- a treatment which involves stimulating certain places on the skin by a variety of techniques, in most cases by manipulating thin, solid, metallic needles that penetrate the skin. Research has shown that low back pain is one area in which acupuncture has benefited some people.
- an injected radioactive material attaches itself to bone, especially in areas where bone is actively breaking down or being formed. The test can detect fractures, tumors, infections, and arthritis, but may not tell one disorder from another. Therefore, a bone scan is usually performed along with other tests. This test is not routinely indicated or of use for deciding on ADR. Failing a bone scan does not eliminate a patient from ADR surgery.
- a sack of nerve roots that continues from the lumbar region, where the spinal cord ends, and continues down to provide neurological function to the lower part of the body. It resembles a "horse's tail" (cauda equina in Latin).
Cauda Equina Syndrome
- an emergency situation, where the Cauda equina is compressed. The patient will e.g. loose control of bladder or bowel function. If this is recent and progressive, immediate surgery within hours is at stake.
- a treatment based on the philosophy that restricted movement in the spine reduces proper function and may cause pain. Chiropractors may manipulate (adjust) the spine in order to restore normal spinal movement. They may also employ traction, a pulling force, to help increase space between the vertebrae and reduce pressure on affected nerves. Some people report that they benefit from chiropractic care. Research thus far has shown that chiropractic treatment is about as effective as conventional, nonoperative treatments for acute back pain.
Computerized Axial Tomography (CAT scan)
- X-rays are passed through the back at different angles, detected by a scanner, and analyzed by a computer. This produces a series of cross-sectional images and/or three-dimensional views of the parts of the back. The scan shows the shape and size of the spinal canal, its contents, and structures surrounding it. The CAT scan is optimal in visualizing bony structures, e.g. facet joints. It has relevant setbacks for visualizing soft tissue, i.e. judging the degree of disc degeneration.
- the resulting image of radio discography, where an opaque dye is injected into suspect discs. The patient reaction and the image helps the physician determine the status of the disc.
Electromyogram and Nerve Conduction Studies (EMG/NCS)
- these tests measure the electrical impulse along nerve roots, peripheral nerves, and muscle tissue. This will indicate whether there is ongoing nerve damage, if the nerves are in a state of healing from a past injury, or whether there is another site of nerve compression.
- joints located on the posterior part of the vertebra. They are formed by a portion of one vertebra and the vertebra above it. They connect the vertebrae to each other and permit back motion.
- pads of cartilage filled with a gel-like substance which lie between vertebrae and act as flexible spacers.
- (also called neural foramen
)—an opening between vertebrae through which nerves leave the spine and extend to other parts of the body.
- part of the vertebra at the back portion of the vertebral arch that forms the roof of the canal through which the spinal cord and nerve roots pass.
- elastic bands of tissue that support the spine by preventing the vertebrae from slipping out of line as the spine moves. A large ligament often involved in spinal stenosis is the ligamentum flavum, which runs as a continuous band from lamina to lamina in the spine. In stenosis it can be thickened considerabely.
- the patient tells the doctor details about symptoms and about any injury, condition, or general health problem that might be causing the symptoms.
Magnetic Resonant Imaging (MRI)
- energy from a powerful magnet (rather than x rays) produces signals that are detected by a scanner and analyzed by computer. This produces a series of cross-sectional images ("slices") and/or a three-dimensional view of parts of the back. An MRI is particularly sensitive for detecting damage or disease of soft tissues, such as the disks between vertebrae or ligaments. It shows the spinal cord, nerve roots, and surrounding spaces, as well as enlargement, degeneration, or tumors.
- a liquid dye that x-rays cannot penetrate is injected into the spinal column. The dye circulates around the spinal cord and spinal nerves, which appear as white objects against bone on an x-ray film. A myelogram can show pressure on the spinal cord or nerves from herniated disks, bone spurs, or tumors.
- narrow stem-like structures on the vertebrae that form the walls of the vertebral arch.
- the doctor for spine patients (1) examines the patient to determine the extent of limitation of movement, (2) checks for pain or symptoms when the patient hyperextends the spine (bends backwards), and (3) checks for normal neurological function (for instance, sensation, muscle strength, and reflexes) in the arms and legs and other areas.
- a type of referred pain originating at a spinal nerve root, which is under compression, and felt in the arm, leg, finger or toe. The sensation can be numbness, shooting pain, tingling, weakness or difficulty controlling the extremity.
- a posterior displacement of one vertebral body with respect to the adjacent vertebrae below to a degree less than a luxation (dislocation).
- a major part of the central nervous system that extends from the base of the brain down to the lower back and that is encased by the vertebral column. It consists of nerve cells and bundles of nerves. The cord connects the brain to all parts of the body via 31 pairs of nerves that branch out from the cord and leave the spine between vertebrae.
- an anterior displacement of one vertebral body with respect to the adjacent vertebrae below to a degree less than a luxation (dislocation). The term includes both Spondylolisthesis vera, where a inherited missing connection between the pedicle and the lamina allows the vertebral body to slip, and the Pseudo-Olisthesis, where a slacking of ligaments and joint capsules caused by DDD allow for a minor degree of slip. Pseudo-Olisthesis is not a contraindication for ADR.
Spondylosis in the spine is the slow degeneration of intervertebral discs and the deformity of vertebrae, which occurs with aging.
- a thin membrane that produces fluid to lubricate the facet joints, allowing them to move easily.
- a circle of bone around the canal through which the spinal cord passes. It is composed of a floor at the back of the vertebral body, walls (the pedicles), and a ceiling where two laminae join.
- a radiation beam at x-ray wavelength is passed through the back to produce a two-dimensional picture. An x ray may be done before other tests to look for signs of an injury, tumor, or inherited problem. This test can show the structure of the vertebrae and the outlines of joints, and can detect calcification. In contrast to MRI and CAT scan x-rays can be taken upright. The x-ray is needed to judge posture or to judge pain associated with movement. Lateral flexion-extension films are need as the patient bends forwards or backwards, which is not possible in an MRI or CAT scan.