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Spinal Glossary

activities of daily living (ADL): Activities and movements that people engage in on a day-to-day basis, including sitting, standing, reaching, lifting, and bending.

acute: Pain that is sudden in nature; categorized as lasting three months or less. Generally caused by an illness or injury, such as a broken bone or cut, that will naturally heal on its own once the underlying cause of the pain has been treated.

allograft: A tissue graft used during surgery that is taken from someone other than the patient being operated on, usually from a cadaver or a bone bank. Spinal fusion surgeries often use allografts to stimulate bone growth so that fusion can take place.

annulus fibrosis: The cartilaginous outer wall of an intervertebral disc; contains the inner gel-like fluid of the disc’s nucleus, called the nucleus pulposus. Over time, the annulus fibrosus can degenerate and become prone to tearing.

anterior: A term used to describe the front plane of the body. One of several anatomical terms of location, including posterior, dorsal, ventral, lateral, medial, proximal, and distal.

anterior interbody fusion (AIF): A spine surgery that is aimed at fusing two vertebral bodies into one solid segment of bone. An anterior fusion accesses the spine through the front of the body, usually with a large incision in the abdomen.

anterior lumbar interbody fusion (ALIF): A spine surgery that fuses two or more lumbar vertebrae together into a solid segment of bone. The fusion takes place between anterior vertebral bodies, meaning the posterior vertebral arch and spinous process is not fused.

arthritis: Commonly used term that describes a disorder that causes inflammation and pain of the joints. Inflammation of a joint.

arthroscopic microdiscectomy (AMD): A minimally invasive procedure that utilizes an arthroscope, which is a type of endoscope, to gain access to the interior of a spinal facet joint or an intervertebral disc that is causing neural compression. Arthroscopy uses a very small incision and does not require cutting of muscles, ligaments, or tendons.

artificial disc replacement (ADR): Also referred to as disc arthroplasty, ADR is a procedure that removes a degenerated intervertebral disc and replaces it with a prosthetic disc. The prosthetic can be made of hydrogel, polyethylene, rubber, titanium, or cobalt chromium.

autograft: A tissue or bone graft used during surgery where the graft is taken from another region of the patient’s body. In the case of an autograft for spinal fusion surgery, the bone is usually taken from the patient’s pelvic bone.

automated percutaneous lumbar discectomy (APLD): A minimally invasive procedure that uses a needle and cannula, or suction tube, to access a bulging or herniated intervertebral disc and remove disc fluid.

annular tear: This condition refers to a rip or tear in the annulus fibrosus (tough exterior) of an intervertebral disc.

anterior posterior fusion: A type of spinal surgery that permanently connects two or more vertebrae; this surgery also may involve the partial or total removal of one or more intervertebral discs

arachnoid mater: The middle layer of a three-layer membrane that surrounds the brain and spinal cord; the arachnoid mater is sandwiched by the dura mater on the outside and the pia mater on the inside.

arthritis of the spine: Degeneration of the joints of the spine (called facet joints).

acetaminophen: A common fever reducer and analgesic for mild to moderate pain.

aspirin: A widely available non-steroidal anti-inflammatory pain killer.

aerobic exercise: Exercise that increases the body’s need for oxygen. Aerobic exercise should be performed with moderate intensity for an extended period of time for best results.

anterior longitudinal ligament: A ligament that traverses the entire length of the spinal canal on the anterior (front) surface of the spine.

arthrodesis: The surgical fusion of two bones to alleviate joint or arthritic pain and stabilize the affected bones.

acupuncture: An alternative therapy that involves the insertion of tiny needles into specific parts of the body, called meridians.

BMP: A growth factor that triggers the formation of new bone or cartilage. Sometimes BMP is used in lieu of a bone graft in spinal fusion surgeries.

bone graft: When missing or damaged portions of bone are replaced with bone from a natural, synthetic, or artificial source. A bone graft is used in a spinal fusion procedure to stimulate osteogenesis (new bone growth) so that fusion can occur.

bone growth stimulator: An electrical device used to induce the growth of new bone after a spinal fusion surgery. A stimulator can be implanted at the surgical site or worn externally.

Bone Spurs: Bone spurs are small and rounded or knobby growths of bone that accumulate in or around joints or where connective tissues (such as ligaments or tendons) and bones meet.

Bulging Disc: Occurs when an intervertebral disc - a tough yet spongy oval-shaped structure that is located between two vertebrae - weakens and loses its natural shape, causing it to protrude outside its normal boundary.

back surgery: Treatment for back conditions that entails one or more incisions so that a surgeon can access the spine, typically with the goal of diagnosing, removing, and/or repairing injured vertebrae, intervertebral discs, muscles, ligaments, etc.

bones of the spine: Also called vertebrae (or singular, vertebra). The bones of the spine are stacked to create a column-like structure that protects the spinal cord and allows our body to perform a variety of movements.

C#: The letter “C” followed by a number is a way to refer to the seven vertebrae of the cervical spine, or neck. For instance, a herniated disc might occur between the C3 and C4 vertebrae.

