Reference

Ankylosis, or Anchylosis is a stiffness of a joint due to abnormal adhesion and rigidity of the bones of the joint, which may be the result of injury or disease. Once a complete ankylosis has developed, there is no more motion across that spinal level. The most common cause of ankylosis in the spine is aging (seen across most levels of the spine in all elderly people), although ankylosis can also occur in younger people after trauma, infection or other destructive/degenerative problem.

The annulus fibrosus is the outer wall of an intervertebral disc. This disc wall is composed of collagen and fibrocartilage. The outer disc wall is actually made up of numerous layers of organic material which crisscross each other at angles for structural strength. The outer disc wall is very strong, but still maintains natural flexibility.

Ligaments are fibrous bands or sheets of connective tissue linking two or more bones, cartilages, or structures together. One or more ligaments provide stability to a joint during rest and movement. Excessive movements such as hyper–extension or hyper–flexion, may be restricted by ligaments.

An arthrosis is a joint, an area where two bones are attached for the purpose of motion of body parts. An arthrosis (joint) is usually formed of fibrous connective tissue and cartilage. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion. A variety of causes—hereditary, developmental, metabolic, and mechanical—may initiate processes leading to loss of cartilage.

This is the upper most vertebra of the spinal column (also labeled C1). The atlas is located just beneath the skull at the top of the cervical spine. The bone has an unusual ring-like appearance, it has a set of joints with the skull and with the next vertebra beneath it, the axis (also labeled C2).

This is the upper most vertebra of the spinal column (also labeled C1). The atlas is located just beneath the skull at the top of the cervical spine. The bone has an unusual ring-like appearance, it has a set of joints with the skull and with the next vertebra beneath it, the axis (also labeled C2).

Bone grafting is a surgical procedure that replaces missing bone with material from the patient's own body, an artificial, synthetic, or natural substitute. Bone grafting is used to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly. The new bone is held in place with pins, plates, or screws. Stitches are used to close the wound. A splint or cast is usually used to prevent injury or movement while healing.

This refers to branches of nerves which originate from the spinal cord in the neck area and extend toward the arms. Brachial plexus reconstruction may be necessary for patients who are experiencing arm paralysis, pain or numbness as a result of damage to nerves in the shoulder. At the Institute for advanced reconstruction, our surgeons are adept at a number of different methods of brachial plexus reconstruction.

This refers to an implantable device used for stabilizing and creating spinal fusion between levels of the spine. Some cages are metal (stainless steel, titanium) and some are made of synthetic materials such as carbon fiber. Many cages are designed such that they can be filled with bone to encourage spinal fusion.

This is the upper most part of the spinal column and includes all vertebrae of the neck. The cervical spine begins at the base of the skull. Seven vertebrae make up the cervical spine with eight pairs of cervical nerves. The individual cervical vertebrae are abbreviated C1, C2, C3, C4, C5, C6 and C7. The cervical nerves are also abbreviated; C1 through C8.

Delayed union fracture refers to a bone fracture that is taking an exceptionally long amount of time to heal. When a spinal fusion is performed during a surgical procedure, the goal is to establish a solid bone union. A delayed union refers to slower than expected healing between levels of the spine.

This bone structure is part of the second spinal vertebra (C2), the axis. The dens is like a small bone peg that protrudes upward from C2 into the ring-like structure of C1. Due to the dens there is good stability and yet motion possible between the upper two cervical vertebrae. The dens is vulnerable to injury with trauma and is frequently involved in advanced rheumatoid arthritis.

The intervertebral disc is a soft tissue structure that sits between vertebrae of the spine. A disc is present at each level of the spine from the second cervical vertebra (the axis, or C2) down to the sacrum (just below L5, the last lumbar vertebra). The disc consists of a gelatinous center, called the nucleus pulpous, and a thick fibrous outer network, called the annulus fibrosus. The healthy disc provides a shock absorbing quality, permits motion between the vertebrae of the spine and ensures controlled motion so that no injury occurs.

