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Index
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Note: Page numbers in bold refer to chapters. Page numbers in italics refer to illustrations or charts.
A
abdominal muscles, 47-48
acetaminophen (Tylenol), 10, 28, 29, 30, 39
acetyl salicylic acid (aspirin), 10, 17, 28, 29, 30
Acromed, 218
Actiq (fentanyl oral swabs), 34, 36, 37
activity and exercise. See also specific forms of exercise such as yoga: alternatives, 62; bed rest compared to, 52; benefits, 20; exercise tolerance, 60, 61; in pregnancy, 44; range-of-motion exercises, 20, 53; sports, 47-48; stingers, 113, 147; strengthening the spine, 47-49, 52, 53, 54, 58; stretching, 48-49, 52, 54, 90-91; treatments based on, 18-20, 58-59, 61
acupressure, 18-19, 58
acupuncture, 18-19, 57-58
Adcon-L, 181
adhesions, 27, 140, 158-59, 202
alendronate (fosamax), 93
Aleve (naproxen), 10, 17, 28, 29
Alexander technique, 18-19, 59
alkaloids, 38
allergic reactions, 266, 272, 281
allografts: advantages, 233-34, 254, 282; in cervical fusion surgery, 240; disadvantages, 262; lumbar implants, 254; rejection, 281; sources, 249, 255; vertebrectomies, 195
Ambrose, Jamie, 125
amitripyline (Elavil), 39
analgesics, 31, 39
anatomy, 63-80
anesthesia: allergic reactions, 272; anesthetics, 31-32, 32, 155; fees, 303; multidisciplinary pain management, 54-55; preemptive anesthesia, 175-76; risks, 172, 275-77
anesthetic discogram, 82, 160, 251
aneurysms, 102
anger management, 56
angiograms, 126, 133-34
ankles, 97, 98
ankylosing spondylitis, 115-16
annulus fibrosis: anatomy, 70, 70; annular tears, 82-83, 84, 86, 101, 128, 160; intradiscal electrothermy (IDET), 128, 164-65, 165
anterior-posterior (AP) X-ray, 122
anti-inflammatory drugs, nonsteroidal (NSAIDs): blood clots, 276; categories, names, and risks, 29; combination medications, 35; diagnostic injections, 155; functions, 17, 28-31; for musculoskeletal pain, 10, 100; neuropathic pain, 38; pre-surgical cessation, 174; during surgery, 175-76
antibiotics, 176, 272, 273, 275
antidepressants, 39
antiemetics (anti-nausea medications), 176
antihypertensives, 32
antiseizure medications (anticonvulsants), 38, 39
antispasmodic medicines, 17
anxiety, 56
aorta, 9, 102
aqua therapy, 59
arachnoid, 73, 110
arbitration agreements, 173-74
arms: anatomy, 74, 75; foraminal stenosis, 85; herniation of the cervical spine, 83, 98-99; medical causes for pain, 102; neck pain and, 14; thoracic outlet syndrome, 117
Arnold-Chiari Malformations, 110-11, 111, 202
arteries, blocked, 17
arthritis: artificial disks, 236, 256; bone spurs from, 14; implants and fusion, 232; narrowing of spinal canal, 16, 192; pedicle screws, 216
arthroplasty, 221-22, 256, 259
Arthrotec (Diclofenac with misoprostol), 29
articular processes, 65
articulations, 65
Aspen collar, 183
aspirin (acetyl salicylic acid), 10, 17, 28, 29, 30
assignment of benefits, 174
athletes, 113, 147
Atlas vertebra, 67, 67
auto accidents, 45-47
autografts: advantages, 144; disadvantages, 234, 261-62; discectomy, 233; hip bone, 195, 233, 234, 254; vertebrectomy, 195
autologous blood, 180, 270, 271
autonomic nervous system, 26, 55, 74-75, 77
availability of treatments, 51
Axis vertebra, 67, 67
axon fibers: anatomy, 72, 146, 146; axonal transport, 39, 151; radiofrequency lesions, 163-64; regeneration, 141, 142-43
B
back pain: causes, 8-10, 13-14, 16-17, 102, 102-3; symptoms, 100-104; three-month rule, 17-21
back school, 18-19, 54
Baclofen (lioresal), 17, 32
Bagby, George, 220
BAK cages, 220
balance, 90, 103, 115
basal ganglia, 77, 79
baths, 20, 56
bed rest, 20-21, 52
beds, 43
benefits, assignment of, 174
benefits of surgery, 172
Bextra (valdecoxib), 29, 30
biofeedback, 56
biotechnology. See technological advances
bladder, 15, 83, 85, 108
blocked arteries, 17
blood-brain barrier, 150
blood clots, 276
blood loss during surgery, 180, 270-72
blood thinners, 276
blood vessels, 13, 16
board certification of surgeons, 286-87
body weight, 48, 60-61
bone-carving techniques, 212-13
bone growth, 261-65, 264
bone morphogenetic protein (BMPs), 265-67