C-collar: A rigid brace, also called a cervical collar, which supports the head and neck. It provides stabilization of the C1-C7 vertebrae, which may be needed after a traumatic accident or after an invasive neck surgery.

C-spine: Refers to the cervical spine, or neck. The cervical spine is composed of seven vertebrae, labeled C1 to C7.

cauda equina: A bundle of nerve roots in the lumbar spine that branch off the end of the spinal cord and extend through the lower extremities, bowel and bladder.

cauda equina syndrome (CES): An emergency condition caused by the compression of the nerve bundle in the lower part of the spinal canal, the cauda equina. Symptoms include pain, paralysis and incontinence; the condition requires immediate medical attention.

cervical: A term used to refer to the neck. The cervical region of the spine is composed of seven vertebrae that allow the head and neck to move together.

chronic: Used in the medical field to describe a persistent medical condition that usually lasts more than three months.

claudication: A medical term that describes difficulty walking. Claudication can often be traced to nerve compression in the spine and may range in severity from mild to extreme.

CNS: The central nervous system (CNS) is composed of the brain and spine, and is responsible for sending and receiving sensory signals throughout the body.

coccyx: Known colloquially as the "tailbone," the coccyx is a vestigial set of bones that is comprised of three to five individual vertebrae that are fused together. The coccyx is attached to and articulates with the sacrum in the pelvis.

corticosteroids: Oral steroids that are a pain medication for patients who need immediate pain relief. These medications are most commonly prescribed to patients dealing with arthritic pain, allergic reactions, chronic back pain and other similar conditions.

COX-2 inhibitor: Cyclooxygenase-2 (COX-2) inhibitors are a non-steroidal anti-inflammatory drug that target the cyclooxygenase enzyme, which is responsible for muscle inflammation. COX-2 inhibitors are often recommended for patients with arthritic pain or pain stemming from degenerative joint conditions.

CSF (cerebrospinal fluid): A clear fluid that surrounds the spinal cord and brain and protects the central nervous system against sudden shock.

CT (computerized tomography): A CT scan uses X-ray technology to study the inner workings of the body. This diagnostic imagery tool is used by medical professionals to generate an image of a specific part of the body from a series of two-dimensional images taken around an axis.

Cervical Radiculopathy: “Radiculopathy” is the general term for the symptoms that arise when there is improper or incomplete function of one or more spinal nerve roots. The term "cervical" refers to the portion of the spine that runs through the neck.

Central Canal Stenosis: Central canal stenosis is the narrowing, or constriction, of the spinal canal.

canal stenosis: A narrowing of the spinal canal, caused when one or more anatomical elements of the spine becomes inflamed or damaged, or shifts out of place.

chronic pain: This term describes pain that lasts longer than three months.

chemonucleolysis: A minimally invasive treatment for patients experiencing degenerative disc conditions in the neck or back. During this procedure, a medical professional carefully injects chymopapain into the affected disc to reduce swelling, alleviate nerve compression and reduce symptoms.

chiropractor: A chiropractor is a health care professional who is concerned with diagnosis and treatment of the musculoskeletal system. Chiropractic therapy is particularly common for patients who have neck or back pain, although chiropractic is considered to be outside of mainstream medicine.

collapsed disc: A collapsed intervertebral disc is a degenerative spine condition that occurs as a result of an injury or regular wear and tear. This condition is relatively common as an individual grows older, and is actually asymptomatic unless the disc or disc material comes into contact with a nerve root or the spinal cord itself.

cartilage in the spine: Soft, flexible tissue that lines the joints of the spine (called facet joints); cartilage is also an integral part of the cushioning discs located in between the vertebrae.

Central Nervous System: Consists of the brain and spinal cord, which control the motor and sensory signals that are sent throughout the body; works in conjunction with the peripheral nervous system.

cerebrospinal fluid: Protective fluid that surrounds the brain and spinal cord; helps keep nerve tissue healthy by removing waste.

corpectomy: A spinal surgery in which the vertebral body is removed with the aim of releasing neural compression.

coccydynia: The medical term used to describe pain in or around the coccyx in the tailbone.

DBM (demineralized bone matrix): A bone grafting option that is often used during spine fusion surgery.

DC (Doctor of Chiropractic): An academic degree that is earned by chiropractic professionals. A chiropractor is a medical professional who specializes in mechanical disorders within the musculoskeletal system. Graduates of chiropractic schools receive their degree in Doctor of Chiropractic but it is important to differentiate this from a medical physician.

decompression: Treatment designed to alleviate pressure on a nerve, nerve root or the spinal cord itself. Decompression treatments vary in relative invasiveness, but are all intended to provide relief from pain and other symptoms.

degenerative disc disease (DDD): Refers to the gradual deterioration of one or more of the intervertebral discs that cushion and support the bones of the spine. Degenerative disc disease is a common result of the aging process but can be exacerbated by injury or other outside influences.

disc: Intervertebral discs are thick pads that cushion the spine and prevent adjacent vertebrae from grinding together in the cervical, thoracic and lumbar spine segments. Discs are comprised of a tough fibrous wall (annulus fibrosus) and a gel-like center (nucleus pulposus).

discectomy: The surgical removal of a herniated intervertebral disc in whole or in part.

discitis: The inflammation of an intervertebral disc commonly caused by infection.

discography: A diagnostic tool in which contrast dye is injected into the nucleus of an intervertebral disc. Discographic images are generated using a fluoroscope and computed tomography (CT) scanning. During the injection, the physician performing the procedure asks the patient if the injection generates pain similar to his/her “usual” pain.