The dura mater, or dura, is the outermost of the three layers of the meninges surrounding the brain and spinal cord. The brain, the spinal cord and a portion of the nerve roots that exit the spinal canal are covered by layers of tissue. The outermost layer is called the dura, it is quite thin and forms a sheath which is quite impermeable. The brain, spinal cord and nerve roots are bathed in a fluid called Cerebrospinal fluid (CSF) contained within the dura.

Facets are flat faces on geometric shapes. The vertebrae in the spinal column are connected to one another in the front of the column by the discs and ligaments. In the back portion (posterior) of the column the vertebrae move in respect to one another through a set of small joints which are called the facet joints.

Facet joints occur in pairs at the back of each vertebra. The facet joints link the vertebrae directly above and below to form a working unit that permits movement of the spine. The structure of the facet joint is identical to other joints in the body, such as knees and hips.

Failed back syndrome (FBS), also called "failed back surgery syndrome" (FBSS), refers to chronic back and/or leg pain that occurs after back (spinal) surgery. There are numerous possible causes of poor outcome and a thorough evaluation is necessary to define the cause of persistent pain or disability.

The Flatback Syndrome is a condition related to poor sagittal plane alignment. In the vast majority of cases this is due to previous spinal fusion, particularly for scoliosis. Common symptoms of Flatback include a feeling of leaning forwards, fatigue in the lower back, difficulty walking on uneven ground and progressive pain. In some cases permanent hip and knee flexion are necessary to maintain balance and level vision.

This term means a tunnel or opening in a tissue or structure. In the spinal canal, the foramen refers to the tunnel leading out of the canal through which the nerves pass on their way to other organs or the arms/legs. The sides of the vertebral formen are mostly solid bone although the facet joint sits along a portion of the foramen. With facet arthritis the facet joints can thicken and slowly encroach upon the space of the vertebral foramen.

Frontal Plane any of the vertical planes passing through the body from the head to the feet, perpendicular to the sagittal planes; the plane parallel to the long axis of the body and at right angles to the median sagittal plane, dividing the body into front and back portions. Also called coronal plane. Compare median plane, sagittal plane, transverse plane. See also frontal section. The term frontal plane therefore refers to the aspect from which one notices changes in position, displacement or deformity. For example, if a patient has a scoliosis with a curve swayed to the side then one could say that the spine is curved when seen from the frontal plane.

In spinal surgery there is sometimes the need to attach a metal rod to the spine in order to provide stability or correction of a deformity. Numerous devices and techniques have been developed to connect something directly to the spinal column (hooks, wires, cables, screws?. Special metal hooks are one of several types of connections to the spine commonly used in scoliosis correction.

The iliolumbar ligaments are very important and very strong ligaments connecting the lower lumbar vertebrae to the crest of the iliac bone. They run, posteriorly and laterally, from the transverse processes of the fourth and fifth lumbar vertebrae to the ilium. In the healthy spine the ligaments provide excellent stability to the last lumbar vertebra (L5) and explains why many degenerative conditions tend to cause more problems at the L4-L5 than at the L5-S1 level.

The ilium is the uppermost and largest bone of the pelvis, and appears in most vertebrates including mammals and birds, but not bony fish. All reptiles have an ilium except snakes, although some snake species have a tiny bone which is considered to be an ilium. This large bone provides muscular attachements to the pelvis, supports the trunk through a connection with the sacrum and is linked to the hips and legs. Due to the size and location of the ilium, it is a common source of taking bone graft, either in the front or the back.

Between the spinous processes in the posterior (back part) spinal column there are a number of ligaments (fibrous bands) that provide support and controlled motion between the vertebrae. The interspinous ligaments run between the spinous processes from level to level, they are rarely injured.

The intervertebral discs make up one fourth of the spinal column's length. There are no discs between the Atlas (C1), Axis (C2), and Coccyx. Discs are not vascular and therefore depend on the end plates to diffuse needed nutrients. The cartilaginous layers of the end plates anchor the discs in place.

