Produces a numbness in localized part of the body and is often administered by injection near a particular nerve.

leptomeninges Two thin layers of fine tissue covering the brain and spinal cord (The pia mater and arachnoid).

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

leptomeningitis Inflammation of the membranes covering the brain and spinal cord.

localization Limitation to a definite area.

The reference of a sensation to its point of origin.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Long Beach pedicle screw Posterolateral fusion screw and rod device. longissimus colli Long muscle immediately anterior to the cervical spine. long tracts The nerve fibers that connect the voluntary muscle messages from the brain. lordoscoliosis Lateral curvature of the spine associated with backward bending of the 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.

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.

loughheed and white For drainage of lower abdominal abscess; coccygectomy and drainage from space anterior to sacrum.

luque isf For posterolateral fusion fixation; a pedicle screw and plate device.

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

luxation Dislocation

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.

M

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 formations 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.

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 angiography (MRA) A non-invasive study that is conducted in a Magnetic Resonance Imager (MRI). The magnetic images are assembled by a computer to provide an image of the arteries in the head and neck. No contrast material is needed, but some patients may experience claustrophobia in the imager.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

magnetic resonance imaging (MRI) An image produced by use of magnetic fields and radio waves to visualize body structures. malignant Resistant to treatment; occurring in severe form, and frequently fatal; tending to become worse and leading to an ingravescent course.

medulloblastoma Tumor composed of medulloblasts, which are cells that develop in the roof of the fourth ventricle (medullary velum). meninges The three membranes covering the spinal cord and brain termed dura mater, arachnoid mater and pia mater.

marginal osteophytes Excess bone formation at the margin of the vertebral body; spondylosis.

meningioma A firm, often vascular, tumor arising from the coverings of the brain. Does not recur if totally removed.

Marie-Strümpell disease Inflammation of the spine, occurring as a rheumatoidtyoe disease in children.

meningismus Apparent irritation of brain or spinal cord in which symptoms simulate meningitis but in which no actual inflammation of the membranes is present; meningism.

massage A method of manipulation of the body by rubbing, pinching, kneading, tapping, etc. massage therapy A pain-relieving therapy that strokes or kneads the muscles with various forms of therapeutic massage.

Mcaffee Anterior retropharyngeal approach to upper cervical spine; often used for fusion, allowing excision of tumor. medial Situated closer to the midline of the body. 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. medical device report (MDR) The required reporting of ’ medical device complaints involving a patient death, serious injury, or device malfunction. medication The act of medicating. A medical substance, or medicament. medulla oblongata The lower portion of the brain stem.

meningitis An infection or inflammation of the membranes covering the brain and spinal cord. Caused by infectious agents such as bacteria, fungi, or viruses. meningocele A protrusion of the coverings of the spinal cord or brain through a defect in the skull or vertebral column. May be congenital or acquired. meningoencephalitis An inflammation or infection of the brain and spinal cord and their membranes. meningoencephalocele A protrusion of both the meninges and brain tissue through a skull defect. meningomyelitis Inflammation of spinal cord, its enveloping arachnoid and pia mater, and sometimes the dura mater.

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.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

morbidity The frequency of the appearance of complications following a surgical procedure or the other treatment. mesencephalic Relating to that part of the brain stem known as the mesencephalon. 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.

MRA See magnetic resonance angiography.

muscular dystrophy Any of a group of hereditary diseases characterized by progressive degeneration of the muscles. musculature The arrangement of the muscles in a part or in the body as a whole.

music therapy The use of music as restorative therapy. myalgia Muscular pain. myelalgia Pain in the spinal cord.

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 that surrounds the axon of nerve fibers and forms an insulating material.