DJD (degenerative joint disease): Also known as osteoarthritis; this is the most common disorder of the joints, especially among people who are middle-aged or older. It can affect any joint in the body, including the fingers, wrists, elbows, shoulders, vertebral joints, hips, knees, ankles and more. It can produce swelling, pain, stiffness or muscle weakness around arthritic joints.

D.O. (Doctor of Osteopathic Medicine): A licensed practitioner of osteopathic medicine, which uses a combination of modern medicine (such as prescription drugs, surgery and other technology) and hands-on musculoskeletal manipulation. There are approximately 67,000 fully licensed osteopathic physicians in the United States. A D.O. works in partnership with a patient to achieve wellness by focusing on health education and the prevention of injury and disease.

DRG (dorsal root ganglion): A nodule adjacent to the dorsal root containing spinal nerve cells. The dorsal nerve root is an afferent, or sensory, nerve. This means it carries neural signals to the central nervous system (spinal cord, brain) from the peripheral nervous system.

Dx: In medical shorthand, the symbol for “diagnosis.” Diagnosis of back pain typically begins with answering a physician’s questions, followed by a physical exam, neurological evaluation, internal imaging (X-ray, MRI, CT scan) and other medical tests.

degenerative joint disease: Also known as osteoarthritis, degenerative joint disease is a condition that leads to the degradation of the joints and can cause significant pain and diminished movement at the joint. This condition is frequently experienced in the vertebral facet joints.

Degenerative Spine: Characterized by the deterioration of cartilaginous areas of the back. Degenerative disc disease and facet disease are both degenerative spine disorders.

Disc Protrusion: A stage of intervertebral disc degeneration during which the disc bulges outside of its normal circumference. A disc protrusion is often defined as a bulge that involves 180 degrees or less of the disc's circumference.

Disc Herniation: Occurs when the gelatin-like nucleus of an intervertebral disc extrudes through a tear or crack in the fibrous disc wall and seeps into the spinal canal.

disc resorption: Disc resorption occurs when a disc herniates and the body recognizes extruded disc material in a place it shouldn't be. The body then releases chemicals that break down and absorb the gel-like material.

depression: A medical condition that describes a prolonged feeling of sadness, melancholy, disappointment and pessimism that interferes with daily life. There is no concrete definition of depression because different people experience it differently, but this illness is serious and usually requires treatment to overcome.

decompression surgery: A procedure aimed at releasing neural compression caused by anatomical abnormalities in the spine; a decompression surgery may involve the removal of bone or tissue to create more room for spinal nerves.

dermatome map: A diagram that identifies dermatomes, or areas of skin that are innervated by a single nerve, and their corresponding nerve roots along the length of the spinal column.

dermatomes: Areas of skin primarily innervated by a single spinal nerve.

disc sequestration: A condition that involves the separation of inner nuclear material (nucleus fibrosus) from the intervertebral disc.

discogenic: A term used to refer to pain that is caused by an abnormality in one or more intervertebral discs.

dura mater: One of three layers that make up the meninges, which is a protective membrane system that surrounds the brain and spinal cord.

discogenic back pain: Pain caused by a condition related to the intervertebral discs of the spine. Common disc abnormalities include bulging discs and herniated discs.

electromyography (EMG): A test that uses the electrical signals of muscles to help detect potential nerve abnormalities. It can be useful in the detection of several spinal disorders, including spinal stenosis, herniated discs, bulging discs and sciatic nerve compression. Often used in conjunction with a nerve conduction study (NCS).

Epidural steroid injection (ESI): A minimally invasive procedure designed to alleviate chronic neck or back pain by reducing swelling at the site of spinal nerve compression. This is accomplished by injecting an anti-inflammatory agent (corticosteroid) into the adjacent epidural space, which is the area between the protective covering of the spinal cord and the vertebrae.

endoscopic: An endoscopic surgery is one that uses an endoscope and camera to perform the procedure. Not all minimally invasive surgeries are performed with an endoscope.

endoscopic spine surgery: A minimally invasive procedure that addresses spinal abnormalities causing painful nerve compression. A series of flexible tubes and a video monitor allow the surgeon to access the affected portion of your spine without making a large incision or causing trauma to connective tissues.

endoscope: A surgical or diagnostic tool that is used to view interior body cavities, including the gastrointestinal tract and spine.

facet joints: The pairs of hinge-like joints that connect vertebrae and allow for articulation of the spine. Like all joints, facet joints are vulnerable to degenerative conditions such as osteoarthritis as the body ages. Facet joints are synovial joints, which means each joint is surrounded by a capsule of connective tissue and produces fluid to lubricate the joint. These are also known as zygapophysial joints.

facet injection: A minimally invasive procedure that uses an injected nerve-blocking agent for two purposes: to reduce pain caused by inflamed facet joints and to confirm that the pain is coming from the suspected facet joint.

