Clinical Correlations of the Back – Key Vocabulary

Comprehensive vocabulary flashcards summarizing congenital, traumatic, degenerative, vascular, and procedural concepts related to spinal clinical correlations presented in the lecture.

Scoliosis

Abnormal lateral spinal curvature >10°; ranges from mild to severe and may require bracing or spinal-fusion surgery.

Lumbarization

Congenital anomaly in which S1 fails to fuse with the sacrum, creating an extra lumbar-type vertebra and possible low-back pain.

Sacralization

Congenital fusion of L5 (occasionally L4) to the sacrum, decreasing lumbar mobility and often producing pain.

Cervical Rib

Extra rib, most commonly at C7, present in 0.2–0.5 % of people; may cause thoracic outlet syndrome.

Harrington Rods

Rigid metal rods (1960s–1990s) once used for scoliosis correction; precursor to modern flexible spinal-fusion systems.

Spinal Fusion Surgery (SFS)

Operative stabilization of spinal segments with flexible rods and screws, commonly used for severe scoliosis or burst fractures.

Spondylosis

Degenerative osteoarthritis of the spine featuring osteophytes, disc narrowing, and possible spinal stenosis.

Spondylolysis

Stress fracture of the pars interarticularis, confirmed radiographically by the "Scotty-dog" collar/neck sign.

Spondylolisthesis

Anterior slippage of one vertebra on another, often following bilateral spondylolysis; graded I–IV by percentage of slippage.

Pars Interarticularis

Thinnest part of vertebral arch between superior and inferior articular facets; fracture site in spondylolysis.

Scotty-Dog Sign

Oblique lumbar X-ray appearance where the pars defect looks like a dog’s broken neck, indicating spondylolysis.

Compression Fracture

Collapse of vertebral body (often osteoporotic); may be treated with vertebroplasty.

Wedge Fracture

Subtype of compression fracture where the anterior vertebral body collapses, creating wedge shape.

Burst Fracture

High-energy shattering of vertebral body in all directions; may impinge spinal cord; e.g., Jefferson fracture of C1.

Jefferson Fracture

Burst fracture of C1 ring caused by axial loading on head; lateral masses separate, transverse ligament may rupture.

Hangman’s Fracture

Traumatic spondylolysis of C2 (pars fracture) from forceful neck hyperextension; high risk of cord/brain-stem injury.

Odontoid (Dens) Fracture

Common C2 injury (40–50 %) involving dens; results from flexion, extension, or low bone mass.

Perched Facet

Partial cervical dislocation where inferior articular facet rests on edge of superior facet below.

Locked Facet

Complete cervical dislocation with facet overlap preventing spontaneous reduction; often requires surgical fixation.

Segmental Medullary Artery

Large radicular branch that reinforces anterior/posterior spinal arteries; formed where radicular arteries anastomose.

Anterior Radicular Artery

Small vessel supplying ventral spinal roots; may form segmental medullary artery.

Posterior Radicular Artery

Small vessel supplying dorsal spinal roots; may form segmental medullary artery.

Vertebral Venous Plexus

Valve-less internal & external venous network along spine; provides pathway for metastasis and pressure equilibration.

Basivertebral Veins

Valveless veins inside vertebral bodies draining to vertebral plexus; conduit for tumor spread to bone.

Ankylosing Spondylitis

Autoimmune axial spondyloarthritis causing osseous bridges across discs, producing "bamboo spine" on imaging.

Bamboo Spine

Radiologic appearance of fused vertebrae with thin syndesmophyte bridges, characteristic of ankylosing spondylitis.

Osteoporosis

Systemic loss of bone mass, especially trabecular bone; predisposes to vertebral compression and wedge fractures.

Vertical Striations (Spine)

Early radiographic sign of osteoporosis reflecting loss of horizontal trabeculae and accentuation of vertical bars.

Spinal Stenosis

Narrowing of vertebral canal or intervertebral foramen; produces myelopathy or radiculopathy.

Myelopathy

Spinal-cord compression within vertebral canal causing upper-motor-neuron signs below lesion.

Radiculopathy

Compression of spinal-nerve root, often in IV foramen, producing dermatomal pain/weakness.

Osteophyte

Bone spur from osteoarthritis; may narrow canal or foramina and cause pain.

Intervertebral Disc Degeneration

Age-related dehydration, fiber tears, and height loss of disc leading to bulging, osteophytes, and pain.

Disc Bulge (Prolapse)

Annulus fibrosus protrusion into canal without nucleus extrusion; may compress nerve root.

Disc Extrusion

Nucleus pulposus breaks through annulus but remains connected to disc ('ruptured disc').

Sequestered Disc

Free fragment of nucleus outside annulus in canal; a type of herniated nucleus pulposus.

Posterolateral Herniation

Most common lumbar disc herniation direction; usually compresses nerve root one level below disc (e.g., L4-5 hits L5).

Cauda Equina

Bundle of lumbar, sacral, and coccygeal nerve roots below L1–L2; vulnerable to large central herniations.

Spurling’s Maneuver

Neck extension/rotation test provoking arm pain in cervical radiculopathy from disc herniation.

Vertebroplasty

Percutaneous injection of bone cement into collapsed vertebral body to stabilize compression fractures.

Lumbar Puncture

Needle access to subarachnoid space (usually L3–L4 or L4–L5) to obtain CSF or deliver anesthesia; performed below conus medullaris.

Epidural Anesthesia

Injection of anesthetic into epidural space, typically below L3, for analgesia without dural penetration.

Greater Occipital Nerve

Dorsal ramus of C2; entrapment in semispinalis capitis/trapezius contributes to tension headaches.

Laminectomy

Surgical removal of vertebral lamina to decompress spinal canal.

Foraminotomy

Enlargement/removal of bone around intervertebral foramen to relieve nerve-root compression.

Thoracic Outlet Syndrome

Neurovascular compression at thoracic outlet; can be precipitated by cervical rib.

Burst Fracture Treatment

Management ranges from bracing to spinal fusion depending on stability and neurologic status.

Segmental Arterial Supply

Vertebrae receive blood from vertebral, posterior intercostal, lumbar, and lateral sacral arteries.

Biconcave Vertebral Body

Central end-plate collapse typical of osteoporotic compression fracture classified as "B" type.

Planar Compression Fracture

Flat vertebral body height loss without wedge shape; late osteoporosis sign.

Locked Facet Imaging

MRI recommended to assess spinal-cord injury even when plain films show facet dislocation.

Traumatic Spondylolysis of C2

Alternative term for Hangman’s fracture caused by hyperextension of neck.

Bilateral Pars Fracture

Necessary precursor for anterior slip in spondylolisthesis.

Grade 2 Spondylolisthesis

Vertebral body displacement of 25–50 % relative to body below; surgical repair considered.

Spinal Venous Metastasis

Prostate, breast, ovarian, and Hodgkin’s cancers spread to vertebrae via valveless vertebral venous plexus.

Disc Degeneration Stages

Degeneration → Prolapse → Extrusion → Sequestration represent progressive annulus/nucleus failure.

CSF Collection Level

L3–L4 or L4–L5 chosen for lumbar puncture because spinal cord ends near L1–L2, reducing injury risk.

Endoscopic Cervical Foraminotomy

Minimally invasive posterior procedure to decompress cervical nerve roots by enlarging foramen.