USC Neurosurgery

FACET - a flat, platelike 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.

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).

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GRISEL SYNDROME - Subluxation of the atlantoaxial joint from inflammatory ligamentous laxity due to infection. Can result in neurologic complications.

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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.

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

HEMIPLEGIA - Paralysis of one side of the body.

HERNIATED INTERVERTBRAL DISC (HID) - Extrusion of part of the nucleus pulposus material through a defect in the annulus fibrosus. Otpouching 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.

HYDROXYAPATITE (HA) - The lattice-like structure of bone composed of calcium and phosphorous crystals which deposits on collagen to provide the rigid structure of bone.

HYPER - Excessive, above normal.

HYPERACUSIS - Abnormal acuteness of hearing or auditory sensation.

HYPERESTHESIA - Excessive sensibility to touch, pain or other stimuli.

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.

HYPERTENSION - High blood pressure.

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 which controls the anterior and posterior pituitary secretions, and is involved in other basic regulatory functions such as temperature control and attention.

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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.

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

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.

INTERVERTEBRAL DISC - See Disc (Intervertebral).

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

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.

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.

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KANEDA - An anteriorly placed fixation device for spinal deformities.

KINETIC - Relating to motion or movement.

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

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

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

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

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

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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.

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 laproscope. 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.

LEEDS - For scoliosis, segmental wiring of a contoured square-ended Harrington rod.

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

LEPTOMENINGITIS - Inflammation of the membranes covering the brain and spinal cord.

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.

LOCALIO - For sacral tumor; a method for partial excision of the scarum.

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

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 Not a disease state, but the normal anterior concavity of the neck or low back.

LOUGHHEED and WHITE - For drainage of lower abdominal abscess; coccygectomy and drainage from space anterior to sacrum.

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

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

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

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

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

LUMBAR KYPHOSIS - Reverse of the normal curve of the 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 of the fifth lumbar vertebra and the top of the sacrum.

LUQUE INSTRUMENTATION -A posterior method of fixation.

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

LUXATION - Dislocation.

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SACCULAR ANEURYSM - A balloon-like outpouching 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.

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

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

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

SACROILITIS - 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.

SCHMORL NODES - Developmental change resulting in inferior or superior extension of the intervertebral disc into the vertebral bodies.

SCHOLLNER COSTOPLASTY - For rib deformity or scoliosis; multiple rib partial excisions.

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

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.

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

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.

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.

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 defect of the spine marked by the absence of a portion of the spine.

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

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

SPINAL COLUMN - See Spine.

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

SPINAL DISC - See Disc (Intervertebral).

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

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

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 most posterior extension of the spine arising from the laminae.

SPONDYLALGIA - Pain in vertebra(e).

SPONDYLARTHRITIS - Arthritis of the spine.

SPONDYLARTHROCACE - Tuberculosis of the spine; spondylocace.

SPONDYLEXARTHROSIS - Dislocation of a vertebra.

SPONDYLITIS - Inflammation of vertebrae, including types such as ankylosing, rheumatoid, traumatic, spondylitis deformans, Kümmel, 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.

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

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

SPONDYLOMALACIA - Softening of vertebrae; Kümmell disease.

SPONDYLOPATHY - Any vertebral disorder.

SPONDYLOPYOSIS - Infection in vertebra(e).

SPONDYLOSCHISIS - Congenital fissure (splitting) of vertebral arch.

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

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

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.

STERILITY - In general, the incapability of fertilization or reproduction.

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

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

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

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

STRAIN - To injure by overuse or improper use.

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.

SUBDURAL HEMATOMA - a collection of blood (clot) trapped under the dura matter, the outermost membrane surrounding the brain and spinal cord.

SUBLUXATION - An incomplete luxation or dislocation; though a relationship is altered, contact between joint surfaces remains.

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

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

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

SYRINGOMYELIA - A fluid filled cavity in the spinal cord. Usually involving upper segments initially and involving the shoulder muscles.

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

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

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

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

THROMBUS - A blood clot attached to the wall of an artery.

THALAMUS - Brain cells which lie in the upper part of the brainstem.

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.

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

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

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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. The plural of vertebra is vertebrae.

