ANTERIOR: Refers to the front. Example: An anterior cervical surgery incision would be done in the front (anterior) of the neck (cervical). ANTERIOR CERVICAL DECOMPRESSION: The surgery incision is made in the front (anterior) of the neck. The surgery is performed in the neck region (cervical). The disc materiel is removed, and the level is usually fused with bone taken from the patient’s hip or a bone bank. Decompression is to release pressure from the nerve or root. ANTERIOR CERVICAL PLATE: A metal plate with four holes inserted into the neck and secured in place by four titanium interlocking screws. The plate is used to hold the cervical fusion in place. ARTHROSCOPY: The introduction of a scope into a joint space to allow direct visualisation of internal structures. In some cases, surgical repair can also be performed. ASPEN CERVICAL COLLAR: A hard plastic cervical collar consisting of a front and back and secured in place by velcro straps. Collar is lined with soft foam pads and worn around the neck. Patients having cervical surgery may have their necks immobilized for several weeks by wearing an Aspen collar. The collar helps support the neck muscles and prevents movement of neck while the surgery heals. ATROPHY: A wasting, a decrease in size of a normally developed organ or tissue from pressure of decreased function or malnutrition. BABINSKI’S REFLEX: (SIGN) When the sole of the foot of a healthy person is firmly stoked, the toes will turned downward. When certain neurological disorders exist, stroking the sole of the foot makes the big toe bend upward. This sign is an abnormal reflex diagnostic of some neurological disorder of the central nervous system. BONE SCANNING: The use of a radioactive compound to detect bone lesion, including RSD and arthritis. This sensitive test shows subtle abnormalities that may not show up in x-rays, CT scan or MRIs. BURSITIS: Inflammation of a bursa. Common forms include painful shoulder, tennis elbow, and housemaid knee. Treatment is usually resting affected area. Sometimes injections of anesthetics or cortisone may be needed. CARDIOTHORACIC SURGEON: A physician specializing in the surgical treatment of heart and chest diseases including obstructions in the arteries, abnormal heart valves, and chest, esophagus, thorax, and lung problems. CAUSALGIA: Persistent severe burning sensation of the skin, usually following direct or indirect (vascular) injury of sensory fibers of a peripheral nerve, accompanied by cutaneous changes (temperature and sweating). CERVICAL SPINE: The cervical section of the spine is made up of seven bones called cervical vertebrae. CERVICAL COLLAR: A soft foam collar to wear around the neck to prevent painful movements. CERVICAL MYELOPATHY: Myelopathy is a general term denoting compromised spinal cord function and or pathological changes in the spinal cord. Myelopathy refers to dysfunction of the long tract of the spinal cord. It may manifest as weakness (upper and lower extremity) and spasticity, sensory loss, position sense loss, and incontinence. It may present initially with hand dysfunction with loss of fine motor function such as writing. The presence of lower extremity clonus, of Babinski extensor plantar response, indicates serious disruption of the normal upper motor neuron inhibition. Hoffman’s reflex, when present and especially when asymmetric, is strongly indicative of cervical cord impingement. CERVICAL RIB SYNDROME: (Thoracic Outlet Syndrome) Symptoms include pain and weakness and paresthesia (a feeling of numbness, or tingling) from compression of nerves in the neck that affect the shoulder, arms and hands; absent pulse in the wrist when raising the arm and turning the head towards the opposite shoulder; poor circulation, characterized by coldness, swelling and blueness in the hands and finger. Can be caused by a cervical rib, or muscles weakness and dropping in the shoulder, and or an injury. CERVICAL SPONDYLOSIS: Refers to a degenerative process of the spine producing narrowing of the spinal canal and neural formina, producing compression of the spinal cord and nerve roots. Symptoms include any of the following: pain in the neck radiating to shoulder blades, across top of the shoulder, upper arms, hand and back of head; crunching sounds with movement of the neck or shoulder muscles; numbness and tingling in the arms, hands and finger; some loss of feeling in the hands and impairment of reflexes; pain, headache, neck stiffness; dizziness, unsteady gait; with advance disease, loss of bladder control and leg weakness. Some patients may develop myelopathy. CERVICAL TITANIUM PLATE: Sometimes used after a cervical fusion, the metal plate is screwed into the spine to hold the fusion stable and aid in the healing process. COMPUTED TOMOGRAPHY: (Cat Scan) A CAT scanner uses thousands of small x-rays beams to take pictures “slices’ of the part being tested. A computer then generates an image that combines all these “slices’ to form a whole picture. This picture can show brain white and gray matter, blood, ruptured disc, fractured bones, and more. CLONUS: Clonus is a hyperactive reflex manifested by multiple beats after striking a tendon rather than a single jerk as is seen when the patellar tendon at the knee is tapped. Multiple beats or sustained clonus indicates that the normal dampening mechanism is not working. Usually that means that there is a disruption of the neural transmission at the cord level. One way