Kyphoplasty is a newer treatment for patients immobilized by the painful vertebral body compression fractures associated with osteoporosis. Like vertebroplasty, kyphoplasty is a minimally invasive procedure that can alleviate up to 90% of the pain caused by compression fractures. In addition to relieving pain, kyphoplasty can also stabilize the fracture, restore height, and reduce deformity.

Kyphosis is a progressive spinal disorder that can affect children or adults. This disorder may cause a deformity described as humpback or hunchback. Kyphosis can be in the form of hyperkyphosis or sharp angular gibbus deformity (see 'Gibbus Deformity' below). Abnormal kyphotic curves are more commonly found in the thoracic or thoracolumbar spine, although they can be cervical.

This refers to the edges of the spinal canal which is housed inside the spinal column. Although the spinal cord and nerve roots run inside the spinal canal, the lateral recess is that portion where the nerves run as they begin to exit the spinal canal (through the foramen). This lateral recess can become narrowed or obstructed by a herniated disc and lead to nerve irritation or compression.

Between the spinous processes in the posterior (back part) spinal column there are a number of ligaments (fibrous bands) that provide support and controlled motion between the vertebrae. The interspinous ligaments run between the spinous processes from level to level, they are rarely injured.

Lordosis is defined as an excessive inward curve of the spine. It differs from the spine's normal curves at the cervical, thoracic, and lumbar regions, which are, to a degree, either kyphotic (near the neck) or lordotic (closer to the low back). The spine's natural curves position the head over the pelvis and work as shock absorbers to distribute mechanical stress during movement.

The lumbar region is sometimes referred to as the lower spine. This refers to the lowest portion of the spinal column (in the area of the lower back). There are 5 lumbar vertebrae in the normal spine, numbered L1 to L5. The lowest vertebra is L5 and it sits just above the sacrum that is part of the pelvis.

A nerve provides a common pathway for the electrochemical nerve impulses that are transmitted along each of the axons. Nerves are found only in the peripheral nervous system. In the central nervous system, the analogous structures are known as tracts.[1][2] Neurons are sometimes called nerve cells, though this term is potentially misleading since many neurons do not form nerves, and nerves also include non-neuronal Schwann cells that coat the axons in myelin.

The portion of a nerve as it forms just off the spinal cord is called the nerve root. In cases of spinal stenosis or disc herniation, it is most commonly the nerve root which is irritated or compressed. A block that is performed to determine if a specific spinal nerve root is the source of pain and reduce inflammation around the nerve root thus decreasing or relieving the pain.

A nonunion occurs when a broken bone does not heal. Bones have a tremendous capacity for healing themselves, and with proper treatment, most all fractures will heal without complication. However, some fractured bones have difficulty healing. When a bone is slow to heal, we call this a "delayed union." When a bone does not heal, we call this a "nonunion."

Nucleus pulposus is the jelly-like substance in the middle of the spinal disc. It is the remnant of the notochord. It functions to distribute hydraulic pressure in all directions within each disc under compressive loads. The nucleus pulposus consists of chondrocytes, collagen fibrils, and proteoglycan aggrecans that have hyaluronic long chains which attract water. Attached to each hyaluronic chain are side chains of chondroitin sulfate and keratan sulfate.

This is a bone structure in the upper cervical spine, also called the dens. The odontoid is part of the C2 vertebra. A small, toothlike, upward projection from the second vertebra of the neck around which the first vertebra rotates.

Osteotomy is a surgical procedure that involves bone-cutting. The surgeon removes a wedge of bone located near the damaged joint. The procedure is supposed to cause a shift of weight from the area where there is cartilage damage to an area where there is more normal or healthy cartilage. Another reason for an osteotomy may be to remove a block of bone that obstructs the spinal canal or requires removal for clearer visualization of nerves or other structures around the spine.

The pedicle is a dense stem-like structure that projects from the posterior of a vertebra. The vertebrae of the spinal column are complex bone structures. The pedicles are part of the vertebra that bridges the front and the back of each of vertebra. It is a bone extension from the vertebral body (front portion) to the laminae, facets, and spinous processes which are posterior (in the back portion). There is one pedicle one each side of a vertebra (right and left). When spinal instrumentation is placed in the spine, pedicle screws are occasionally used.

