Glossary of Terms associated with the Spine (A to Z)
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A condition where there is an insensitivity to pain, usually following an interruption of the nerve supply or under the influence of a drug that blocks the pain sensation. The individual is fully conscious.
Taking sample of tissue for histological (microscopic) examination to assess whether it is abnormal and if so in what way. For spinal purposes usually performed with image guidance with a needle.
A bundle of spinal nerve roots that arise from the bottom end of the spinal cord. The cauda equina comprises the roots of all the spinal nerve roots below the level of the first lumbar (L1) vertebra, namely the sacral and coccygeal nerves.
Usually poly methyl methacrylate (PMMA) - a biologically well tolerated malleable paste that hardens within minutes of mixing with a catalyst. It may be injected vertebrae into vertebral bodies to treat fragility fractures (osteoporosis) or reinforce vertebrae weakened by tumour.
The use of drugs that kill cancer cells, or prevent or slow their growth.
A doctor who specialises in the treatment of cancer patients, particularly through the use of radiotherapy, but may also use chemotherapy.
Research studies in which groups of patients with a particular condition or specific characteristic are compared with matched groups who do not have it.
Computed Tomography (CT)
An X-ray imaging technique, which allows detailed investigation of the internal organ of the body.
Removal of tissues surrounding the nerve elements of the spine to prevent loss of, or in the hope of regaining nerve function. This is usually achieved by removing bone from the back of the spine in the low back or from the front or back of the spine in the neck.
Deep Venous Thrombosis (DVT)
A blood clot that forms in a vein resulting in obstruction of venous flow, most common clinically in the lower extremities.
Movement of solid material(s) inappropriate to location within blood vessels with the potential to block blood supply in the distribution of that blood vessel. This may be used therapeutically before surgery to decrease the potential bleeding at an operation site.
The study of populations in order to determine the frequency and distribution of disease and measure risks.
Situated within the spinal canal, on or outside the dura mater.
Usually pertaining to removal of tumours, in this instance not entering the tumour to avoid spreading tumour cells to adjoining tissues.
Relating to the study of cells and tissue on the microscopic level.
Intensity Modulated Radiotherapy (IMRT)
In intensity modulated radiation therapy (IMRT), very small beams, or beamlets, are aimed at a tumour from many angles. During treatment, the radiation intensity of each beamlet is controlled and the beam shape changes hundreds of times during each treatment. As a result, the radiation dose bends around important healthy tissues in a way that is impossible with other techniques. Because of the complexity of these motions, physicians use special high-speed computers, treatment-planning software, diagnostic imaging and patient-positioning devices to plan treatments and control the radiation dose during therapy (Mayo Clinic definition).
Intensity modulated Proton Therapy (IMPT)
Similar to IMRT only using Protons (particles) rather than X-ray beams.
Usually pertaining to removal of tumours, in this instance entering the tumour as part of the process of removal, potentially spreading tumour cells to adjoining tissues.
Person who, with the patient’s consent and agreement, takes a key role in coordinating the patient’s care and promoting continuity, ensuring the patient knows who to access for information and advice.
Kyphosis is an increased forward angulation of the spine when looking at the spine from the side.
A minimally invasive spinal surgery procedure used to treat painful, progressive vertebral compression fractures (VCFs). Kyphoplasty involves the use of a device called a balloon tamp to restore the height and shape of the vertebral body. This is followed by application of bone cement to strengthen the vertebra.
A surgical procedure that is performed to alleviate pain caused by neural impingement. The laminectomy surgery is designed to remove a small portion of the bone over the nerve root and/or disc material from under the nerve root to give the nerve root more space and a better healing environment.
Magnetic Resonance Imaging (MRI)
A special imaging technique used to image internal structures of the body, particularly the soft tissues. An MRI image is often superior to a normal plain X-ray image. It uses the influence of a large magnet to polarize hydrogen atoms in the tissues and then monitors the summation of the spinning energies within living cells. Images are very clear and are particularly good for soft tissue, brain and spinal cord, joints and abdomen. These scans may be used for detecting some cancers or for following their progress.