that could happen is compression of the spinal cord. This is a finding commonly seen in patients with myelopathy. CYSTIC FIBROSIS: An inherited, incurable disease manifesting as chronic obstructive pulmonary disease, and pancreatic deficiency and high salt concentration in the sweat. It is a major cause of chronic lung disease in children. Some symptoms: bronchitis, nasal polyps, salt depletion, malabsorption, loose stools, and coughing. DECOMPRESSION: To release pressure from the nerve or root. DISCECTOMY: Surgical removal of an intervertebral disk. ELECTROMYOGRAPHY: (EMG) The EMG uses a needle electrode to examine muscles and determine if there is abnormal muscles, or if the nerves to muscles are not working normally. The studies use small electric shocks to measure the long pathways of nerves from limb to the brain. FASCIA: A fibrous membrane covering, supporting and separating muscles. It also unites the skin with underlying tissues. FIBROMYLAGIA: A condition that causes chronic muscle pain, soreness, and muscles spasm. The pain involves many muscles, tendon, ligaments, bursa, and joints. Most people have sleep disturbance and fatigue. There are distinct areas of tenderness in specific location called tender points. With or without involvement of myofascial pain syndrome that involves trigger points. (see: Myofascial Pain Syndrome) FROZEN SHOULDER: Pain and stiffness in the shoulder joint, often slight, that progresses to severe pain that interferes with sleep and normal activities. Pain that worsens with shoulder movement. In later stages, pain in the arm, and neck, inability to move the shoulder, and intolerable shoulder pain. FUNICULUS PAIN: Characterized by central burning and stinging (with or without Lhermitte’ Sign). May also be present with myelopathy. FUSION: Surgical fusion of two or more vertebrae is performed by countersinking iliac bone grafts (bone taken from your hip or bone bank) between vertebral bodies to prevent movement. HERNIATED DISK: A herniated disc is a fragment of the disc nucleus which is pushed out of the outer disc margin, into the spinal canal through a tear or "rupture." The displaced disk may exert force on a nearby root causing the typical neurological symptoms of radiating pain, (to extremity) numbness, tingling, and weakness. When these discs are healthy they act as shock absorbers for the spine and keep the spine flexible. When a disc bulges or ruptures, it is called a herniated disc (or sometimes a slipped or ruptured disc). HOFFMAN REFLEX TEST: Is performed by flipping the volar or dorsal surfaces of the middle finger and observing the reflex contration of the thumb and index finger. This sign is evidence of upper motor neuron disease because there should normally be no reaction. Positioning the neck in flexion may worsen the reflexes. HYPALGESIA: A decreased sensitivity to pain or other stimulus. HYPERALGESIA: An increased sensitivity to pain, lowered pain threshold. HYPESTHESIA: A dulled sensibility to touch. LAMINECTOMY: The removal of a portion of the spine bone. A laminectomy may be performed to alleviate the pain of a ruptured or herniated disc causing pressure on the spinal cord or nerve root. Lamina is the Latin name given to the bone protecting the spinal canal, and otomy means opening or hole. The laminectomy simply opens up the spinal canal in order to visualize the pinched nerve root. Surgical treatment involves making the spinal canal bigger by removing the bony elements that are compressing the nerves. Frequently, a fusion surgery is done at this time. INTERVERTEBRAL DISK: A fibro-carilaginous disk which separates the vertebral bodies in the spine. These disk are composed of a central gelatinous-like material that helps to cushion spinal column to axial stress. Disk may herniate or rupture, resulting in a condition known as radiculopathy. LHERMITTE’S SIGN: A sudden electric-like shocks spreading down the body when flexing the head forward. MAGNETIC REASONANCE IMAGING: (MRI) This specialized imaging is accomplished by placing the patient in a powerful magnetic field, then beaming radio waves into the field which causes tissue particles to orient themselves in a specific pattern in the magnetic field. In a closed MRI, patient is placed in a long cylinder type tube. In an open MRI, the sides are open. MYELOGRAM: A special X-ray of the spinal canal and spinal cord, requiring a spinal tap and injection of dye that is visible on X-ray film. The dye shows up on the film and gives an anatomical view of the spinal cord and nerve root areas. Any abnormality within the spaces, such as protruding or herniated disk pressing on certain nerves, can be detected. MYELOPATHY: (See: Cervical Myelopathy) MYELOPATHY HAND: Finger escape sign (small finger spontaneously abducts due to weak intrinsics) indicating cervical myelopathy. MYOFASCIAL PAIN SYNDROME: Pain coming from the muscle fiber and connective tissues. It is a common condition causing muscle pain. Trigger points are characteristic of myofascial pain syndrome. They are found only in muscles. When the trigger points are pressed on, they cause referred pain and numbness to a different area. Some think that myofascial pain syndrome and fibromyaligia related. MYOPATHY: Any disease or abnormal condition of the muscles. NEURALGIA: Sharp severe pain, occurring along the course of a nerve. It is caused by pressure on the nerve trunks, inflammation, or toxins. NEURITIS: Inflammation of a nerve or