bone rings, 254
bone spurs (osteophytes): development of, 84-87, 192; diagnosis, 86; imaging, 156; neck pain, 14-15; radiculopathy, 88; removing, 232
bones, 273-74, 279-80
bowel control, 15, 83, 85, 108
braces, 43, 54
brachial plexus, 74, 75, 100, 100
bradykinins (inflammatory chemicals), 140
brain, 23, 79, 150
bruises, 147
butalbital (Fioricet), 39
buttock pain, 11-13
C
cable-and-strut assemblies, 240
caffeine, 39
cages, 220-21, 222, 254, 255
calcium, 93-94, 262-63
cancellous bone, 64
cancers, 102
car accidents, 45-47
carbamazepine (Tegretol), 39
carbon-fiber implants, 222-24, 223, 263
cardiovascular risks, 276-77
carisoprodol (Soma), 17, 31, 32
carpal tunnel syndrome, 99, 135
CAT scans. See CT scans (computerized axial tomography)
Catapes TTS (clonidine patch), 32, 37
caudal epidural, 158
causalgia, 26
Celebrex (celcoxib), 29
cell saver devices, 180, 271-72
central canal, 72
central nervous system, 23, 24. See also brain; spinal cord
central pain, 25-26, 27
centrally acting pain medications, 39
cerebellar tonsils, 110-11
cerebellum, 78, 79, 111
cerebral cortex, 76-77
cerebrospinal fluid (CSF), 72, 111, 158, 201-2
cervical collar, 92, 183, 234, 238
cervical spine. See also neck: anatomy, 63, 65, 66, 66-69, 67, 68, 71-72, 74; anterior cervical plating system, 235; artificial disks, 237; foraminotomy, 193, 194; fractures, 219-20, 221; herniation, 83, 87-88, 98-99, 99; laminectomy, 190; number of vertebrae, 117; pain in, 14-16; radiculopathy, 99; recovery from surgery, 295; risks of surgery, 279; slippage in spinal joints, 90; stenosis, 99; subluxation, 89, 92; surgery, 229-41, 231, 279, 295; thoracic outlet, 117; time required for fusion, 294; torn ligaments, 92; traction, 52-53; types of problems, 85; vertebrectomy, 196
chairs, 10, 43
chest, 16-17, 83, 88, 102
children, 192, 213, 214
chiropractic manipulation, 14, 16, 18-19, 59-60, 61
chlorzoxazone (Parafon Forte), 32
chronic pain, 12-13, 25, 27
claudication pain, 13-14
claw devices, 240
cleaning activities, 43-44
Clinoril (sulindac), 29
clonidine patch (Catapes TTS), 32, 37
clonus, 104
Cloward, Ralph, 212
clumsiness, 15
coblation, 167-68
coccyx, 68
codeine and aspirin (Empirin), 34
codeine and Tylenol (Tylenol no. 3), 34, 35
cohort studies, 284
complex regional pain syndrome (CRPS), 26, 169
complications of surgery, 269-82
computer ergonomics, 42
computer image-guidance systems, 224-26, 225, 239, 247, 257
computerized axial tomography. See CT scans
condyle, 65
congenital abnormalities, 13, 202
congenitally narrow spinal canal, 113
Consumer Reports, 46
contrast agents, 126-29, 160
coordination, 15
corsets, 43, 54
cortex, 64, 79
cosmetic issues, 178, 184, 292-93
costovertebral joints, 69
costs of surgery, 299-311
counseling, 56
COX-2 inhibitors, 29, 30
cranium, 63
CT scans (computerized axial tomography): carbon-fiber implants, 223, 223, 263; checking for bone spurs, 86; chronic pain, 101; contrast agents, 126-29; facet blocks, 159; functions, 120, 124, 124-26; identifying slippage, 89; myelography, 126, 127, 203; stenosis, 193
cubital tunnel, 100, 135
curvature and ankylosing spondylitis, 115-16
cyclobenaprene (Flexeril), 17, 31, 32
cysts, 73
D
Damadian, Raymond, 131
Danek Corporation, 221
Darvocet (propoxyphene), 34, 35
Darvon (propoxyphene and aspirin), 34, 35
Daypro (oxaprazosin), 29
DEA Schedule II and III narcotics, 34
decompression, 91, 237, 238
deep vein thrombosis (DVT), 276
delays in treatment, 17-18
Demerol (meperidine injection), 34
demineralized bone matrix (DBM), 262
demyelination, 141-42
dens ("tooth"), 68
depression, 56
Dermabond, 182, 182, 293
dermatome, 97, 99
desk work, 42
diagnosis, 52, 119-37. See also imaging
diazepam (Valium), 17, 31, 32
Diclofenac (Voltaren XR), 29, 30
Diclofenac with misoprostol (Arthrotec), 29
diffuse idiopathic spinal hyperostosis (DISH), 116
Dilantin (phenytoin), 39
Dilaudid (hydromorphone), 34, 36
discography: annular tears, 82-83; contrast agents, 126; myelogram compared to, 128; procedures, 128-29, 160-61, 161, 251