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

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WEDGING - Deformity of vertebral body, caused by trauma or gradual collapse, resulting in wedgeshaped 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.

WHITECLIUD and LAROCCA - Anterior technique for cervical spine fusion using fibular graft.

WILTSE - A bilateral lateral spine fusion for spondylolisthesis.

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.

WISCONSIN (DRUMMOND) INTERSPINOUS SEGMENTAL SPINAL - Series of wires, rods, and buttons for multisegmental spine stabilization.

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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.

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ZIELKE INSTRUMENTATION - A method of fixation.

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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 which 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.

MAGNETIC RESONANCE IMAGING (MRI) - Diagnostic test that produces three-dimensional images of body structures using powerful magnets and computer technology rather than x-rays.

MALIGNANT - resistant to treatment; occurring in severe form, and frequently fatal; tending to become worse and leading to an ingravescent course.

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

MARIE-STRÜMPELL d - Inflammation of the spine, occurring as a rheumatoid-tyoe disease in children.

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

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

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

MEDIAL - Situated closer to the midline of the body.

MEDICAL DEVICE REPORT (MDR) - The required reporting of' medical device complaints involving a patient death, serious injury, or device malfunction.

MENINGES - The three membranes covering the spinal cord and brain termed dura mater, arachnoid mater and pia mater.

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.

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.

MORBIDITY the frequency of the appearance of complications following a surgical procedure or the other treatment.

MRA - Magnetic Resonance Angiography. A non-invasive study which 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.

MRI - Magnetic Resonance Imaging - Scanning technique for views of the brain or spinal cord. No radiation is involved, but rather pulsed magnetic waves are used to delineate the structures within the brain.

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.

MUSCULATURE - The arrangement of the muscles in a part or in the body as a whole.

MUSCULOSKELETAL INJURIES - injuries affecting the muscles.

MYALGIA - Muscular pain.

MYELALGIA - Pain in the spinal cord.

MYELANALOSIS - Wasting of spinal marrow, tabes dorsalis.

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

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

MYELATELIA - Imperfect development of the spinal cord.

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

MYELAUXE - Abnormal increase in size of spinal cord.

MYELETEROSIS - Abnormal alteration of the spinal cord.

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

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.

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

MYELOGRAPHY - Radiography of the spinal cord and nerve roots after the injection of a contrast medium into the spinal subarachnoid space.

MYELOMALACIA - Softening of the spinal cord.

MYELOMENINGITIS - Inflammation of the spinal cord and meninges (spinal membranes).

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

MYELONEURITIS - Inflammation of the spinal cord and peripheral nerves.

MYELOPARALYSIS - Spinal paralysis.

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

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

MYELOPLEGIA - Spinal paralysis.

MYELORADICULITIS - Inflammation of spinal cord and nerve roots.

MYELORADICULOPATHY - Disease of spinal cord and spinal nerve roots.

MYELORRHAGIA - Spinal hemorrhage.

MYELOSCELEROSIS - Hardening of the spinal cord.

MYELOSYPHILIS - Syphilis of the spinal cord.

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

MYOPATHY - Any disease of muscle.

MYOSITIS - Inflammation of the muscle.

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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.

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

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

NEUROFIBROMA - Fibrous tumor of a nerve, which may affect a nerve root and thus give the appearance of herniated disc disease.

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

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 of a severe, throbbing, or stabbing character in the course or distribution of a nerve.

NEURECTOMY - Excision of part of a nerve.

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

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

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

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

NEUROHYPOPHYSIS - The posterior lobe of the pituitary gland.

NEUROLYSIS - Removal of scar or reactive tissue from a nerve or nerve root.

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.

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

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

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

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

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

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

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

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

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OCCIPITAL NERVE - Nerve from the back of the neck that supplies motor function and sensation to the forehead; two parts- greater and lesser.

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

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.

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.

ORTHOPAEDIC IMPLANTS - Medical devices used to replace or provide fixation of bone or to replace articulating surfaces of a joint.

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

OSTEOINDUCTIVE - A material with the ability to induce bone to grow

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.

OSTEOMA - A benign tumor of bone.

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

OSTEOPHYTE - A bony outgrowth or protuberance.

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

OTHER NERVES (twelfth cranial) - Transcervical, supraclavicular, posterior rami, facial, greater auricular, and hypoglossal.

