Spinal Cord Injuries

Classification & Terminology

The effects of SCI depend on the type of injury and the level of the injury. SCI can be divided into two types of injury - complete and incomplete.

Complete: A complete injury means that there is no function below the level of the injury; no sensation and no voluntary movement. Both sides of the body are equally affected.

Incomplete: An incomplete injury means that there is some functioning below the primary level of the injury. A person with an incomplete injury may be able to move one limb more than another, may be able to feel parts of the body that cannot be moved, or may have more functioning on one side of the body than the other. With the advances in acute treatment of SCI, incomplete injuries are becoming more common.

The following terminology has developed around classification of SCI:

• Tetraplegia (replaced the term quadriplegia) - Injury to the spinal cord in the cervical region with associated loss of muscle strength in all 4 extremities

• Paraplegia - Injury in the spinal cord in the thoracic, lumbar, or sacral segments, including the cauda equina and conus medullaris.

ALIF
Anterior Lumbar Interbody Fusion - is the placement of bone or cages between vertebrae from an anterior approach.

Annulus
The outer portion of a disc in the spinal column, the annulus provides structure and strength to a disc and is comprised of a complex series of interwoven layers of fibrous tissues, which hold it's nucleus in place.

Anterior
Refers to the frontal or ventral surface of the body.

Arthroscopic Lumbar Discectomy
PLD using an endoscope for visualization.

Autograft
This refers to bone taken from the patient, usually the hip, to be used as graft.

Bone Graft
An option for fusing the spine. This requires either moving bone from one part of the body (autograft) or using bone from an outside source (allograft).

Cat Scan
Computerized x-ray system which provides cross-sectional images of the spine or other parts of the body. Sometimes is done following a myelogram or discogram.

Cervical
Pertains to the neck.

Conservative Therapy
Method of relieving pain with bed rest, analgesics and chiropractic and physical therapy.

Degenerative Disc Disease
Deterioration in disc structure and function, which commonly causes pain and loss of function.

Diagnostic
Test or process used to determine the source of a problem, i.e., a diagnosis.

Disc
Discs serve as shock absorbers between the vertebrae of the spinal column. The center of the disc is known as the nucleus and the outer ring of the disc is called the annulus.

Discectomy
The procedure where a disc is removed surgicaly.

Discogram
Provocative discography is the instillation of sterile saline (not dye) into the disc to try and reproduce the patient's pain.

Dorsal
Refers to a position toward the posterior or back side of the body.

Fusion
Growth of bone where bone does not normally grow, as in replacing a disc with a bone graft. The bone graft is normally taken from the patient or a donor.

Herniated Disc
AKA a slipped disc, is a condition in which nucleus tissue is moved from the center of a disc into the spinal canal. Herniated discs cause great pain in the low back and leg or the neck and arm and they create pressure against one or more of the spinal nerves. Other names for herniated discs are prolapsed discs or ruptured discs.

Interbody Fusion
Placing of a graft or cages between vertebral bodies.

Kyphoplasty
A surgical procedure designed to stop the pain caused by the bone fracture, stabilize the bone, and to restore the lost vertebral body height due to the compression fracture.

Laminectomy
Surgery technique in which part of the back of the vertebra is removed in order to reach to the nerves and discs. This may or may not require the disc be removed as part of the procedure.

Ligaments
This is bands of fibrous tissue that connect bones or cartilages that support and strengthen the bone joints. Ligaments surround the spine on all sides.

Lumbar
This refers to the lower back.

Microdiscectomy
Surgical technique for removal of a disc via a small opening using a microscope.

Morbidity
Refers to postoperative pain and complications from to surgery.

MRI Scan
Computerized magnetic imaging system that provides cross-sectional images of the spine or other body parts.

Myelogram
Diagnostic procedure in which an iodine is injected as a dye into the spinal canal and shows up on x-rays that are taken.

Nucleus
The center part of a disc and is made of a soft, rubber-like material that takes the shock of movement such as standing, walking, running, etc.

Pedicle Fixation
Invlolves placing bone screws into the spine from a posterior approach through what is known as the pedicle. Screws are then used with a rod or plate to keep the spine stable following bone grafting.

Percutaneous Cervical Discectomy
An outpatient procedure that uses minimally-invasive suction to remove herniated cervical discs.

Percutaneous Lumbar Discectomy
PLD using an endoscope for visualization.

PLIF
Stand for Posterior Lumbar Interbody Fusion, which is the placement of bone or cages between vertebrae from a posterior approach.

PLITF
Stands for Posterior Lateral Inter-Transverse Process Fusion, which involves the placement of bone graft on and between transverse process of vertebrae to promote bone fusion.

Porous
Surface area amount which allows for bone growth from the implant.

Posterior
This term refers to the back or dorsal surface of the body.

Prolapsed Disc
AKA a slipped disc, is a condition in which nucleus tissue is moved from the center of a disc into the spinal canal. Herniated discs cause great pain in the low back and leg or the neck and arm and they create pressure against one or more of the spinal nerves. Other names for herniated discs or ruptured discs.

Ruptured Disc
See above

Sacrum
This is the lower portion of the spinal column.

Slipped Disc
See Ruptured Disc.

Spinal Cord
This is the primary nervous system, that runs from base of the skull to the lower back via the spinal canal. Problems or impingement of bony or soft tissues on cord or nerve roots is primary reason for spine surgery.

Spinal Fusion
Surgical treatment for back pain in which the disc between two adjacent vertebrae is removed. Then two vertebrae are fused using bone graft and instrumentation methods.

Spine
This is the structure composed of vertebrae, discs, and ligaments. It contains 26 vertebrae in five separate regions. There are 7 cervical, 12 thoracic, 5 lumbar, 1 sacral, and 1 coccygeal vertebrae. The primary function of the spine are body support and spinal cord protection.

Spinal Column
Longitudinal skeletal axis of the human body that is composed of 26 distinct bones which are called vertebrae.

Therapeutic
A procedure which is related to the treatment of disease in the human body.

Thoracic Spine
The twelve vertebrae in mid-torso that are attached to the rib cage.

Thorax
The portion of the chest composed of the spine, ribs and, breast bone.

Titanium Alloy
This is a very bio-compatible material with great fatigue strength and good imaging characteristics.

Vertebra
This a bone that is used as a building block for the spinal column.

Vertebral Column
The longitudinal skeletal axis of the body that is composed of 26 distinct bones which are called vertebrae.