disks: anatomy, 70-71; artificial disks, 236-37, 237, 255-56; bulging disks, 81-84, 84, 86, 87, 87-88, 156, 160-61; discitis (infections), 273-74; discogenic pain, 82, 164, 251; discoplasty, 167-69; diskectomies, 186-89, 188, 230-32, 272; replacement technologies, 264; tears, 128, 164-65, 165; thoracic spine, 69
dislodgment, 281-82
distracting stimuli, 27
distribution, 24-25
dorsal root ganglia, 73, 134, 146
double-blind randomized trials, 282-83
drainage, 294
Drug Enforcement Agency (DEA), 35
dual-energy X-ray absorpsiometry (DEXA) scan, 93, 122
dura: anatomy, 73; Arnold-Chiari malformations, 110; epidural injections, 158; myelography, 127, 203; surgery inside dural lining, 201-6; tumor locations, 198, 199
Duragen, 203
Duragesic (Fentanyl patch), 34, 36
E
elasticity, 263-64
Elavil (amitripyline), 39
electrical nerve testing, 98
electrical stimulation, 53
electrodiagnosis, 134-37, 136
electromyography (EMG), 135, 136
electroneural interfaces, 151-52
electronic fusion stimulators, 268
electronic pain relief, 163-67
eloquent (neurological quality), 14
embolization, 197-98
emergencies, 8, 172
Empirin (codeine and aspirin), 34
end plates, 64
endorphins, 38
endoscopy, 168-69, 178, 245, 246, 253-54
entubulation, 144-45
epidural abscesses, 274
epidural injections, 13, 156-58, 157
epidural stimulators, 166, 166-67
epiduroscopy, 158-59
epineurium, 73, 141
ergonomics, 20, 41-49
esophagus, 16
evoked potential, 136, 136-37
exercise. See activity and exercise
expectations of patients, 51
expense of treatments, 51
experimental procedures, 171, 310-11
exploratory surgery, 137
extrusions, 83-84, 88
F
facet joints: anatomy, 64, 65-66; artificial joints, 259; facet blocks, 157, 159, 164; facetectomy, 194; pain in, 159, 164, 243, 249
fascia, 181, 291-92
fascicles, 140, 141, 145
feet, 15
Feldenkrais, 18-19, 59
fellowship training for surgeons, 287
femoral nerves, 74, 76, 97
fentanyl oral swab (Actiq), 34, 36, 37
Fentanyl patch (Duragesic), 34, 36
fetuses, 129
fibrocytes, 140
fibrosis (scarring): antiscarring agents, 181; of the dura, 202; limiting, 150; lysis of adhesions, 158-59; nerve compression and, 140-41; nerve regeneration and, 143, 150; spinal cord injuries, 145, 147, 148; surgical wound, 293-94
fibula bone, 135
"fight or flight nerves," 75
filum terminale, 109
financial considerations, 299-311
fingers, 14, 15, 87, 99-100, 117
Fioricet (butalbital), 39
fixation, 209-21
"flat back syndrome," 252
Flexeril (cyclobenaprene), 17, 31, 32
flexibility, 58
flexion-extension studies, 92, 123
fluoroscopy, 120, 121, 209, 210, 257-58
Food and Drug Administration (FDA): artificial disks, 236, 256; carbon-fiber spine implants, 224; cervical lateral mass screws, 241; disk replacement technologies, 264; Luque system, 215; oversight authority, 171; pedicle screws, 217-18
foramen: anatomy, 65; foraminotomy, 192-93, 194, 230-32, 237-38; radiculopathy, 87; stenosis, 85, 86
foramen magnum, 110-11, 111, 202
fosamax (alendronate), 93
fractures: cervical spine, 210, 219-20, 221; diagnosis, 131; osteoporotic fractures, 94; risks, surgical, 280; seat belt fractures, 218-19; spontaneous spine fractures, 93; thoracic spine, 244, 248; unlocking, 208-9
fragile bones, 93-94. See also osteoporosis
"funny bone," 100
furniture, 43
fusion: anti-inflammatory agents, 176; benefits, 211-12; blood loss, 180; cervical spine, 232-33, 237, 238; electronic fusion stimulators, 268; failed fusions, 280, 281, 296; grafts, 232-33, 240; implants, 222, 232; lumbar spine, 91, 251-52, 255, 294; posterolateral fusion, 258; proteins and, 265-67, 266; spine carpentry, 209-21; time required, 294-96
G
gabapentin (Neurontin), 38, 39
ganglion, 73
gene therapy, 38-39, 265, 267
Glacier Cross, Inc., 53
Gore-Tex, 202-3
grafts. See also implants: advantages, 233-34, 254, 282; disadvantages, 262, 281; dural substitutes, 202-3; fusion, 232-33, 240; lumbar implants, 254; nerve grafts, 144-45; rejection, 281; sources, 249, 255, 261-65; for vertebral disks, 221; vertebrectomies, 195, 249, 249-50
gray matter, 71-72, 72, 146, 146-47
H
hamstring muscles, 58
hands, 14-15, 75, 85, 86, 117, 117
hardware for bone repair, 186, 210-11, 212-24. See also implants