OVERTON - A dowel graft that is applied across facet joints.

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PARAPLEGIA - Paralysis of the lower part of the body including the legs.

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.

PHYSICAL - Relating to the body, as distinguished from the mind.

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

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

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.

PLEXITIS - Inflammation of the plexus.

PLEXUS - A network or interjoining of nerves and blood vessels or of lymphatic vessels.

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

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

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

POSTERIOR 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.

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.

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QUADRIPLEGIA - Paralysis of all four limbs.

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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.

RACHIOPLEGIA - Spinal paralysis.

RACHIOSCOLIOSIS - Lateral curvature of the spine.

RACHIOTOMY - Incision into a vertebral canal for exploration.

RACHISAGRA - Pain or gout in the spine.

RACHISCHISIS - Abnormal congenital opening of the vertebral column.

RACHITOMY - Surgical or anatomic opening of the vertebral canal.

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

RADICULOPATHY - Disease of the nerve roots in or near the spinal canal as a result of direct pressure from a

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

RHEUMATOID ARTHRITIS - generalized inflammatory joint disease.

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.

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.

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.

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AEBI, ETTER, AND COSICA - Anterior approach to inferior C-2 to fractured dens with screws.

ALAR DYSGENESIS - Abnormality in development of the sacroiliac joint.

ALLOGRAFT BONE - Sterile bone derived from another human which is used for grafting procedures.

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.

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; Hodgson, Roaf. For specific cervical spinal explorations and fusions; Southwick and Robinson, Bailey and Badgley, Whitesides and kelly, Henry (to vertebral artery).

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

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

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

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

ANTERIOR SPINAL FUSION - Approaching the spine from the front, the 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.

ANTEROLATERAL - Situated or occurring in front of and to the side.

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.

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.

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.

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 - Joint pain.

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 as a result 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 it's 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.

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.

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

AUTOGENOUS BONE - Bone originating from the same individual; i.e., an individual's own bone.

AUTOGRAFT BONE - Bone transplanted from one part to another part of the body in the same individual.

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.

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BACKBONE - See Spine.

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

BMP-LIKE PRODUCTS - proteins that enhance mineralization, which can increase bone formation.

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

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- naturally occurring chemicals in the body- that 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 which is affixed to bone via screws. Bone plates are used to immobilize bones or bone fragments such that healing can occur.

BONE SCREW - A threaded metal device which is 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.

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

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.

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CADAVER - A term generally applied to a dead human body preserved for anatomical study.

CANCELLOUS BONE - The spongy or honeycomb structure of some bone tissue typically found at the ends of long bones.

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

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

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

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

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

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

CERVICAL - Of or relating to the neck.

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

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

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

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

COCCYALGIA - Pain in the coccyx region5 coccygodynia, coccyodynia, coccydynia.

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

COCCYGECTOMY - Excision of the coccyx (tailbone).

COCCYGOTOMY - Incision into the coccyx (tailbone).

COCCYX - The small bone at the end of the spinal column 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.

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.

CONGENITAL SCOLIOSIS - Scoliosis due to bony abnormalities present at birth involving either failure of formation of a vertebra or separation of adjacent vertebrae.

CORDOTOMY - Transverse incision into the spinal cord.

CORPECTOMY - Excision of vertebral body usually combined with interpostion of prosthesis or bone graft.

CORTICAL BONE - The dense bone that forms the outer surface of bone.

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 breast bone.

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

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

COTREL-DUBOUSSET - Posterior fixation device for spinal deformity, fracture, tumor, and degenerative conditions.

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

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

DEGENERATIVE - The lesion results from intersegmental instability of long duration.

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

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

DE-MINERALIZED BONE - Bone tissue which has been depleted of its minerals; e.g., calcium and phosphorous.

DEMINERALIZED BONE MATRIX (DMB) - is 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.

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

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.

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 - Nonbacterial inflammation of an intervertebral disc or disc space.

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

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

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

DURA - Dura mater.

DYSESTHESIA - A condition in which a disagreeable sensation is produced by ordinary touch, temperature or movement.

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 affl iction occurring especially in children, marked by muscular contractions producing distortions of the spin and hips.

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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.

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