FDA (Food and Drug Administration): An agency within the U.S. Department of Health and Human Services (HHS). The FDA is responsible for the protection of public health by assuring the safety, effectiveness and security of human and veterinary drugs, vaccines, other biological products, medical devices, the food supply, cosmetics, dietary supplements and more.

fluoroscopic guidance: Use of radiologic imaging to assist in the placement of instrumentation for invasive diagnostic and surgical procedures.

fusion: Surgery to permanently connect two or more vertebrae in the spine. The goal is to eliminate motion between vertebral segments, thereby alleviating chronic symptoms such as pain, tingling, numbness or muscle weakness caused by spinal nerve compression. Implants are used to secure the vertebrae together, and a bone graft is often used to enhance stability.

Facet Disease: Facet disease is a degenerative condition that develops over time and affects the facet joints.

Failed Back Surgery Syndrome: Failed back surgery syndrome (FBSS) does not have a clear definition — this is because it is not so much a medical condition as it is a way to describe the negative outcomes of spinal operations that have not effectively addressed your neck or back pain.

Foraminal Stenosis: Refers to the narrowing of the canals in the vertebrae that are responsible for protecting the nerve roots as they exit the spinal column.

facetogenic: Describes pain related to the degeneration of one or more of the vertebral facet joints in the spine. Facetogenic pain can cause chronic neck or back pain, in addition to other symptoms related to nerve compression.

facetectomy: A facetectomy is a surgical procedure in which an orthopedic surgeon excises one or more degenerated vertebral facet joints in order to remove a common cause of nerve compression and neck and back pain.

facet syndrome: The deterioration of the vertebral joints that interlock adjacent vertebrae and stabilize the spine.

foramen: A foramen is an opening or canal in the spinal column through which spinal nerves travel after branching off the spinal cord.

foramina: Refers to the canals or narrow passageways that exist between the vertebrae and protect spinal nerves. Plural of foramen.

foraminal narrowing: Also known as foraminal stenosis, the gradual narrowing of the foraminal canals in the spine may lead to painful nerve compression.

fibromyalgia: Chronic pain that affects muscles and connective tissues. The condition is most likely to affect middle-aged women and is thought to be caused by a genetic predisposition, stress, depression or an abnormality in the central nervous system.

graft: Surgery to place new bone or bone substitutes into spaces around broken bone or bones with defects. When used in reference to the spine, it means bone particulate placed during a fusion procedure.

general anesthesia: Used during surgery when the patient needs to be rendered unconscious and incapacitated. A variety of different medications and dosages might be required to successfully place the patient in this protective state.

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

HHS (U.S. Department of Health and Human Services): The U.S. Government’s primary agency for protecting the health of Americans and providing essential human services. It is administered by a cabinet secretary who oversees 12 operating divisions, including the Food and Drug Administration, the National Institutes of Health and Centers for Disease Control and Prevention.

HMO (health maintenance organization): An organization that provides comprehensive health care to voluntarily enrolled people in a particular geographic area by member physicians with limited referral to outside specialists. An HMO is financed by fixed periodic payments determined in advance.

herniated nucleus pulposus (HNP): The leaking of the gel-like inner material (nucleus pulposus) of an intervertebral disc through a tear in the fibrous outer wall of the disc. This can occur as a result of the natural wear and tear of age, which causes the nucleus to lose water content and the wall to become brittle and weak. While not always symptomatic, contact by the extruded nucleus material with adjacent nerve roots or the spinal cord can produce pain, tingling, numbness or muscle weakness.

Hx (medical history): Medical shorthand for the background on a patient’s health. A physician may determine patient history through records or questioning the patient directly. This is also referred to as anamnesis.

HNP: Herniated nucleus pulposus (HNP) refers to a condition where a tear develops in the outer wall of an intervertebral disc causing the gel-like disc material – the nucleus pulposus – to extrude out of the disc into the spinal canal. HNP is also known as a herniated disc, ruptured disc and torn disc, among others.

hypertrophic: Descriptive term for an organ or body part that has experienced an enlargement of the cells. This is relevant to the spine in cases of ligamentum flavum hypertrophy, in which one or more of the ligaments between the vertebrae have begun to ossify, or thicken, potentially leading to nerve compression.

IDET (intradiscal electrothermal therapy): The insertion of a probe to heat tissues within a degenerating intervertebral disc that is the source of nerve compression causing pain, tingling, numbness or muscle weakness. This causes disc tissue to shrink, thereby alleviating nerve compression. Small nerve fibers on the periphery of the disc are cauterized, which may also account for diminished symptoms.

instability: As related to the spine, this refers to an inability of a portion of the spinal anatomy to perform its intended function. This can be caused by a number of degenerative spine conditions or by traumatic injury.

interbody fusion: Grafting bone in the space where an intervertebral disc used to be, for the purpose of fusing two or more vertebral segments.

intervertebral cage: A type of instrumentation used to promote fusion during surgery.

