Ablation & Radiofrequency Ablation
Ablation is removal of material from the surface of an object by vaporization, chipping, or other erosive processes. For example, removal of biological tissues in medicine.
Radiofrequency ablation (RFA) is a medical procedure in which part of the electrical conduction system of the heart, tumor or other dysfunctional tissue is ablated using the heat generated from high frequency alternating current (in the range of 350–500 kHz). RFA is generally conducted in the outpatient setting, using either local anesthetics or conscious sedation anesthesia.
An arthropathy is a disease of a joint.
Scope: Arthritis is a form of arthropathy that involves inflammation of one or more joints, while the term arthropathy may be used regardless of whether there is inflammation or not.
Coccydynia is a medical term meaning pain in the coccyx or tailbone area, usually brought on by sitting too abruptly. Coccydynia is also known as coccygodynia, coccygeal pain, coccyx pain, or coccalgia.
A discectomy (also called open discectomy) is the surgical removal of herniated disc material that presses on a nerve root or the spinal cord. The procedure involves removing the central portion of an intervertebral disc, the nucleus pulposus, which causes pain by stressing the spinal cord or radiating nerves. The traditional open discectomy, or Love's technique, was published by Ross and Love in 1971. Advances in options have produced effective alternatives to traditional discectomy procedures (i.e. Microdiscectomy, Endoscopic Discectomy, and Laser Discectomy). In conjunction with the traditional discectomy, a laminotomy is often involved to permit access to the intervertebral disc. In this procedure, a small piece of bone (the lamina) is removed from the affected vertebra, allowing the surgeon to better see and access the area of disc herniation.
An endoscopic procedure is commonly referred to as “getting scoped”. An endoscopic discectomy is the surgical removal of herniated disc/bulging disc material that presses on a nerve root or the spinal cord. Laser Spine Institute surgeons use an endoscopic - or minimally invasive - approach for this procedure. It is performed when a patient's history, physical examination and imaging (such as a CT scan or MRI) indicate a herniated or bulging disc, and the material inside the disc has not ruptured into the spinal canal.
Facet syndrome is a syndrome in which the zygapophysial joints (synovial diarthroses, from C2 to S1) cause back pain. 55% of facet syndrome cases occur in cervical vertebrae, and 31% in lumbar. Facet syndrome can progress to spinal osteoarthritis, which is known as spondylosis. Pathology of the C1-C2 (atlantoaxial) joint, the most mobile of all vertebral segments, accounts for 4% of all spondylosis.
Failed Back Syndrome
Failed back syndrome or post-laminectomy syndrome is a condition characterized by persistent pain following back surgeries. Failed back syndrome (FBS), also called "failed back surgery syndrome" (FBSS), refers to chronic back and/or leg pain that occurs after back (spinal) surgery, usually after laminectomy. It is characterized as a chronic pain syndrome. Multiple factors can contribute to the onset or development of FBS. Contributing factors include but are not limited to residual or recurrent disc herniation, persistent post-operative pressure on a spinal nerve, altered joint mobility, joint hypermobility with instability, scar tissue (fibrosis), depression, anxiety, sleeplessness and spinal muscular deconditioning. An individual may be predisposed to the development of FBS due to systemic disorders such as diabetes, autoimmune disease and peripheral blood vessels (vascular) disease.
Fibromyalgia (FM or FMS) is characterised by chronic widespread pain and allodynia (a heightened and painful response to pressure). Fibromyalgia symptoms are not restricted to pain, leading to the use of the alternative term fibromyalgia syndrome for the condition. Other symptoms include debilitating fatigue, sleep disturbance, and joint stiffness. Some people also report difficulty with swallowing, bowel and bladder abnormalities, numbness and tingling, and cognitive dysfunction. Fibromyalgia is frequently associated with psychiatric conditions such as depression and anxiety and stress-related disorders such as post traumatic stress disorder. Not all people with fibromyalgia experience all associated symptoms.