Harrington, Paula, 213
Harrington rod, 213-15, 214, 219
headaches, 15, 111, 202
heart problems, 16, 17, 102
heat, 53
Hellerwork, 18-19
helplessness, feelings of, 56
hemilaminectomy, 190-91
herniation: anatomy, 69; cervical spine, 98-99, 99; discectomy, 186-89; imaging, 131; injections, 157; location of, 87-88; lumbar spine, 97; radiculopathy, 88; recovery from, 140; reherniation, 296; results of, 83-84; sciatica, 96-98, 97, 98; thoracic spine, 243, 244; types of, 84
hip joint, 58
hoarseness, 172-73, 230, 275
holistic approaches, 20
holograms, 129-30
home environment, 43-44, 54
hot wires, 189
Hounsfield, Sir Godfrey Newbold, 125
hydrocodone and aspirin (Vicoprofen), 34, 35
hydrocodone and Tylenol (Norco, Lorcet, or Vicodin), 34, 35
hydromorphone (Dilaudid), 34, 36
hypnosis, 18-19
I
ibuprofen (Motrin), 17, 28, 29
imaging. See also specific technologies such as X-rays, magnetic resonance imaging (MRI) or CT scans: available technologies, 119-37, 132; bone spurs, 86; carbon-fiber implants, 223, 223, 263; contrast agents, 126-29; diagnosing chronic pain, 101; discography, 82, 160; facet blocks, 159; false positives, 96, 156; flexion and extension, 92, 123; identifying slippage, 89; image-guided surgery, 179, 224-26, 225, 227, 239, 247, 248-49, 257, 257-58; injections and, 82-83, 101, 156-63, 157 (see also discography); myelography, 127, 203; prenatal imaging, 129; risks, 131; spinal cord compression, 104; spinal cord injuries, 148; spine carpentry, 207; stenosis, 193; surgery preparations, 174; torn spinal ligaments, 92, 92
immobilization and healing, 27
Imodium, 33
impingement syndromes, 99
implants. See also grafts: carbon-fiber implants, 222-24, 223, 263; fusion and, 232-33; infections, 274-75; interbody implants, 220-21, 252-56; metal implants, 127, 250; risks of surgery, 280-82; in spine carpentry, 210-11; titanium implants, 234-36, 249, 254, 255, 263, 264; types of, 254
incentive spirometer, 273
incisions, 177-79
Indocin (indomethacin), 29
infections, 9, 102, 172, 272-75
inflammation, 24, 55, 114-15, 157, 281
informed consent, 171-74, 285-86
InFuse, 267
injections: diagnosis and treatment, 156-63; epidurals, 13, 156-58, 157; imaging, 82-83, 101, 156-63, 157 (see also discography); intradiscal injections, 82-83, 164; local anesthetic, 277; locations, 157; outcomes, 51-52
instability in spinal joints, 89-92
insurance, 299-302, 304-11
intention, 76-77
interactive therapies, 56
Interbody Fusion System, 220
intercostal nerves, 74, 243
intradiscal anesthetic injections, 164
intradiscal electrothermy (IDET), 128, 164-65, 165
intraoperative electrodiagnostic monitoring, 136, 136-37
introspective methods, 55-56, 58
intubation, 275-76
iodine, 126
irritation of nerves, 140
isometrics, 61
J
joints of the spine: artificial, 259; bone spurs (osteophytes), 85; costovertebral joints, 69; facet joints, 64, 65-66, 159, 164, 243, 259; instability in, 89-92; multiple joint facet syndrome, 159; rehabilitation for, 52-53; risks of surgery, 279-80; slippage in (spondylolisthesis), 89-92, 90, 116; unco-vertebral joint, 192
K
Kadian (morphine slow-release), 34
Kaneda, Kiyoshi, 219
Keppra (levitiracetam), 39
Kerrison punch, 193
Kessler, Richard, 217-18
ketoprofen (Orudis), 29
ketorolac intravenous (Toradol), 29, 30, 276
kidneys, 9, 102
knees, 97, 98
Kuslich, Stephen, 220
kyphoplasty, 196, 197
kyphosis, 191
kyphotic deformity, 191
L
Lamictal (Lamotrigine), 39
lamina, 64, 65, 185, 189, 258
laminectomy, 113, 115, 189-92, 193
laminoplasty, 115, 189-92, 191
Lamotrigine (Lamictal), 39
lasers, 167, 189, 198
lateral mass, 65
lateral mass screws, 238-40, 239, 241
lateral recess stenosis, 194
lateral X-ray, 122
Lauterbur, Paul, 130-31
legal rights, 173-74. See also litigation
legs: anatomy, 74, 76; claudication pain, 13-14; herniation in the lumbar spine, 83; neck injury and, 15; ossification of the posterior longitudinal ligament, 115; sciatica, 11-13; spinal stenosis, 85, 157; spondylolisthesis, 89
levitiracetam (Keppra), 39
liability litigation, 174, 216-18, 223, 278
lidocaine derivative-oral (Mexilitene), 32, 32