MRI See magnetic resonance imaging.

musculoskeletal injuries Injuries affecting the muscles.

myelanalosis Wasting of spinal marrow, tabes dorsalis.

myelocele Protrusion of the spinal cord in spina bifida. Herniation and protrusion of substance of spinal cord through defect in the bony spinal canal. myelocystocele Cystic protrusion of substance of the spinal cord through a defect in the bony spinal canal. myelocystomeningocele Cystic protrusion of substance of the spinal cord, with meninges, through a defect in the spinal canal. myelodyiastasis Separation of the spinal cord. myelodysplasia Defective development of any part of spinal cord. myeloencephalitis Inflammation of the spinal cord and brain; myelencephalitis.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

myelogram An x-ray of the spinal canal following injection of a contrast material into the surrounding cerebrospinal fluid spaces. myelography Radiography of 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. myofascial pain Pain and tenderness in the muscles and adjacent fibrous tissues (fascia). myopathy Any disease of muscle. myositis Inflammation of the muscle.

N Naffziger syndrome Intervertebral disc disease, cervical rib, or some other disorder causes the scalene muscles to go into spasm, resulting in pressure on the major nerve plexus of the arm causing pain in the neck, shoulder, arm, and hand; scalenus anticus syndrome. narcotics A group of drugs that relieve pain by preventing transmission of pain messages to the brain. 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 unlyelinated 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 block A local anesthetic that is injected around a nerve, preventing pain messages traveling along that nerve pathway from reaching the brain. Used most often to relieve pain for a short period, such as during a surgery.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

nerve root The portion of a spinal nerve in close proximity to its origin from the spinal cord. nervous system The entire system of nerve cells and nerves, including the brain and spinal cord, which receive and respond to stimuli. neural arch The bony arch of the posterior aspect of a vertebra that surrounds the spinal cord, also referred to as the vertebral arch. neuralgia Pain in distribution of nerves. neurectomy Excision of part of a nerve. neuritis A medical term for inflammation of the nerves. 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 systems. neurogenic pain Pain initiated or caused by a primary lesion, dysfunction, or transitory perturbation in the peripheral or central nervous system. neurohypophysis The posterior lobe of the pituitary gland. neurologist A medical doctor who treats disorders of the nervous system, such as certain types of headaches and forms of nerve damage.

neurolysis Removal of scar or reactive tissue from a nerve or nerve root. neurolytic A substance or procedure that destroys nerves. neuroma A tumor or new growth largely made up of nerve fibers and connective tissue. neuromuscular scoliosis Scoliosis caused by a muscle or central nervous system disorder. neuron Any single nerve cell that carries electrical impulses in one direction or the other. Each neuron contains a cell body that contains the nucleus, and fine branches or terminals at each end. neuropathic pain Pain initiated or caused by a primary lesion or dysfunction in the nervous system. neuropathy A disturbance of function or a pathological change in a nerve. 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.

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Patient Resource Guide

Glossary E-N A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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

nutritionist or registered dietician Specialist who designs an appropriate nutritional program focusing on aspects of diet.

neurotransmitter Chemical compounds flowing across tiny spaces called synapses between neurons, helping to transmit or suppress messages from one part of the body to another in a fraction of a second.

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

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. nociceptor A nerve receptor sensitive to noxious stimuli that transmit the impulse. Nociception is the process by which a noxious stimulus is transmitted by the peripheral nervous system to the spinal cord and brain. non-union Failure of the fragments of a fractured bone to heal or to obtain bony fusion following an arthrodesis.

NSAIDs Nonsteroidal anti-inflammatory drugs such as aspirin that relieve the pain associated with inflammation. 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.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

O

orthopedic surgeon A physician who treats the musculoskeletal system, extremities, and spine by operation or manipulation.

occipital nerve Nerve from the back of the neck that supplies motor function and sensation to the forehead; two partsgreater and lesser. occiput The back part of the head. The base of the skull. occupational therapy A therapy that helps build or restore the ability to carry out everyday tasks at home or at work. oligodendroglia Non-nerve cells, (see glia) forming part of the supporting structure of the central nervous system. oligodendroglioma A growth of new cells derived from the oligodendroglia olisthy Slipping of bone(s) from normal anatomic site; for example, a slipped disc. ophthalmoplegia Paralysis of one or more of the eye muscles. opiate drugs Drugs refined or chemically derived from the opium poppy, such as morphine. Also called narcotics. opioids Prescription medications that relieve pain by binding to receptors in the brain and spinal cord. Some are natural compounds derived from opium; others are synthetic medications that work in a similar way. orthopaedic implants Medical devices used to replace or provide fixation of bone or to replace articulating surfaces of a joint. 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.