Kyphosis (from Greek κυφός kyphos, a hump), refers to the normal convex curvature of the spine as it occurs in the thoracic and sacral regions. Inward concave curving of the cervical and lumbar regions of the spine is called lordosis. The term kyphosis can also be used to describe excessive kyphosis or overcurvature when it is also known as hyperkyphosis. Kyphosis can be called roundback or Kelso's hunchback. It can result from degenerative diseases such as arthritis; developmental problems, most commonly Scheuermann's disease; osteoporosis with compression fractures of the vertebrae, or trauma. A normal thoracic spine extends from the 1st to the 12th vertebra and should have a slight kyphosis ranging from 20° to 45°. When the "roundness" of the upper spine increases past 45° it is called "hyperkyphosis". Scheuermann's kyphosis is the most classic form of hyperkyphosis and is the result of wedged vertebrae that develop during adolescence. The cause is not currently known and the condition appears to be multifactorial and is seen more frequently in males than females.
Neck Pain (Cervicalgia)
Neck pain (or cervicalgia) is a common problem, with two-thirds of the population having neck pain at some point in their lives. Neck pain, although felt in the neck, can be caused by numerous other spinal problems. Neck pain may arise due to muscular tightness in both the neck and upper back, or pinching of the nerves emanating from the cervical vertebrae. Joint disruption in the neck creates pain, as does joint disruption in the upper back.
Occipital neuralgia, also known as C2 neuralgia, or (rarely) Arnold's neuralgia, is a medical condition characterized by chronic pain in the upper neck, back of the head and behind the eyes. These areas correspond to the locations of the lesser and greater occipital nerves. The greater occipital nerve also has an artery that supplies blood that is wrapped around it - the occipital artery - that can contribute to the neuralgia. This condition is also sometimes characterized with diminished sensation in the affected area as well.
Vertebroplasty and kyphoplasty are similar medical spinal procedures in which bone cement is injected through a small hole in the skin (percutaneously) into a fractured vertebra with the goal of relieving back pain caused by vertebral compression fractures. It was found not to be effective in treating osteoporosis-related compression fractures of the spine in the only two placebo controlled and randomized clinical trials. The patients in both the experimental and placebo groups of the blinded study reported improvement in their pain, suggesting that the clinical benefit noted in unblinded trials is related to the placebo effect.
Peripheral neuropathy (PN) is damage or disease affecting nerves, which may impair sensation, movement, gland or organ function, or other aspects of health, depending on the type of nerve affected. Common causes include systemic diseases (such as diabetes or leprosy), vitamin deficiency, medication (e.g., chemotherapy), traumatic injury, excessive alcohol consumption, immune system disease, or infection, or it may be inherited (present from birth). In conventional medical usage, the word neuropathy (neuro- + -pathy) without modifier usually means peripheral neuropathy.
Piriformis syndrome is a common cause of buttock and posterior leg pain. Typically, the piriformis muscle becomes taught, tender, and contracted. This causes a deep aching sensation in the mid-gluteal region that is sometimes associated with pain radiating down the posterior leg. The tight piriformis muscle may cause a nerve and vessel entrapment syndrome because of its close proximity to the sciatic nerve and surrounding vessels. The piriformis muscle exits the pelvis through the greater sciatic foramen and inserts on the greater trochanter of the femur. The obturator internus exits the pelvis by passing through the lesser sciatic foramen. It also inserts on the greater trochanter of the femur. Both muscles assist in the same movement of the thigh (external rotation and abduction). The primary symptom of piriformis syndrome is buttock pain, with or without posterior thigh pain, that is aggravated by sitting or activity. Associated low back pain suggests involvement of other structures, such as facet joints or iliopsoas muscles. In an isolated piriformis syndrome, the major findings include buttock tenderness from the sacrum to the greater trochanter and reproduction of buttock pain on prolonged hip flexion, adduction, and internal rotation.