lidocaine (injectable anesthetic), 32
lidocaine patch (Lidoderm), 32, 32
lifting, 42-43, 44, 292
ligaments, 10, 10, 92, 92, 100
ligamentum flavum, 87, 187
lioresal (Baclofen), 17, 32
lipomyelomeningocele, 108-9
litigation, 174, 216-18, 223, 278
loading and lubrication, 52
localization, 95
long tracts of white matter, 71-72, 79, 146, 146-47
Lorcet (hydrocodone and Tylenol), 34
lumbar spine: anatomy, 10, 63, 64, 65, 68, 68, 74; artificial lumbar facet joints, 259; exercise-based treatments, 58; foraminotomy, 193; fusion, 91, 251-52, 255, 294; herniation, 83, 97; imaging, 156; implants, 252-56; lumbar disks, 70; lumbar drain, 202; lumbar support, 43, 45; number of vertebrae, 117-18, 118; pain in, 9-10; pedicle screws, 256-58; recovery from surgery, 295; risks of surgery, 279; sciatica, 12, 98; slippage in spinal joints, 91; stenosis, 87; surgery, 251-59, 279, 295; traction, 53
lumbosacral plexus, 74, 76
lungs, 16, 17
Luque system, 215-16
M
magnetic resonance imaging (MRI): carbon-fiber implants, 223, 223; chronic pain, 101; discography, 82, 160; facet blocks, 159; false positives, 96, 156; functions, 130-34; identifying slippage, 89; lumbar spine, 156; MR angiography, 133-34; MR myelogram, 134; MR neurography, 98, 133-34, 134; narrowing of the foramen, 193; osteophytes, 86; surgery within scanners, 226, 227; torn spinal ligaments, 92; types, 132
manipulation, chiropractic, 14, 16, 18-19, 59-60, 61
Mansfield, Sir Peter, 131
manual reduction of fractures, 208-9
Marcaine (injectable anesthetic), 32
marrow, 64
massage, 18-19, 20, 53, 61
median nerves, 74, 99
Medicare, 306-7, 308-9
medications. See also anesthesia; specific drug names: addiction, 37; blood thinners, 276; categories, 25, 28-39, 29, 32, 34, 39; centrally acting pain medications, 39; drug delivery techniques, 39, 40, 150-51; failure to alleviate pain, 27; Medicare, 307; neural protection and regeneration, 150; prophylactic antibiotics, 176; side effects, 29, 34; spinal cord injuries, 149
meditation, 55-56
Medrol Dosepak (methylprednisolone), 31, 32, 150
meningitis, 274
Mensendieck, 18-19
meperidine injection (Demerol), 34
Mercedes, 46
metabolic disorders, 102
metal implants, 127
metaxalone (Skelaxin), 32
methocarbamol (Robaxin), 31, 32
methylprednisolone (Medrol Dosepak), 31, 32, 149, 150
Mexilitene (lidocaine derivative-oral), 32, 32
Miacalcin, 93, 94
microchips, 151
microdiscectomy, 187, 188
microendoscopy, 188-89
mind-body connection, 20, 55
misoprostol with Diclofenac (Arthrotec), 29
morphine pump, 161-63, 162
morphine slow-release (Kadian or MS Contin), 34, 36
motion, neural control of, 75-80
motor circuitry, 78
motor evoked potentials (MEPs), 136-37
motor nerve filaments, 73
motor neurons, 79
motor units, 79
Motrin (ibuprofen), 17, 28, 29
movement, 15, 20, 66-67
MR angiography, 133-34
MR myelogram, 134
MR neurography, 98, 133-34, 134
MS Contin (morphine slow-release), 34, 36
multiple joint facet syndrome, 159
multiple sclerosis, 102
muscles: muscle relaxants, 31, 32; muscle spasms, 17, 31, 181, 292; sensors, 79, 79-80; strained muscles, 100
musculocutaneous nerves, 74
myelin, 141, 148
myelography: discogram compared to, 128; MR myelograms, 134; nerve root pinches, 193; procedure, 126, 127; sealing the dura, 203
myelomeningocele, 108
myelopathy, 87-89, 103-4, 104
N
nabumetone (Relafen), 29
Naprosyn (naproxen), 28
naproxen (Aleve), 10, 17, 28, 29
narcotics, 33, 34, 35, 36-37, 38, 277
narrowing. See stenosis
neck. See also cervical spine: causes of pain, 14-16; cervical collars, 14, 92, 183, 234, 238; stiffness, 274; surgery, 101-2; symptoms, 98-99, 99, 100-104; trauma risks, 92
nerves: anatomy, 71-75, 72, 73, 75, 76, 146; broken nerves, 142-43; compression, 140-41, 185-200; conduits, 140, 142-43, 144-45; contrast agents, 126, 127, 145; crunched nerves, 86; grafts, 144-45; nerve compression, 91; nerve conduction velocity (NCV), 135; nerve diseases, 102; neuropathic pain, 24-25, 38; numbering, 74; pain communication, 24; peripheral nerves, 11; pinched nerves, 86, 87, 88, 101, 140; recovery, 139-45; regeneration, 142-43, 150; risks of surgery, 279; root blocks, 157, 159; rootlets, 73, 73; sciatica, 11-13; structure, 141; surgery, 101-2, 185-200, 279; types of nerve damage, 141