orthopedist A medical doctor who treats disorders involving the bones or joints of the skeleton, such as spinal problems. 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. osteoinductive A material with the ability to induce bone to grow. osteoma A benign tumor of bone. osteomyelitis Inflammation of bone due to infection, which may be localized or generalized. osteopath A doctor of osteopathy (D.O.) who manipulates the spine and uses other means to restore normal body functions. Focuses on the muscles, bones, and joints and believes they should be properly balanced to assure good health. 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. other nerves (twelfth cranial) Transcervical, supraclavicular, posterior rami, facial, greater auricular, and hypoglossal.

Overton

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

P

papilledema Swelling of the optic nerve head, can be seen in the back of the retina during eye examination.

pain An unpleasant sensory and emotional experience associated with damage to the body. pain center A facility with a group of physicians and other healthcare providers whose collective expertise allows for the management of a variety of pain problems. pain clinic A facility with one or more physicians and other healthcare providers who specialize in the treatment of painful conditions, such as back pain or headaches. pain pump A device that is surgically implanted in the lower abdomen, where it provides a steady stream of medication—typically an opioid—to the spinal column. It is generally used to control pain associated with a terminal illness or severe nerve damage. pain rehabilitation program A program that provides comprehensive, rehabilitative therapy for people suffering from chronic pain. pain scale A system of rating pain. pain threshold The level of sensation at which any stimulus, such as pressure or heat, is first recognized by the body as painful. pain tolerance level A medical term for the level at which pain cannot be voluntarily endured palliative treatment Treatment that seeks to mitigate symptoms but does not cure the underlying condition. Primarily give to improve the quality of life.

paraesthesia Sensations alongside normal ones, unpleasant and different but not painful in themselves, such as in “pins and needles” pains that occur without apparent cause. paraplegia Paralysis of the lower part of the body including the legs. paravertebral muscle spasm Spasm in the muscles on either side of the spinous processes (midline of the back); the term may be used to describe a physical finding or improperly used to define a disease process. parietal lobe The middle portion of each cerebral hemisphere. 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 Something that results from a process in the body that is not normal, such as an abnormal growth or an infection. patient controlled analgesia (PCA) A system that allows patients to control the amount of pain medicine they receive. The patient pushes a button and a machine delivers a dose of pain medicine into the blood stream through a vein. pectoral (also pectoralis)Relating to the chest. pedicle The part of each side of the neural arch of a vertebra. It connects the lamina with the vertebral body. The first portion of the posterior spine arising from the vertebral body.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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 Therapeutic physical treatments for pain involving the muscles, bones, joints, nerves, such as heat and cold treatments. Physiotherapists and kinesiotherapists utilize similar techniques to help correct postural defects and other muscular and joint problems, employing conservative, noninvasive treatment techniques.

peripheral nerves Nerves that run from the spinal cord to all other parts of the body. Transmit messages from the spinal cord and the brain to and from other parts of the body, and send sensory signals back to the spinal cord and brain.

physiology The science of the functioning of living organisms, and of their component systems or parts.

peritoneal cavity Body cavity in which the abdominal organs are situated. phantom pain Pain or discomfort following amputation that feels as if it comes from the missing limb. pharmacology The science of drugs, including their chemical structure and how they achieve particular effects on the body. phasic pain Pain that feels as if it spreads from a location along a nerve to peripheral areas served by the nerve. For example, in sciatica, caused by pressure on the sciatic nerve, the pain feels as though it is radiating down one leg. phrenic nerve Nerve arising from three cervical nerve roots (C-3 to C5); supplies the diaphragm. physiatrist A medical doctor who specializes in physical or rehabilitative medicine. physical Relating to the body, as distinguished from the mind.