group of nerves, characterized by pain, loss of reflexes, and atrophy of the affected muscles. NEUROLOGIC SYMPTOMS: Neurologic symptoms can be variable. They can include: numbness, tingling, hyperesthesia (increased sensitivity), paralysis, (localized weakness), dysarthria (difficulty speaking), dysphagia (difficulty swallowing), difficulty walking, confusion, and lethargy. NEUROPATHY: A disturbance of the function of a nerve or a pathological change in the nerve. NEUROSURGEON: A physician specializing in surgery of the nervous system. ORTHOPEDICS: A physician specializing in the prevention or correcting of the skeleton joints, muscles, fascia, and other supporting structures such as ligament and cartilage. PAIN: Acute pain warns the patient that something is wrong, but persistent acute pain may interfere with the healing and recovery process. When pain persists beyond the expected time required for healing of an injury or disease, it is considered chronic. PARESTHESIAS: Neurologic symptoms which include: a sensation of numbness, pricking or tingling hyperesthesia (heightened sensitivity). Any abnormality of sensation. PERIPHERAL NERVOUS SYSTEM: The part of the vertebrate nervous system constituting the nerves outside the central nervous system and including the cranial nerves, the spinal nerves and the sympathetic and parasympathetic nervous systems. PHILADELPHIA CERVICAL COLLAR: A hard molded plastic cervical collar consisting of two pieces connected by velcro straps that support the neck muscles and prevent movement of the neck. PHYSICAL THERAPY: Uses exercise and physical activities to condition muscles and improve level of activity. POSTERIOR: Located behind a part or towards the rear of a structure. Example: a cervical posterior surgery would be done on the back of the neck. POST OPERATIVE: Happening or done after a surgical operation: POST TRAUMATIC STRESS DISORDER: (P.T.S.D.) A psychological disorder affecting individuals who have experienced profound emotional trauma, characterized by recurrent flashbacks of the traumatic event, nightmares, eating disorders, anxiety, fatigue, forgetfulness, and social withdrawal. RADICULOPATHY: Dysfunction of the nerve root by any cause. The motor manifestations are weakness, while the sensory manifestations may consist of pain, numbness, or tingling (paresthesias) or a combination of these. Can be associated with myelopathy. RAYNAUDS: A disorder of the circulatory system that affects the blood circulation to fingers and occasionally toes. Fingers that turn pale blue color when exposed to cold. Pain, numbness and tingling accompany the color changes. Warmth relieves these symptoms. REFLEX SYMPATHETIC DYSTROPHY: (R.S.D.) A condition that features a group of typical symptoms, including pain (of burning type) in extremities, tenderness, and swelling of an extremity associated with varying degrees of sweating, warmth and /or coolness, flushing, discoloration and shiny skin. It consist of a localized hyperactivity in the sympathetic (even a minor one) or it can occur spontaneously. There are a variety of treatment approaches such as a series of anesthetic blocks (see: Stella Ganglion Blocks), cool mist applications to burning symptoms, exercises, and medicines. RUPTURED DISC: See HERNIATED DISK. SPINAL CORD INJURY: Any injury to the spinal cord via blunt or penetrating trauma. Extreme flexion or extension (particularly in the neck region) of the spine can result in traction of the spinal cord with subsequent injury and development of neurologic symptoms. (see: Neurologic Symptoms) SPINAL TAP: A diagnostic procedure which introduces a sterile needle into the spine to collect cerebrospinal fluid, or prior to surgery, with spinal anesthesia. (see: Myelogram) SPURLING SIGN: Refers to the reproduction or exacerbation of pain upon pushing down on the head and bending it towards the involved side. STELLA GANGLION NERVE BLOCKS: In a stellate ganglion block, a long-acting local anesthetic agent is injected near the ganglion (root) of the nerve. The injection site for face or arm pain is on the neck. This type of nerve block results in the blockage of the sympathetic nerves. This results in a warm, dry extremity on the blocked side. Pain relief can last for hours or days or weeks. This is usually repeated several times over several weeks. It is performed by an anesthesiologist, a physician specializing in anesthesia. THORACIC OUTLET SYNDROME: (see Cervical Rib Syndrome) TRANSCUTANEOUS ELECTRIC NERVE STIMULATION: (TENS) A small battery operates device that consists of a set of electrodes that are placed on the skin around the site of the pain and through which a low voltage electrical stimulus is passed. A TENS stimulates the nerves electrically until they lose all sensation temporarily, giving relief to pain. TRIGGER POINTS INJECTION: The trigger point is injected usually with anesthetic and cortisone. A trigger point is a taut place in the muscles. (see: Myofascial Pain Syndrome) TWO POSTER CERVICAL BRACE: It is made of metal covered in plastic, consisting of a front and back. The brace is firmly secured around the neck with either straps and velcro. The front bottom of the brace rests on the chest, while the back bottom rests on the back. The front and back are secured in place by straps going across the top of each shoulder. It is made to keep the neck immobile, especially after cervical surgery.

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