Intervertebral Disc: A cartilaginous disc between two vertebrae that serves to provide cushioning and absorb impact.

internal disc disruption (IDD): A controversial condition that is believed to cause discogenic pain when the structures of the intervertebral disc deteriorate without necessarily extruding into the spinal column.

ibuprofen: An analgesic in the non-steroidal anti-inflammatory drug class used to treat mild to moderate pain and inflammation.

Currently no terms for the letter "J".

kyphoplasty: Procedure to repair osteoporosis fractures, where glue-like material is injected into a balloon inserted into a collapsed vertebra.

kyphosis: A curve in the spine that points to the back of the body. A hunchback is one example of kyphosis.

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

laminectomy: Surgical procedure removing the shingle-like portions of a vertebra to relieve pressure on the spinal cord and nerve roots (see anatomy section).

laminotomy: Surgical procedure removing a small bony portion of shigle-like elements (lamina) that protect the neural canal to relieve pressure on the nerve roots.

LBP: Low back pain.

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

lumbar: Lower back.

Lumbar Radiculopathy: “Lumbar” refers to the lower region of your back. “Radiculopathy” refers to a set of symptoms usually associated with a compressed spinal nerve – symptoms such as pain, numbness, tingling, and muscle weakness.

Lumbosacral radiculopathy: A broad term referring to a range of symptoms associated with the nerves of the lumbosacral plexus in the lower back.

Ligamentum flavum: Tough bands of tissue that connect the vertebrae, lend stability for good posture and allow for a wide range of back movement, especially flexion; called “flavum” (Latin for yellow) because of their yellow appearance.

Lateral Lumbar Interbody Fusion (LLIF): A type of spinal fusion surgery where the surgeon enters the lower back through the side rather than back. This procedure is designed to be completed through minimally invasive means.

ligaments of the spine: The ligaments of the spine, like ligaments throughout the body, are in place to support the neck and back, and they help stabilize the spinal column. Over the years, however, ligaments can become strained or even calcified, which may lead to painful symptoms.

MD: Medical Doctor.

methylprednisolone: A drug (steroid) that reduces inflammation of the joints and is commonly used to mitigate the damage of a spinal cord injury.

microdiscectomy: A surgical procedure performed with an endoscope; used to remove herniated disc material.

minimally invasive surgery (MIS): Surgery performed through multiple small incisions rather than a large incision.

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

myelitis: Spinal cord inflammation.

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

muscular back pain: Dull, sharp, acute or chronic pain in the muscles of the back. Pain can be caused by injury or a spinal condition such as a herniated disc.

microdecompression: The surgical excision of a small amount of bone or disc material to alleviate nerve compression in the spinal column

muscles of the spine: The muscles in the neck and back are tasked with taking pressure off the spinal cord, protecting the spinal column and supporting the neck and back.

McKenzie method: A world-renowned philosophy based on active patient involvement during the treatment and prevention of neck, back and extremity pain.

muscle spasms: The involuntary contraction of a muscle, which often results in sharp, temporary pain.

muscle cramping: Often known as muscle spasms, cramping refers to the spontaneous and involuntary contraction of a muscle or muscle group that leads to acute pain.

mechanical pain: Acute pain that may result from excessive or abnormal pressure or strain being placed on the muscles and other supporting structures of the spinal canal.

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

neoplasm: An abnormal overgrowth of cells that can eventually produce a mass of tissue such as a tumor or a lump.

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

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

NP: Nurse practitioner. Registered nurse with additional education and training.

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

nucleus pulposus: The gel-like inner nucleus material of an intervertebral disc. It is contained by the annulus fibrosus, which is the cartilaginous outer wall of the disc. A ruptured disc can cause the nucleus pulposus to leak from the disc and compress nearby spinal nerves.

neuropathy: A term used to describe damage to a nerve, which may be caused by disease, injury, degenerative conditions or a variety of other causes. Mild cases of neuropathy may result in traveling symptoms like pain and tingling that follow the path of the damaged nerve. However, severe cases of neuropathy can result in paralysis and muscle atrophy.

neuropathic: A term used to describe pain and other symptoms that are caused by damage to a nerve. Nerve damage can be the result of disease, injury or degeneration due to aging. Neuropathic pain can vary in severity, either remaining localized at the site of nerve damage or spreading throughout the body and affecting any muscles or dermatomes innervated by that nerve.

neck pain: Any type of discomfort in the cervical (upper) region of the spine; the pain may be due to muscular strain, bone fracture, nerve impingement or a wide range of other conditions.

nerve pain: Various forms of pain (sharp, stabbing, throbbing, burning, etc.) that follows the path of a nerve.