Reflex Sympathetic Dystrophy or RSD
Complex regional pain syndrome (CRPS) formerly reflex sympathetic dystrophy (RSD), "causalgia", or reflex neurovascular dystrophy (RND) is an amplified musculoskeletal pain syndrome (AMPS). It is a chronic systemic disease characterized by severe pain, swelling, and changes in the skin. CRPS is expected to worsen over time. It often initially affects an arm or a leg and often spreads throughout the body; 92% of patients state that they have experienced a spread, and 35% of patients report symptoms in their whole body.
A rhizotomy is a term chiefly referring to a neurosurgical procedure that selectively destroys problematic nerve roots in the spinal cord, most often to relieve the symptoms of neuromuscular conditions such as spastic diplegia and other forms of spastic cerebral palsy. The selective dorsal rhizotomy (SDR) for spastic cerebral palsy has been the main use of rhizotomy for neurosurgeons specialising in spastic CP since the 1980s; in this surgery, the spasticity-causing nerves are isolated and then targeted and destroyed. The sensory nerve roots, where spasticity is located, are first separated from the motor ones, and the nerve fibres to be cut are then identified via electromyographic stimulation. The ones producing spasticity are then selectively lesioned with tiny electrical pulses.
Sacroiliac Joints (SI joint)
The sacroiliac joint (SIJ) is the joint in the bony pelvis between the sacrum and the ilium of the pelvis, which are joined by strong ligaments. In humans, the sacrum supports the spine and is supported in turn by an ilium on each side. The joint is a strong, weight bearing synovial joint with irregular elevations and depressions that produce interlocking of the two bones. The human body has two sacroiliac joints, one on the left and one on the right, that often match each other but are highly variable from person to person.
Sciatica (sciatic neuritis, sciatic neuralgia, or lumbar radiculopathy) is a set of symptoms including pain caused by general compression or irritation of one of five spinal nerve roots of each sciatic nerve—or by compression or irritation of the left or right or both sciatic nerves. Symptoms include lower back pain, buttock pain, and numbness, pain or weakness in various parts of the leg and foot. Other symptoms include a "pins and needles" sensation, or tingling and difficulty moving or controlling the leg. Typically, symptoms only manifest on one side of the body. The pain may radiate above the knee, but does not always.
Spinal stenosis is an abnormal narrowing (stenosis) of the spinal canal that may occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. Symptoms include pain, numbness, paraesthesia, and loss of motor control. The location of the stenosis determines which area of the body is affected. With spinal stenosis, the spinal canal is narrowed at the vertebral canal, which is a foramen between the vertebrae where the spinal cord (in the cervical or thoracic spine) or nerve roots (in the lumbar spine) pass through. There are several types of spinal stenosis, with lumbar stenosis and cervical stenosis being the most frequent. While lumbar spinal stenosis is more common, cervical spinal stenosis is more dangerous because it involves compression of the spinal cord whereas the lumbar spinal stenosis involves compression of the cauda equina.
Spondylolisthesis & Spondylosis
Spondylolisthesis is the forward displacement of a vertebra, especially the fifth lumbar vertebra, most commonly occurring after a break or fracture. Backward displacement is referred to as retrolisthesis. Spondylosis is a term referring to degenerative osteoarthritis of the joints between the center of the spinal vertebrae and/or neural foramina. If this condition occurs in the zygapophysial joints, it can be considered facet syndrome. If severe, it may cause pressure on nerve roots with subsequent sensory and/or motor disturbances, such as pain, paresthesia, or muscle weakness in the limbs.
Trigger points, also known as trigger sites or muscle knots, are described as hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers. The trigger point model states that unexplained pain frequently radiates from these points of local tenderness to broader areas, sometimes distant from the trigger point itself. Practitioners claim to have identified reliable referred pain patterns which associate pain in one location with trigger points elsewhere. There is variation in the methodology for diagnosis of trigger points and a dearth of theory to explain how they arise and why they produce specific patterns of referred pain.