Type of back pain, which is caused by putting abnormal stress and strain on the muscles which support the vertebral column.
Spread of cancer away from the primary site to somewhere else via the bloodstream or the lymphatic system.
Metastatic Spinal Cord Compression (MSCC)
Pressure on the nerve elements within the spinal canal resulting from tumour or fracture of vertebra(e) infiltrated by tumour which may result in alteration or loss of nerve function (if severe) causing paralysis and loss of bowel and bladder control.
Multi-Disciplinary Team (MDT)
A team with members from different health care professions (eg, urology, oncology, pathology, radiology, nursing).
Myelography is an imaging examination that shows the passage of contrast material in the space around the spinal cord (the subarachnoid space) using a real-time form of plain X-ray (radiography) called fluoroscopy, in which organs can be seen over many seconds (rather than in the static image called a plain X-ray or radiograph).
A healthcare professional who works with people of all ages helping them to carry out activities that they need or want to do in order to live healthy and fulfilling lives.
The study of cancers.
A chemical substance that has a morphine-like action in the body. The main use is for pain relief.
Relating to bone and connected tissues. For spinal purposes the bones, joints discs and ligaments of the spine.
A reduction in the amount of bone mass, leading to fractures after minimal trauma.
Oswestry Disability Index (ODI)
The Oswestry Disability Index (ODI) was first described in 1980 and is one of the principal condition-specific outcome measures used in the management of spinal disorders. The ODI is the most commonly outcome measures in patients with low back pain. It has been extensively tested, shows good psychometric properties and is applicable in a wide variety of settings. It has been translated into many languages. Obtain licence and correct version from MAPI Trust (PROinformation@mapi-trust.org ; www.mapi-trust.org).
Anything which serves to alleviate symptoms due to the underlying cancer but is not expected to cure it.
The active holistic care of patients with advanced, progressive illness. Management of pain and other symptoms and the provision psychological, social and spiritual support is paramount. The goal of palliative care is achievement of the best quality of life for patients and families. Many aspects of palliative care are also applicable earlier in the course of the illness in conjunction with other treatments.
Paralysis of the legs and lower part of the body. Usually accompanied by loss of bowel and bladder control and sexual function.
Performed through the skin, as injection of radiopaque material in radiological examination or the removal of tissue for biopsy accomplished by a needle.
A healthcare professional concerned with human function, movement and maximising potential.
A radiograph made without use of a contrast medium.
Positron Emission Tomography (PET)
A specialised imaging technique using a radioactive tracer to produce a computerised image of metabolic activity in body tissues and find abnormalities. PET scans may be used to help diagnose cancer, to see how far it has spread and to investigate response to treatment. Since PET looks at function, it is often combined with CT [PETCT] which reveals the underlying structure.
A prediction of the likely outcome or course of a disease; the chance of recovery or recurrence.
Professional support which can help people with a wide range of psychological problems such as anxiety and depression, and can provide emotional assistance during times of distress.
Pus forming - descriptive of a type of infection caused by specific types of bacteria.
Pain in a nerve root distribution, typically extending down the arm, round the trunk of the leg.
Where root compression is more pronounced there may be alteration of sensory function (feeling) or motor function (weakness) in the distribution of that nerve.
An image produced on a radio-sensitive surface, such as a photographic film, by radiation other than visible light, especially by plain X-rays passed through an object or by photographing a fluoroscopic image.
A healthcare professional who is qualified to undertake and interpret radiographic images. In oncology, radiographers are highly trained in the use of high energy radiation and the management of patients with cancer.
A version of a chemical element that has an unstable nucleus and emits radiation during its decay to a stable form. Radioisotopes have important uses in medical diagnosis, treatment, and research. A radioisotope is so-named because it is a radioactive isotope, an isotope being an alternate version of a chemical element that has a different atomic mass.