neuralgia: Chronic nerve pain that travels along the path of the nerve and may present in a variety of ways, such as sharp, dull, throbbing or burning pain.

neurogenic claudication: A combination of symptoms that typically includes lower back pain, leg pain, leg weakness and numbness; these symptoms may intensify when standing or walking. Neurogenic claudication is a common set of symptoms with spinal stenosis, or a narrowing of nerve passageways in the lumbar (lower) spine.

neck surgery: Any operation performed in the neck area. Neck surgery can be performed for a variety of reasons, but when it relates to the spine, neck procedures are often performed to relieve pain caused by a degenerative spine condition.

nerve root: The beginning portion of a nerve that is branching off the central nervous system.

naproxen: A non-steroidal anti-inflammatory drug used to treat mild to moderate pain.

neurosurgery: A medical specialty dealing with the prevention, diagnosis and treatment of the nervous system, including the brain, spinal cord and peripheral nervous system.

neurosurgeon: A surgeon who specializes in the surgical treatment of conditions affecting the brain, spine and other innervated areas of the body.

neurogenic pain: Pain that develops in the nervous system, including pain resulting from compression of a spinal nerve, which may be felt at the site of the impingement or in other innervated areas of the body.

opioids: Drugs that treat pain by affecting pain perception without treating the underlying cause. These medications affect pain perception only and do not treat the pathologic condition.

osteophytes: Bone spurs.

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

orthosis: Brace.

Osteoarthritis: A disease affecting the load-bearing joints, characterized by the deterioration of articulating cartilage that leads to cartilage and bone loss.

Osteophyte: Commonly referred to as a bone spur, an osteophyte is a smooth growth of bone that the body develops as a natural healing mechanism.

orthopedic(s): A branch of medicine that focuses on the study, diagnosis and treatment of the skeletal system, joints, muscles, ligaments and associated nerves.

orthopedic surgeon: A surgeon who specializes in treatment of conditions involving the musculoskeletal system.

open back surgery: The traditional form of back surgery that is massively invasive, often requiring a large incision, the cutting of muscle, the insertion of implants and/or bone grafts, hospitalization and a lengthy recovery period.

open neck surgery: The traditional form of surgical procedure to treat a spinal condition in the cervical (upper) region.

outpatient: A patient who does not stay in a hospital for 24 hours or more but visits a hospital or medical facility for diagnosis and/or treatment. Related to surgery, outpatient refers to a procedure that does not require the patient to stay in the hospital overnight.

ossification: The natural process of bone formation, also called osteogenesis. Ossification can also refer to the hardening of a soft tissue into a bony substance.

PA: Physician's assistant.

PDR: Physicians' Desk Reference. Guide to drugs available in U.S.

pedicle: Projection of bone from the back of the vertebra that helps form the ring around the spinal canal.

percutaneous: Passage through skin by needle or other object.

percutaneous lumbar discectomy (PLD): The removal of bulging disc material through a large bore needle inserted into the disc space. The disc material is removed using cutting, sucking or laser appliances. Also known as percutaneous microdiscectomy.

percutaneous nucleotomy: The removal of disc material through a large bore needle.

PMMA (polymethyl methacrylate): A synthetic polymer of methyl methacrylate. This transparent thermoplastic was developed in 1928 and is used in a number of different applications, including as a glass substitute for daylight redirection, artistic and aesthetic purposes and also in medical applications.

posterior: A term that is defined as nearer to the end or further back. Derived from the Latin "post," meaning "after," posterior is often used in an anatomical setting to describe things that are situated toward the rear end or toward the back plane of the body.

posterior lumbar interbody fusion (PLIF): A spinal surgical procedure in which a bone graft and/or spinal implant is inserted into the disc space in order to achieve spinal fusion. This fusion provides stabilization, thereby potentially ending painful symptoms resulting from a spinal condition.

PRN (pro re nata): In Latin, means "in the circumstances." As used in a medical field, it means "as needed," as in reference to the dosage of a prescribed medication.

pseudarthrosis: (variation: pseudoarthrosis) Derived from the Greek "pseud," meaning "false," and "arthrosis," meaning "joint." It describes a condition in which a bone has movement at the location of a fracture due to the inadequate healing of the fracture.

PT (Physical Therapist): A trained medical professional who treats people of all ages with medical problems, conditions, illnesses or injuries that limit their capacity for movement and ability to perform activities necessary in their daily lives.

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

Pinched Nerve: A colloquial term for nerve compression, often associated with degenerative conditions such as spinal arthritis and degenerative disc disease. This condition can occur at any level of the spine but is most common in the lumbar (lower back) and cervical (neck) regions. A pinched nerve produces localized pain, radiating pain, tingling, numbness and/or muscle weakness.