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. pituitary Gland at base of the brain that secretes hormones into the blood stream. Those hormones then regulate other glands including the thyroid, adrenals and gonads. The “Master Gland”. platysma Thin outermost muscle layer of the anterior neck. plexitis Inflammation of the plexus. plexus A network or inter-joining of nerves and blood vessels or of lymphatic vessels.

PLIF See posterolateral interbody fusion. polyneuritis Inflammation of two or more nerves simultaneously. porencephaly Abnormal cavity within brain tissue, usually resulting from out-pouching of a lateral ventricle. 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.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

posterior cervical spinal fusion Spinal fusion done from the back, using the lamina, facets, and spinous processes of the neck. posterior neck muscles Splenius, spinalis, and semispinalis. posterior fossa The internal base of the skull. 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. post-ictal State following a seizure, often characterized by altered function of the limbs or mentation. posture The position of the limbs or the carriage of the body as a whole.

Pott’s disease Tuberculosis of the spine, usually in the lower thoracic segments.

powered surgical instruments Instruments that are powered by compressed air or electricity and are used in surgical procedures to cut, drill, or otherwise remove bone and cartilage, as well as to evacuate fluids. pre-clinical studies Tests occurring prior to clinical studies, usually in vitro or in vivo involving animals. The purpose of these studies is to determine the safety and efficacy of the test material. premarket notification [510(k)] A regulatory method for gaining clearance from the FDA to market a device. The FDA is petitioned by a company to determine if a particular medical device is “substantially equivalent” to a device which was commercially available prior to May 28, 1976. This method usually applies to Class I or II medical devices. premarket approval (PMA) A regulatory method for gaining a marketing clearance from the FDA for a Class III medical device. A company submits information to the FDA that documents the safety and effectiveness of the device. prognosis A doctor’s prediction of the future course of a disease and the chances for recovery. pronator A muscle that turns a part into the prone position. proprioception Sensation concerning movements of joints and position of the body in space. prosthesis An artificial body part such as an artificial leg or arm. The term prosthesis is also used to describe some of the implants used in the body such as a hip or knee replacement device. 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.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

pseudotumor cerebri Raised intracranial pressure, usually causing only headache and papilledema. No clear underlying structural abnormality. pseudoarthrosis (also pseudarthrosis) A form of non-union in which there is the formation of a false joint with some cartilage covering the ends of the bones and a cavity containing fluid that resembles a normal joint. pseudoclauducation Increased pain and decreased strength in lower limbs associated with physical activity. Complaints are similar to those caused by insufficient blood supply to the limb but are caused by diminished blood supply to the nerves in a narrowed spinal canal. psoas abscess A localized collection of puss surrounded by inflamed tissue of either of two internal muscles of the loin, the psoas minor and major. psychiatrist A medical doctor who also has an advanced degree in psychology, specializing in mental health problems. A psychiatrist can prescribe antidepressant medications for short-term treatment for mental problems such as depression, which can accompany chronic pain. psychogenic pain A medical term for pain that has emotional or mental causes. psychologist A licensed mental health professional who practices psychotherapy or psychological techniques, including individual therapy and group sessions, but who does not prescribe medications. pupil The black part of the eye through which light enters; enlarges in dim light and decreases in size in bright light. pyelonephritis Inflammation of the parenchyma of a kidney and the lining of its renal pelvis, especially due to bacterial infection.

pyramidal tract Carries the voluntary muscle messages from the brain.

Q quadrantanopia Defect in vision or blindness in one fourth of the visual field. 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. rachicentesis Lumbar puncture for examination of the spinal fluid; rachiocentesis. 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.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

rachioplegia Spinal paralysis.