Today's standard is a polyaxial pedicle screw made of Titanium, which is highly resistant to corrosion and fatigue, and is MRI compatible. The screw is threaded and the head is mobile - it swivels helping to defray vertebral stress. Like other screws, polyaxial screws come in many sizes. Polyaxial pedicle screw length ranges from 30mm to 60mm (up to 2-1/2 inches). The diameter ranges from 5.0mm to 8.5mm (up to 1/4 inch).

The connection between the legs (hips) and the lower spine is through the large bone structures that grouped together are called the pelvis. The bones that make up the pelvis include the ilium, pubis, ischium and through the ilium they are attached to the sacrum. The hip joints are part of the pelvis and the lumbosacral junction refers to the connection between L5 (last lumbar vertebra) and S1 (upper most part of the sacrum).

A pinched nerve occurs when too much pressure is applied to a nerve by surrounding tissues — such as bones, cartilage, muscles or tendons. This pressure disrupts the nerve's function, causing pain, tingling, numbness or weakness.

This is a term which refers to the balance, in a standing person, of the head being centered above the pelvis when seen from the front (frontal plane) and from the side (sagittal plane). In a simple way the plumb line is a string which has a weight on the end. When one holds the upper part of the string against an xray of a standing person in the middle of the cervical spine then the free end of the string (with the weight attached) should be hanging straight down and pass directly through the center of the pelvis and sacrum on the xray.

The posterior longitudinal ligament is situated within the vertebral canal, and extends along the posterior surfaces of the bodies of the vertebræ, from the body of the axis, where it is continuous with the membrana tectoria, to the sacrum. It sits just behind the vertebral bodies (and discs) of the spinal column and provides stability and limits motion between vertebrae.

A spinal fusion procedure has as a goal to obtain a solid bone bridge between two or more levels of the spine. It may take months and sometimes over a year to obtain a solid fusion. When this does not occur, and bone never completely grows across an area of intended spinal fusion, then one calls this a "non-union" or pseudarthrosis

Radiculopathy is not a specific condition, but rather a description of a problem in which one or more nerves are affected and do not work properly (a neuropathy). The emphasis is on the nerve root (Radix = "root"). This can result in pain (radicular pain), weakness, numbness, or difficulty controlling specific muscles.

When surgery has not lead to the desired results or many years after an operation a new problem develops that requires another surgery in the same area, one calls this revision surgery. Revision surgery is often a complex undertaking though, and should only be considered after a thorough review of all treatment options.

The lowest portion of the spine (L5, lumbar vertebra) attaches to the pelvis through the sacrum. The sacrum is a bone which houses some of the lowest spinal nerves, it is rarely injured and rarely is a cause of nerve related troubles. Instrumentation is sometimes placed into the sacrum to offer solid anchorage/fixation to the spine in the setting of spinal fusion.

Alignment Technique uses one of the most sophisticated procedures you will ever learn that is applied without even actually touching the spine. This process removes blocks in the nervous system and the bones go in. Alignment Technique uses triggers in the spine and neck for a perfect spinal alignment. It avoids forceful osseous manipulation completely, and instead relies in gentle and safe contact points.

Spinal stenosis is a narrowing of the spinal canal, which places pressure on the spinal cord. If the stenosis is located on the lower part of the spinal cord it is called lumbar spinal stenosis. Stenosis in the upper part of the spinal cord is called cervical spinal stenosis.

Spinal Cord Injury (SCI) is damage to the spinal cord that results in a loss of function such as mobility or feeling. Frequent causes of damage are trauma (car accident, gunshot, falls, etc.) or disease (polio, spina bifida, Friedreich's Ataxia, etc.). SCI is very different from back injuries such as ruptured disks, spinal stenosis or pinched nerves.