Prolapsed Disc: Occurs when the soft jelly-like material that comprises the center of a disc pushes through the fibrous shell and into the spinal column. Also known as a herniated or ruptured disc.

physical therapy: The medical field focused on developing, maintaining and restoring maximum movement and functional ability for an individual whose quality of life and abilities in these areas are threatened by age, injury, disease or environment.

pia mater: The innermost layer of the meninges, which is the system of membranes that surrounds the brain and spinal cord. As a group, the meninges protect the central nervous system by containing cerebrospinal fluid, which cushions the spine.

posterolateral fusion: A form of spinal fusion surgery performed from the back, this procedure is designed to increase spinal stability in patients with degenerative spine conditions.

posture: In a general sense, the habitually assumed or intentionally assumed position of the human body.

posterior longitudinal ligament: A ligament situated in the spinal canal that begins in the axis and culminates in the sacrum. This ligament runs behind the spinal cord and limits flexion in the spine.

pars fracture: Also known as spondylolysis, a pars fracture is an injury to the pars interarticularis in the posterior section of the spinal column. This stress fracture is extremely common in young athletes and is commonly caused by overexertion and repetitive motions.

pars fracture surgery: A surgical procedure used to address a pars fracture or spondylolysis and alleviate chronic pain.

paralysis: Loss of muscle function due to an interruption of sensory and motor signals between the brain and the spinal cord. Paralysis is usually caused by a stroke or nerve damage of some kind.

pregnancy and back pain: Back pain can be common in pregnant women due to the increased amount of weight that is putting pressure on the lumbar spine (lower back). Many pregnant women have also reported feeling pain in their posterior pelvis area, deep in the buttocks and in the backs of the thighs.

physical exam: A means for evaluating exterior abnormalities and other symptoms that may indicate whether a patient has a certain medical condition.

Currently no terms for the letter "Q".

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

RCT (randomized clinical trial): A study to evaluate the safety and effectiveness of a medication or medical device by monitoring the effects on a large group of people. In this type of trial, the subjects are assigned by chance to the different treatments, or to a placebo.

RN (Registered Nurse): A health care professional responsible for assisting with the recovery and care of sick patients and maintaining their health.

ROM (range of motion): Refers to the direction and distance that a joint can move to its full potential. Expressed in degrees, the range of motion can vary from one specific joint to another.

Rheumatoid Arthritis: Rheumatoid arthritis is a chronic disease of certain joints in the body, with the potential to cause inflammation elsewhere in the body.

Ruptured Disc: Also known as a herniated disc, prolapsed disc or the misleading “slipped” disc, a ruptured disc is a deteriorated intervertebral disc in the spine.

resorption (as in disc resorption): The process by which the body naturally re-absorbs inner disc material that has extruded through a tear in the outer disc wall – a herniated disc. The immune system releases white blood cells to break down and absorb the gel-like inner disc material, allowing the disc wall to heal.

recovery time after surgery: The period of time after an operation necessary for the full healing process to take place and for the patient to regain strength and resume a normal lifestyle.

risk factors: Variables associated with an increased risk of developing a certain medical condition.

sacrum: The triangular-shaped bone made up of five fused vertebrae near the very end of the spine.

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

scoliosis: Abnormal sideways curvature of the spine, affecting about 20 million Americans. The most common type, idiopathic, occurs most frequently in adolescent girls, and its origin is unknown.

SI (Sacroiliac): A pair of joints within the pelvis between the sacrum and the ilium bones.

SPECT scan: A Single Photon Emission Computerized Tomography (SPECT) scan is a nuclear imaging test that allows a technician or physician to analyze the function of internal organs.

spina bifida occulta: One of the mildest forms of spina bifida, in which the outer parts of some vertebrae are not completely closed; no spinal cord protrusion is present because the split in the vertebra is relatively small. Known as occulta (Latin for “hidden”) because no opening of the skin is evident, and the condition typically is asymptomatic.

spinal cord stimulation (SCS): A method of treatment in which a surgically implanted pulse generator sends electrical current through the spine in order to interfere with nerve impulses that cause chronic pain.

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

spondylolisthesis, degenerative: Slippage of one vertebra over another as a result of an age-related degenerative condition, such as osteoarthritis or degenerative disc disease.

spondylolisthesis, isthmic: Slippage of one vertebra over another as a result of spinal fracture; could be related to traumatic injury or a result of repetitive stress.

spondylolysis: A fracture (crack) in the pars interarticularis, a portion of bone where the vertebral body and the posterior elements protecting the nerve roots are joined. It appears most frequently in adolescent athletes, particularly in participants in sports that require repeated hyperextension of the lower back, such as rowing and gymnastics.

Sx: Symptoms: Medical shorthand for “symptoms.”

Slipped Disc: A slipped or herniated disc occurs when the tough, fibrous outer wall of an intervertebral disc tears and allows the disc’s nucleus material to extrude into the spinal canal.