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

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. radiation oncologist A medical doctor who has received advanced training in the treatment of persons receiving x-ray treatment for an illness. radiation physicist A person having a PhD degree who is trained in the science dealing with the properties, changes and interactions of continuous energy. radicle A rootlet or structure resembling one, a minute veinlet joining with others to form a vein. radiculalgia Pain along the distribution of one or more sensory nerve roots. radicular Relating to the radicle. radiculectomy Excision of a rootlet or resection of spinal nerve roots. radiculitis Inflammation of one or more nerve roots. Does not apply unless inflammation is present. radiculopathy A disturbance of function or pathologic change in one or more nerve roots.

radiotherapy Treatment of a lesion with radiation. radius The lateral and shorter of the two bones of the foreman. rebound pain When regular use of a pain medication makes a person’s pain worse instead of better. recombinant human proteins Proteins developed by isolating a human protein and using recombinant DNA technology to produce genetically engineered proteins that act like natural proteins. referred pain Areas or trigger points of persisting tenderness, which “refer” or shift the sensation of pain to other parts of the body. 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. regional anesthesia Medications used to block pain in a certain region of the body without altering consciousness. 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.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

rhBMP2 Recombinant human bone morphogenetic protein made by isolating the BMP-2 protein from bone tissue, splicing the BMP-2 gene into a cell line in the lab via recombinant DNA technology. The genetically engineered cells produce pure and natural BMP-2 protein. rheumatalgia Chronic pain that comes from rheumatism rheumatoid arthritis Generalized inflammatory joint disease. rheumatologist A medical doctor who treats diseases of the joints, such as rheumatoid arthritis or other disorders of the rheumatic system. rhizotomy Division of the roots of the spinal nerves.

Risser For scoliosis deformity; particular attention to fusion of facet joints and use of cast stabilization.

Roaf, Kirkaldy-Willis, and Cattero Drainage of thoracic spinal abscess through dorsolateral approach.

Robinson and Riley An extensive anterior approach for fusion of C-1 to C-3 or lower. rod In spinal applications, a slender, metal implant that is used to immobilize and alien 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. rounding of the cranial border Relationship of the height to the width of the rounded portion of the superior sacrum.

Roy-Camille For stabilization between the skull and C-2; posterior bone graft with wire and parallel vertical screw plate fixation from occiput to C-3. Posterior pedicle screw and plate device for spinal stabilization. rudimentary ribs Nubbins of ribs seen below the level where the last rib normally occurs. ruptured disc See herniated disc.

S saccular aneurysm A balloon-like out-pouching of a vessel (the more common type of aneurysm). sacral Five fused segments of the lower spine, below the end of the spinal column, that connect to the pelvis and have four formina on each side. sacral agenesis Absence, failure of formation, or imperfect development of the lower portions of the spinal column and pelvis. sacral ala Lateral portions of the sacral bone. sacral cyst Abnormality in the spinal fluid sac in the sacrum. sacralgia Pain in the sacrum.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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.

Schmorl’s nodes Developmental change resulting in inferior or superior extension of the intervertebral disc into the vertebral bodies.

sacralized transverse process One or both of the lumbar spinous transverse processes abnormally joining with the sacrum; sacralization.

Schollner costoplasty For rib deformity or scoliosis; multiple rib partial excisions.

sacrodynia Pain perceived to be in the area of the sacrum but may originate elsewhere; referred pain.

sciatica A 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.

sacroiliitis Inflammation of the sacroiliac joint. A very painful, often one-sided sacral area pain that follows delivery, is 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 anticus), middle scalene m. (scalenus medius), and posterior scalene m. (scalenus posticus). scapula A large triangular flattened bone lying over the ribs, posteriorly on either side.

Scheuermann’s disease Inflammation of the anterior cartilage of the bodies of the lower thoracic and upper segments, causing pain in some older, growing children. There is more than 5 degrees of wedging of at least three adjacent vertebrae as seen on radiographs.

sciatic nerves The body’s largest nerves, which begin in the buttocks and carry sensation to most of the legs. scoliorachitis Disease of the spine caused by rickets; abnormal bone mineralization. scoliosis Lateral (sideways) curvature of the spine. scotoma An area of decreased vision surrounded by an area of less depressed or normal vision.