A doctor who specialises in acquiring and interpreting pictures of areas inside the body using plain X-rays and other specialised imaging techniques. An interventional radiologist specialises in the use of imaging techniques for treatment, for example catheter insertion for abscess drainage.
The use of radiation, usually plain X-rays or gamma rays, to kill cancer cells and treat tumours.
Randomised Controlled Trial (RCT)
A type of experiment which is used to compare the effectiveness of different treatments. The crucial feature of this form of trial is that patients are assigned at random to groups which receive the interventions being assessed or control treatments. RCTs offer the most reliable (ie, least biased) form of evidence of effectiveness.
Scoliosis is a curvature of the spine to the right or left when looking at the patient from behind and is associated rotation of the bones of the spine (vertebrae).
Spinal Cord Pain
Neurogenic pain-radicular pain: Pain arising from neural irritation, compression or damage, usually in the case of MSCC by direct pressure or indirect vascular effects to disturb neurological function and cause pain of a typical nature and recognisable distribution (band-like deep-seated aching discomfort in the case of nerve root, burning cold indescribable in the case of the cord with or without sensory disturbance or weakness in a distinct clinical pattern reflecting the level nature and extent of neurological compression).
Scoliosis, kyphosis or a combination of the two.
Clinical stability definition: The ability of the spine under physiologic loads to limit patterns of displacement so as not to damage or irritate the spinal cord or nerve roots and, in addition, to prevent incapacitating deformity or pain due to structural changes. Description and Examples: Any disruption of the spinal components (ligaments, discs, facets) holding the spine together will decrease the clinical stability of the spine. When the spine loses enough of these components to prevent it from adequately providing the mechanical function of protection, surgical or other measures are taken to re-establish stability.
Pain in or arising from the bones, joints, or soft tissues of the spinal column. It may be mechanical (increased by movement and relieved by rest), postural (worse with prolonged standing and eased by movement), recumbent (worse when lying and improved by standing – sometimes associated with cord compression), or non-specific (without change due to posture or movement). All are thought to result from disturbance of the dynamic structural integrity of the spinal column (or filling of the spinal canal in the case of recumbency pain) without symptoms or signs of associated neurological injury.
“A state of transient physiological (rather than anatomical) reflex depression of cord function below the level of injury with associated flaccid areflexia loss of all sensory and motor function”.
Lying on the back.
‘… helps the patient, partners, carers and their family to cope with cancer and treatment of it – from pre-diagnosis, through the process of diagnosis and treatment, to cure, continuing illness or death and into bereavement. It helps the patient to maximise the benefits of treatment and to live as well as possible with the effects of the disease. It is given equal priority alongside diagnosis and treatment.’
Paralysis of all four limbs, both arms and both legs, as from a high spinal cord accident or stroke. Severe or complete loss of motor function in all four limbs which may result from brain diseases; spinal cord diseases; peripheral nervous system diseases; neuromuscular diseases; or rarely muscular diseases. The locked-in syndrome is characterised by quadriplegia in combination with cranial muscle paralysis. Consciousness is spared and the only retained voluntary motor activity may be limited eye movements. This condition is usually caused by a lesion in the upper brain stem which injures the descending cortico-spinal and cortico-bulbar tracts.
An incision into the chest.
A condition in which a blood clot (thrombus) forms in a vein. Blood flow through the affected vein can be limited by the clot, causing swelling and pain. Venous thrombosis most commonly occurs in the 'deep veins' in the legs, thighs, or pelvis. This is known as a deep vein thrombosis.
Vertebroplasty is an image-guided, minimally invasive, nonsurgical therapy used to strengthen a broken vertebra (spinal bone) that has been weakened by osteoporosis or, less commonly, cancer. Percutaneous vertebroplasty involves the injection of acrylic bone cement into the vertebral body in order to relieve pain and/or stabilise the fractured vertebrae and in some cases, restore vertebral height.