nervi nervorum, 25
nervous system, 23, 24. See also brain; spinal cord
neural control of motion, 75-80
neural protection and regeneration, 150
neural tissue risks, 278-79
Neuro Tube products, 145
NeuroGen, 145
neurologic injuries, 92, 216
neurologic symptoms, 86, 108, 111, 113
neuroma, 143
neurons, 71-72
Neurontin (gabapentin), 38, 39
neuropathies, 14
neurosurgeons, 16
nonmedical approaches to treatment, 18-20, 58-59
nonsteroidal anti-inflammatories. See anti-inflammatory drugs
nonsurgical treatments, 51-62
Norco (hydrocodone and Tylenol), 34
notochord, 70-71
novacaine (injectable anesthetic), 32
NSAIDs. See anti-inflammatory drugs
nuclear medicine, 119, 129
nucleoplasty, 168, 189
nucleus pulposus, 70, 70-71, 83-84, 84, 188
numbness: cervical spine origins, 14-15; herniation, 99; nerve entrapments, 98; nerve root blocks, 159; pressure on nerves, 140; sciatica, 12-13; slipped vertebra, 89; subdural empyema, 274; tethered cord syndrome, 108; thoracic outlet compression, 15
Nuquin, 184
O
obex, 111
oblique X-ray, 122
obturator nerves, 74
occipital condyle, 65, 67
occipital muscles, 15
older people, 13
operating microscopes, 178
opiates, 36, 38
ordination, 14
Orudis (ketoprofen), 29
ossification of the posterior longitudinal ligament (OPLL), 114, 114-15, 192
osteoblasts, 266, 294
osteoclast cells, 266, 294
osteocytes, 294
osteogenic proteins, 267
osteomyelitis, 273-74
osteopathy, 18-19
osteophytes. See bone spurs
osteoporosis: collapsed vertebra, 248; development and effects of, 93-94, 94; evaluation of, 122; kyphoplasty, 196, 197; as surgical complication, 240
osteoporotic fractures, 94
outcomes, 282-87
oxaprazosin (Daypro), 29
oxycodone and Tylenol (Percocet or Percodan), 34, 36
oxycodone fast-release tablet (Oxy-IR), 34, 36, 37
oxycodone slow-release tablet (Oxycontin), 34, 36
oxygen, 148
P
pain: attention to pain, 23; chronic pain, 12-13, 25, 27; claudication pain, 13-14; medications, 25, 28-39 (see also anesthesia); multidisciplinary pain management, 54-55; nature of pain, 23-40; pain fibers, 55; pain generators, 52; positions for pain relief, 10, 15, 98, 100, 276; postoperative pain, 175, 180-81, 277-78; psychological impact of pain, 55-56; referred pain, 95; surgery to block, 204-5; technological advances, 38-39, 40; treatment, 26-27; types, 23-26
pancreas, 9
Parafon Forte (chlorzoxazone), 32
paralysis, 173
parasympathetic nerves, 74-75, 77
parents, 44
Parkinson's disease, 77
pars interarticularis, 116, 123
pedicle screws: functions, 215-16, 217, 219, 221, 222; litigation, 216-18; lumbar spine, 256-58, 257
pedicles, 65, 113, 121
pelvis, 58, 97-98, 98
peptides, 38
Percocet (oxycodone and Tylenol), 34, 36
Percodan (oxycodone and Tylenol), 34, 36
percutaneous procedures, 155-69
perineum, 68, 141
periosteum, 86
peripheral nerves, 11
peroneal nerve, 135
personality, 20
phenytoin (Dilantin), 39
physical therapy, 18-19, 53-54, 296, 297
Pilates, 18-19, 58-59, 61
piriformis muscle, 98
Piriformis Pinch, 96-98
placebo effects, 56-57
plasticity, 25
plate systems, 219-20, 234-35, 235-36, 249-50
pleural lining, 244-45
plus-nerve barrier, 150
pneumonia, 17, 273
point-based treatments, 57-58
polio, 213
polymers, 151, 264
pool therapy, 59
positioning, 10, 15, 98, 100, 276
positron emission tomography (PET), 129
posterior-anterior (PA) X-ray, 122
posterolateral fusion, 258
posterolateral maneuvers, 247-48
postsurgical therapy, 304
posture, 49, 54, 59
pregnancy, 44, 129
preinjury condition, 61-62
pressure, 140-41
Pronex devices, 53
prophylactic antibiotics, 176
propoxyphene and aspirin (Darvon), 34, 35
propoxyphene (Darvocet), 34, 35
prospective cooperative studies, 283-84
proteins, 265, 266, 267
provocative discogram, 82, 160
pseudoarthrosis, 233, 280
psychological aspects of pain management, 42, 54, 55-56
R
radial nerves, 74
radiculopathy, 87-89, 103
radiofrequency (RF) treatment, 163-64, 167-68
range-of-motion exercises, 20, 53
Ranitidine, 31
Ray, Charles, 220, 264
Ray Threaded Fusion Cage, 220-21