Scott Use of cross-wire fixation transverse process to inferior pedicle in stabilization of spondylolysis fusion. seddon Drainage of thoracic spinal abscess through anterolateral approach with partial resection of rib. segmental instability Abnormal response to applied loads characterized by motion in the motor segment beyond normal constraints. sepsis A state of infection of tissue due to disease-producing bacteria or toxins. septum A thin wall dividing two cavities or masses of softer tissue.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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

spinal accessory nerve (eleventh cranial) The nerve from the brainstem that supplies the sternocleidomastoid muscles.

shunt A tube or device implanted in the body (usually made of Silastic) to redivert excess CSF away from the brain to another place in the body.

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.

side effect A secondary, usually unwanted reaction to medication or treatment.

Simmons Use of keystoned-shaped graft in anterior fusion. For cervical spinal kyphosis; a posterior osteotomy 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. somatic pain Pain emanating from any of the body’s sensory nerves, except those of the internal organs. somatosensory Refers to sensory signals from all tissues of the body including skin, viscera, muscles, and joints.

Southwick A posterior fusion with wire attaching bone graft to the facet joints.

Speed (Kellogg Speed) For spondylolisthesis spine fusion and anterior interbody fusion by using tibial cortical graft.

Spetzler Approach to anterior C-1 to C-3 by using a transoral approach for fusion following excision of tumor. 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 column See Spine. spinal cord A cordlike bundle of nerves that extends from the base of the brain to the small of the back spinal cord stimulation A procedure intended to relieve chronic pain. The spinal cord is electrically stimulated so that a new sensation, such as tingling, overrides the pain sensation. 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 nerve block A procedure that is used to relieve pain affecting a broad area, such as the abdomen or the legs. A local anesthetic is injected in or near the spinal column, preventing pain messages traveling along that nerve pathway from reaching the brain. 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.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

spinal thalamic tract The main tract of pain to the brain. 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 posterior extension of the spine arising from the laminae.

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.

spondylalgia Pain in vertebra(e).

spondylopathy Any vertebral disorder.

spondylarthritis Arthritis of the spine.

spondylopyosis Infection in vertebra(e).

spondylarthrocace Tuberculosis of the spine; spondylocace.

spondyloschisis Congenital fissure (splitting) of vertebral arch.

spondylexarthrosis Dislocation of a vertebra.

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.

spondylitis Inflammation of vertebrae, including types such as ankylosing, rheumatoid, traumatic, spondylitis deformans, Kümmell, and Marie-Strümpell d. spondylizema Depression or downward displacement of a vertebra, with destruction or softening of one below it. spondylodynia Pain in vertebra(e). spondyloepiphyseal dysplasia Disorder of growth affecting both the spine and the ends of long bones.

spondylosyndesis Surgical immobilization or ankylosis by fusion of the vertebral bodies with a short bone graft in cases of tuberculosis of the spine; spondylodesis, Albee procedure. 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.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

stainless steel Iron-based metal containing chromium that is highly resistant to stain, rust, and corrosion. Certain grades of stainless steel are commonly used to make surgical implants and instruments.

Steffee plate For posterolateral fusion fixation; plate and screw device. 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. stereotactic Originated from the Greek words stereo meaning three dimensional and tactos meaning touched and relating to stereotaxy. stereotaxy A precise method of destroying deep-seated brain structures located by use of three dimension coordinates. stereotactic radiosurgery The precise delivery of radiation to a preselected stereotactically localized target. sterile Free from living organisms. Relating to or characterized by sterility.

strabismus Deviation of eye movement which prevents the two eyes from moving in a parallel fashion. strain To injure by overuse or improper use. strap muscles A general term applied to the ribbon-like muscles in the anterior neck; they include omohyoid, sternhyoid, sternthyroid, and thyrohyoid. structural curve A fixed lateral curve of the spinal column. subarachnoid hemorrhage Blood in, or bleeding into, the space under the arachnoid membrane, most commonly from trauma or from rupture of an aneurysm. subclinical pain Pain that has no visible symptoms. subcutaneous Below the skin, as in a subcutaneous injection. subdural hematoma A collection of blood (clot) trapped under the dura matter, the outermost membrane surrounding the brain and spinal cord.

sterilization The method used to render a material free from living organisms. Usual methods include steam under pressure, gas, and ionizing radiation.

subluxation An incomplete luxation or dislocation; though a relationship is altered, contact between joint surfaces remains. suffering A state of severe distress associated with events that threaten the intactness of a person and may or may not be associated with pain.