The incidence and etiology of postoperative (iatrogenic) spinal cord injury varies with the type of surgery. With neurosurgical removal of intramedullary tumors the lesion typically involves direct mechanical damage to long tract axons. In contrast, after resection of thoraco-abdominal aortic aneurysms there is a high incidence of ischemic spinal cord injury, caused by temporary cross-clamping or permanent interruption of spinal cord blood supply.

Spinal fusion is a surgical procedure used to correct problems with the small bones of the spine (vertebrae). It is essentially a "welding" process. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone.

Spinal instrumentation utilizes surgical procedures to implant titanium, titanium-alloy, stainless steel, or non-metallic devices into the spine. Instrumentation provides a permanent solution to spinal instability. Medical implants are specially designed and come in many shapes and sizes. Typically these include rods, hooks, braided cable, plates, screws, and interbody cages. Spinal instrumentation is a method of keeping the spine rigid after spinal fusion surgery by surgically attaching hooks, rods, and wire to the spine in a way that redistributes the stresses on the bones and keeps them in proper alignment while the bones of the spine fuse.

The spinous process of a vertebra is directed backward and downward from the junction of the laminae (in humans), and serves for the attachment of muscles and ligaments. In animals without an erect stance, the process points upward and may slant forward or backward. Spinous processes are exaggerated in some animals, such as the extinct Dimetrodon and Spinosaurus, where they form a sail- or finback.

A stinger (technically referred to as a sting) is a colloquial term for a sharp organ or body part found in various animals (typically arthropods) that usually delivers some kind of venom (usually piercing the skin of another animal). This is a term commonly used by athletes and trainers to describe pain experience with vigorous sports activity. A stinger describes a burning and sudden pain, most commonly in the neck area related to a muscle strain.

A sublaminar wire for connecting a spinal column corrective device to a spinal column has first and second end portions. A flat center portion extendable under the lamina of a vertebra of the spinal column has a larger cross-sectional area than each of the cross-sectional areas of the first and second end portions.

The Spinal Column is also called the vertebral column. The bones in the spine are called vertebrae (ver-ta-bray). The column starts at the base of the skull and continues to the pelvis. Alternate layers of bone (vertebrae) and cartilage (car-til-ledge, the intervertebral discs) stack vertically one on top of the other in the spinal column. The lattice-like structure of the cancellous bone (cancel-lus, the spongy interior) in a vertebra absorbs external pressure.

The transverse process is a protrusion extending out from either side of a vertebral body. Each vertebra has a pair of transverse processes, one on either side. Spinal muscles attach to the transverse processes. In the lumbar spine the transverse processes have attachments to muscles and ligaments that aid in stabilization of the spinal column.

The uncinate process is a sickle-shaped, bony leaflet that descends from its anterosuperior attachment on the lateral nasal wall to its posteroinferior attachment on the inferior turbinate (figure). It also extends posteromedially to its free margin. Its concave posterosuperior free margin is parallel to the anterior surface of the ethmoid bulla. The uncinate process attaches to the perpendicular process of the palatine bone and the ethmoid process of the inferior turbinate with bony spicules.

A vertebra (plural: vertebrae) is an individual bone in the flexible column that defines vertebrate animals, e.g., humans. The vertebral column encases and protects the spinal cord, which runs from the base of the cranium down the dorsal side of the animal until reaching the pelvis. Additionally, the sacrum, at the lowest part of the spine in the pelvic area consists of several vertebrae that are fused together into one large bone.

The vertebral arteries are major arteries of the neck. They branch from the subclavian arteries and merge to form the single midline basilar artery in a complex called the vertebrobasilar system, which supplies blood to the posterior part of the circle of Willis and thus significant portions of the brain.

This refers to a surgical procedure of removal of all or part of a vertebra in the spinal column. Special surgical instruments and very careful surgical technique are required to safely remove a segment of bone from the spine. The nerves and spinal cord which lie inside the spinal canal are at risk from injury in such a procedure. A vertebrectomy is sometimes performed in rigid deformities of the spinal column that can only be corrected once some bone has been removed.