recovery, 139-52, 291-98
referred pain, 12, 95
reflex sympathetic dystrophy, 26, 169
reflexes, 103, 104
reflexology, 18-19
regeneration of nerves, 141, 142-43, 150
Reiki, 18-19
rejection, 281
Relafen (nabumetone), 29
relaxation, 56
retaining ring, 128
retrospective reviews, 284
ribs, 65, 69, 69, 117, 117
risks of surgery, 172-73, 230, 269-82, 285-86
Robaxin (methocarbamol), 31, 32
robotics, 226, 257, 268
rofecoxib (Vioxx), 29, 30
rolfing, 18, 60
Romberg sign, 104
rootlets, 73, 73
rotator cuff, 99
running, 61, 62
S
sacral spine, 10, 63, 68
safety, 19
scalene muscles, 15, 100
scarring. See fibrosis (scarring)
schools of therapy, 51-62
Schwann cell, 141-42, 145
sciatic nerves, 74, 76
sciatic notch, 98
sciatica: aspects of, 96-98; described, 11-13; extrusions and, 83; herniation, 98; lumbar spine, 98; pain distribution, 97; pelvis, 97-98, 98
scoliosis, 91, 106, 106-7, 213, 214, 214, 248
screw-and-plate systems, 219-20
screw-rod systems, 249
screws, 224, 234-35, 238-40, 239, 241, 256-57. See also pedicle screws
seat belt fractures, 218-19
second opinions, 288
secondary injury, 150
segmentation, 105
self-care, 20-21
sensors, microchip, 151
sensors, muscle, 79, 79-80
Seprafilm, 181
shiatsu, 18-19, 58, 61
shortness of breath, 16
shoulders: bone spurs, 99; brachial plexus nerves, 75; cervical spine and, 14, 15, 85; disk herniation, 98-99, 99
shunt (tube), 112
side effects of medications, 29, 34
single-photon emission-computed tomography (SPECT), 129
sitting, 12, 98, 101
Skelaxin (metaxalone), 32
slippage in spinal joints (spondylolisthesis), 89-92, 90, 116
Soma (carisoprodol), 17, 31, 32
somatic pain, 24
somatosensory evoked potential (SSEP), 136, 136-37
spa therapy, 56
spicules, 64
spina bifida, 107-13, 109
spinal canal, 64-65, 72-73, 83, 131, 192
spinal cord: anatomy, 11, 11-12, 64, 71-75, 146; blood flow, 148; compression (myelopathy), 87-89, 103-4, 104; injuries, 92, 145-49, 149, 149-52; neck pain and, 15, 16; nerves, 76; neural routing, 72; recoveries, 147-48; risks of surgery, 279; technological advances, 149-52
spine. See also specific vertebral regions, including cervical spine, thoracic spine, and lumbar spine: anatomy, 68; brain's interaction with, 79; spinal joints (see joints of the spine); spinal manipulation, 14, 16, 18-19, 59-60, 61; spine carpentry, 207-27; spine protectors, 43; spine series of X-rays, 122; technological advances in spinal repair, 221-26
spinous processes, 64, 65, 189-91, 240
spondylolisthesis (slippage), 89-92, 90, 116
spondylolysis, 116, 116, 123, 258-59
spontaneous spine fractures, 93
sports, 47-48
stabilization, 18-19, 90-91
standing, 98
staples, 181-82, 293
Steffee, Arthur, 216, 218, 222
stem cells, 267-68
stenosis: cervical spine, 99; congenitally narrow spinal canals, 113; development of, 192; effects of, 85; epidural steroids, 157; foraminal stenosis, 85; imaging, 131, 156, 193; laminectomies, 189-91, 193; lateral recess stenosis, 194; lumbar stenosis, 87; osteophyte formation, 86-87
sternotomy, 247
steroids: discograms, 160; disk herniation, 157; functions, 31; names and risks, 32; nerve root blocks, 159; postoperative pain control, 180; spinal cord injuries, 148-49, 150
stingers, 113, 147
stomach ulcers, 9, 102
strengthening the spine, 47-49, 52, 53, 54, 58. See also activity and exercise
stress, 42, 56
stretching, 48-49, 52, 54, 90-91
struts, 240
subdural empyema, 274
sublaminar wires, 240
subluxation, 89-90, 91, 92
successful outcomes, 282-87
sulindac (Clinoril), 29
sural nerves, 144
surgeons: choosing, 286-89; experience of, 287-88; fees, 302; surgeon-patient relationship, 278, 289, 314
surgery, 171-84; biotechnology, 261-68; braces, 184; cervical spine, 229-41, 231; cosmetic issues, 178, 184, 292-93; drains, 181; dressings, 183-84; exploratory surgery, 137; image-guided surgery, 179, 224-26, 225, 227, 239, 247, 248-49, 257, 257-58; inside dural lining, 201-6; lumbar spine, 251-59; nerves, 101-2, 185-200; outcomes, 51-52; postoperative pain, 180-81, 277-78; preparations for, 174-75; recovery, 291-98; retroperitoneal technique, 253; risks of surgery, 172, 269-82, 285-86; robotics, 226, 257, 268; skin closure methods, 181-83, 182; spinal cord symptoms, 103-4; spine carpentry, 207-27; surgical series, 284-85; surgical techniques, 179-80; surgical wound, 291-94; sympathectomy surgery, 169, 246; terminology, 185-86; thoracic spine, 243-50, 279; tools, 186, 210-11, 212-24; transabdominal approach, 253