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

superior Situated above or directed upward toward the head of an individual

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

support group A group of people who meet on a regular basis to discuss topics of mutual interest and concern, such as how to live with chronic pain.

sterility In general, the incapability of fertilization or reproduction.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

surgeon A medical doctor who performs surgery and other procedures. May specialize in an area such as orthopedic surgery, neurosurgery, or oral surgery. 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. sympathetic nerve block An injection of an anesthetic to relieve pain resulting from abnormal activity of the sympathetic nervous system. The sympathetic nerves control circulation and perspiration and are part of the autonomic nervous system. syndrome A group of signs or symptoms which indicate an abnormal condition. syringomyelia A fluid filled cavity in the spinal cord. Usually involving upper segments initially and involving the shoulder muscles. systemic pain Pain that affects the entire body.

tendonitis Inflammation of a tendon.

TENS See ranscutaneous electrical nerve stimulation. tension The act of stretching. The condition of being stretched or tense, or a stretching or pulling force. tentorium cerebelli The process of the dura matter between the cerebrum and cerebellum supporting the occipital lobes. teratoma Tumor or growth made up of several different types of tissue (fat, bone, muscle, skin).

Texas Scottish Rite Hospital Instrumentation used anteriorly and posteriorly. thalamus Brain cells which lie in the upper part of the brainstem. therapist A person skilled in giving a particular type of treatment, usually in a specialized area of healthcare. third party payor The source of reimbursement or payment of charges for medical services when the patient does not make direct payment: i.e., payments made by insurance companies, government agencies or employers. The patient and the doctor represent the two other parties in third party pay arrangements.

T temporomandibular joint syndrome Complex of symptoms often seen in cervical sprain conditions. Symptoms include clicking in the jaw on opening and closing the mouth, soreness in the jaw, headaches, buzzing sounds, changes in hearing, stiffness in the neck and shoulders, dizziness, and swallowing disorders. tendon The fibrous band of tissue that connects muscle to bone. It is mainly composed of collagen.

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.

Š 2004 PainCare America, S.C.Institute, All rights reserved.

Glossary. Š Prairie Spine & Pain S. C.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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. thrombus A blood clot attached to the wall of an artery. thyroid cartilage Widening expanses of cartilage above the trachea, the top marks the level of C-4, the bottom C-5. thyroid gland Near the “Adam’s apple;” responsible for secretion of hormone that is involved in regulation of the rate of metabolism. tic douloureux See trigeminal neuralgia. tissue A collection of similar cells and the intercellular substances surrounding them. titanium A metallic element used to make surgical implants. tolerance The point at which a person adapts to a specific substance, so larger amounts of the prescribed medication or a new medication is needed to achieve the same results. tonic pain Continuous pain that may fluctuate in intensity. topical anesthetic Applied to the surface of the body and causes a lack of sensation in the area around the application. titanium A metallic element used to make surgical implants.

TLIF See transforaminal lumbar interbody fusion. 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. toxicology The study of the toxic or harmful effects of substances on the body. trachea The windpipe. 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. tranquilizer A drug that promotes tranquility by calming, soothing, quieting, or pacifying without sedating or depressant effects. transcutaneous electrical nerve stimulation (TENS) A treatment that relieves pain using small mechanical stimulators that provide mild doses of harmless electricity. 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.

© 2004 PainCare America, S.C.Institute, All rights reserved.

Glossary. © Prairie Spine & Pain S. C.