Spondylolisthesis: The slippage of a vertebra forward over another vertebra

Stenosis: Occurs when one of the neural passageways associated with the spine – especially the spinal canal and the foramina – become constricted because of an anatomical abnormality.

spinal narrowing: A reduction in the size of the spinal canal, resulting in less space available for the spinal cord and associated nerve roots; also known as spinal stenosis.

spinal injections: Direct injections of anesthetic and steroidal medications into or near spinal nerve roots, or the epidural space surrounding the spinal cord. Spinal injections are typically suggested to treat moderate to severe neck and back pain and to reduce inflammation.

selective nerve root block: A type of spinal injection during which numbing anesthetic and anti-inflammatory steroidal medications are injected into or near a pinched spinal nerve root.

spinal arthritis: Occurs when the protective cartilage lining of the facet joints in the spine wears down over time, which can cause pain and other symptoms.

spinal canal: The passageway, encased by vertebrae, through which the spinal cord passes.

spinal column: The column of vertebrae, intervertebral discs, ligaments, tendons, joints, fluid, nerves and other tissue that runs down the center of the back and serves as skeletal support for the upper body while protecting the spinal cord.

spinal cord: A tubular bundle of nerve fibers that runs from the base of the skull to the lower back and is responsible for transmitting sensory and motor signals between the body’s extremities and the brain. Along with the brain, it is a part of the central nervous system.

spinal instrumentation: The rods, plates, screws, hooks, braided cable, mesh cages and other metal or plastic implants that stabilize vertebral segments during spinal fusion and/or disc replacement surgery.

spondylitis: A degenerative disease that produces inflammation of the joints between the vertebrae, as well as the joints between the spine and the pelvis; also known as ankylosing spondylitis.

spondylosis: A general term used to refer to age-related degeneration of the anatomical components of the spine; commonly used interchangeably with the term spinal arthritis.

stretching: The act of extending the muscles of the legs, neck, back, shoulders and arms in preparation for exercise; also used to combat neck and back pain by improving flexibility of muscles and ligaments, reducing stress on joints and improving blood flow.

sprains and back pain: Sprains can occur in the spine when a spinal ligament is stretched beyond its normal capacity or torn. A sprain should not be confused with a strain, which affects muscles and tendons.

stress and back pain: Stress and back pain often go hand in hand. Stress can affect a person’s circulation, muscle tenseness, hormone levels and much more, any or all of which can play a role in neck or back pain.

sports injuries: Sports injuries occur when an individual is participating in sports or any type of athletic activity. Sports injuries can happen suddenly or they may develop over time due to prolonged overexertion.

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

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

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

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

trigger point injections: Injection of local numbing agent (with or without corticosteroid) into soft tissues (i.e., muscles or ligaments) along the spine or over the back of the pelvis. Generally used for pain control.

Tx: Treatment.

torn disc: A rupture in the tough exterior of an intervertebral disc, called the annulus fibrosus. This condition can occur as a result of the natural aging process; intervertebral discs tend to dry out and lose flexibility over time, making them more prone to deterioration. Sudden impact from athletic injuries, car accidents and other forms of trauma also can cause a disc to tear.

tai chi: A system of exercise based on the ancient Chinese martial art Tai Chi Quan; emphasizes slow, controlled movements to improve balance, coordination, strength, flexibility and stamina.

thinning disc: The loss of height within an intervertebral disc; typically associated with diminished water content within the nucleus pulposus and is a natural byproduct of the aging process or a sign of degenerative disc disease.

traditional back surgery: Highly invasive surgical procedure designed to address spinal abnormalities by permanently fusing one or more vertebral segments together; generally accomplished by implanting metal or plastic stabilizing implants and, in some cases, bone grafts. Can be performed from the front (anterior), the back (posterior) or the side (posterolateral).

Transforaminal Lumbar Interbody Fusion (TLIF): A traditional open back surgery used to alleviate the symptoms produced by a compressed nerve within the lumbar (lower back) region of the spine; involves the replacement of a diseased or damaged intervertebral disc with bone graft.

unremitting low back pain: Another term for chronic low back pain. To be classified as unremitting low back pain, symptoms must persist for more than three months and have been unresponsive to primary care treatment recommendations.

vertebrae: Bones that makes up the spine. (Vertebra is the singular form of vertebrae.)

vertebroplasty: Procedure to repair fractures related to osteoporosis, where glue-like cement material is injected into a collapsed vertebra.

vertebra: A bone that makes up the spine. (Vertebrae is the plural form of vertebra.)

vertebral subluxation: Significant misalignment or displacement of one or more vertebrae in the spine. Subluxation can result in painful nerve compression in the spinal column and lead to chronic back and neck pain without treatment.

whiplash: Commonly referred to as "neck sprain or strain" although symptoms may have other causes. Common in car accidents.

water walking: A low-impact walking exercise designed to use water’s increased resistance as a tool. Water walking allows for the strengthening and building of muscle tissue without added stress on the joints of the body, including the knees, hips, and spine.

X-ray: A diagnostic tool that uses electromagnetic radiation (light waves) to view dense structures inside of the body, including bones, muscles and ligaments.

yoga: A form of exercise that involves stretching various parts of the body and holding a variety of poses in order to strengthen specific muscle groups.

Z-joint (Zygapophysial joint): Zygapophysial zoint. See also facet joints.

Zygapophysial joint injections: Injections of steroids and numbing agents into a facet joint to determine if it is a source of pain or to reduce pain and inflammation.

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