13

Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

transplant The implantation of bone tissue, as in grafting, from one part of the body to another. Transplant also refers to the transfer of an organ such as a kidney or heart from one individual to another. transsphenoidal approach Operative method of reaching the pituitary gland or skull base traversing the nose and sinuses. 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. traumatic Results from fracture in other areas of the bony hook than in pars interarticularis. triangles For surgical approaches and other considerations, the anterior half of the neck is divided into trianglesanterior, digastric, posterior, submental, and carotid. trigeminal neuralgia Paroxysmal pain in the face. Pain may be so severe that it causes an involuntary grimace or “tic”. (tic douloureux). trigger point A hypersensitive area of muscle or connective tissue, usually associated with myofascial pain syndrome. tsuli For severe cervical spondylosis; an expansive, multiple laminectomy. tumor Any swelling or tumefaction. twelfth cranial nerves See other nerves.

U 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.

U.S. Food and Drug Administration See Food and Drug Administration.

V vagus nerve The tenth cranial nerve, which is a mixed nerve that has both motor and sensory function. The long nerve in the anterior neck traveling with the carotid artery; responsible for many organ functions in the chest and abdomen. vagus nerve stimulation (VNS) Therapy for epilepsy that applies small electrical pulses to the vagus nerve in the neck that regulates internal organs.

This therapy is used in patients suffering from partial epilepsy who have failed traditional drug therapy. valve Device placed in a shunt system to regulate the rate and direction of CSF flow. vascular Relating to or containing blood vessels. vasoconstriction A decrease in the diameter of blood vessels. vasodilatation An increase in the diameter of blood vessels. vasopressin A hormone secreted by the hypothalamus and stored in the posterior pituitary that raises blood pressure and increases reabsorption of water by the kidneys.

© 2004 PainCare America, S.C.Institute, All rights reserved.

Glossary. © Prairie Spine & Pain S. C.

14

Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

vasopressor An agent that constricts the arteries and raises blood pressure. vasospasm Spasm of blood vessels, decreasing their diameter. ventricle The cavities or chambers within the brain that contain the cerebrospinal fluid. There are two lateral ventricles and midline third and fourth ventricles. ventricular drainage Insertion of a small tube into the ventricles to drain cerebrospinal fluid, usually when pressure is increased. ventriculitis Inflammation or infection of the ventricles. ventriculogram An X-ray study of the ventricles. ventriculostomy An opening into the ventricles of the brain, such as by inserting a small, thin, hollow catheter.

vertigo An abnormal sensation of rotation or movement of one’s self, or the environment. visceral pain A medical term for pain emanating from the internal organs, or viscera.

W wedging Deformity of vertebral body, caused by trauma or gradual collapse, resulting in wedge-shaped vertebra; can also occur congenitally. wertheim bohlman For occipital cervical fusion; use of iliac crest graft and wire fixation from occiput to C-2. whiplash Poplar term for hyperextension-hyperflexion.

vermis Middle part of the cerebellum between the two hemispheres.

whitecloud and larocca Anterior technique for cervical spine fusion using fibular graft.

Vermont (krag) Posteriorly placed internal fixation device.

wiltse A bilateral lateral spine fusion for spondylolisthesis.

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 laminae and pedicles as well as the other structures in the posterior aspect of the vertebra) that protects the spinal cord. vertebrae The bones of the spine. vertebral body From a lateral view, it is the main rectangular portion of the spine; from an overview, oval.

wiltse plate Screw plate device for posterior spinal stabilization. winter For hemivertebra deformity; anterior and posterior approach with stabilization. Also a procedure for correction of congenital kyphosis, by using an anterior approach and strut bone grafts. wire Metal thread available in various diameters and various degrees of stiffness and is generally used in surgery to transfix fractured bone.

Š 2004 PainCare America, S.C.Institute, All rights reserved.

Glossary. Š Prairie Spine & Pain S. C.

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Patient Resource Guide

Glossary O-Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Wisconsin (drummond) interspinous segmental spinal Series of wires, rods, and buttons for multisegmental spine stabilization.

X xenograft A graft derived from one species for use in another species. 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. A radiograph.

Y (none)

Z zielke instrumentation A method of fixation.

Š 2004 PainCare America, S.C.Institute, All rights reserved.

Glossary. Š Prairie Spine & Pain S. C.

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