sutures, 292-93
swimming, 20, 61, 62
sympathectomy surgery, 169, 246
sympathetic ganglia, 75, 169
sympathetic nerves, 74-75, 77
symptoms, 19, 95-104
synthetic vectors, 267
syringomyelia, 73, 111-13, 112
syrinx, 112
T
Tagamet, 31
tai chi, 18-19, 59
tailbone (coccyx), 68
tarsal tunnel, 98, 135
technological advances: in pain management, 38-39, 40; in spinal cord injuries, 149-52; in spinal repair, 221-26; in synthetics for bone growth, 261-65, 264
Tegaderm, 183
Tegretol (carbamazepine), 39
tension, 42, 56
terminology, 63, 185-86
tethered cord syndrome, 108-9, 109
thighs, 97
thoracic outlet syndrome, 14-16, 99, 100, 117, 247
thoracic spine: anatomy, 63, 65, 68, 68, 69, 69, 74; facets, 243, 249; fixation, 218-19; herniation, 83; number of vertebrae, 117; pain in, 16-17; pedicle screws, 248-49, 250; surgery, 196, 243-50, 249, 279; thoracotomy, 196, 244-46, 249; transaxillary and cervical access, 247; vertebrectomy, 196, 249
threaded dowels, 221
three-month rule, 17-21
tibial nerve, 98
tingling, 99, 140
titanium implants: advantages, 263; cages, 254, 255; plates, 234-35, 235-36, 249; types, 264
toes, 12, 97, 314
tools for bone repair, 186, 210-11, 212-24
Topamax (topiramate), 39
Toradol (ketorolac intravenous), 29, 30, 276
torques (rotating forces), 47
traction: benefits, 52-53, 53; cervical fracture reduction, 210; correcting subluxation, 90; Harrington Rod, 213-15; limitations, 209; for scoliosis, 91; spinal cord injuries, 149
Trager, 18-19
tramadol (Ultram), 39
transarticular screws, 224
transcutaneous electroneural stimulators (TENS), 166
transforaminal epidural, 158
transfusions, 271-72
transpedicular kyphoplasty, 248
transpedicular tunneling, 247
transverse processes, 65
travel ergonomics, 44-45
triplicate prescriptions, 35-36
trophins, 145
tubular retractors, 178
tumors: diagnosis, 131; locations, 199; pain associated with, 9; removing, 196-98; spinal cord, 205-6; thoracic spine, 244
turning, 66-67
20/20, 217
twisting, 101
Tylenol (acetaminophen), 10, 28, 29, 30, 39
Tylenol no. 3 (codeine and Tylenol), 34, 35
U
ulcers, 102
ulnar nerves, 74
Ultram (tramadol), 39
ultrasound, 53, 119, 129
unco-vertebral joint, 192
urinary tract infections, 102, 273
Urist, Marshall, 265
V
valdecoxib (Bextra), 29, 30
Valium (diazepam), 17, 31, 32
vehicle accidents, 45-47
ventral rami, 75
ventricle system, 72, 111
vertebra. See also specific vertebral regions, including cervical spine, thoracic spine, and lumbar spine: anatomy, 63-69, 64, 70; collapsed vertebra, 249; number of, 116-18, 118; rescue or removal, 248-50, 249; vertebral bodies, 64, 65, 66; vertebrectomies, 194-96, 195, 249-50
vertebral artery, 65
vibration, 43
Vicodin (hydrocodone and Tylenol), 34, 35
Vicoprofen (hydrocodone and aspirin), 34, 35
Vioxx (rofecoxib), 29, 30
vitamin D supplements, 93, 94
vocal cords, risks to, 172-73, 230, 275
Voltaren XR (Diclofenac), 29, 30
W
walking, 13, 20, 61, 90, 98, 157
weakness: nerve entrapments, 98; pressure on nerves, 140; sciatica, 12-13; spinal cord injuries, 148; subdural empyema, 274; tethered cord syndrome, 108; thoracic outlet compression, 15
wedge collapses, 93
weight (body), 48, 60-61
whiplash, 14-16, 100
white matter, 71-72, 79, 146, 146-47
wire wraps, 212
workplace, 42-43, 54
X
X-rays. See also CT scans: anterior-posterior (AP) X-ray, 122; for bone spurs, 86; carbon-fiber implants, 263; categories, 119; chronic pain, 101; computer image-guidance systems, 224, 225; contrast agents, 126-29; dual-energy X-ray absorpsiometry (DEXA) scan, 93, 122; facet blocks, 159; flexion and extension, 92, 123; fluoroscopy, 120, 121, 209, 210, 257-58; functions, 119-23; identifying slippage, 89; lateral X-ray, 122; lumbar spine, 156; myelography, 126, 127, 203; oblique X-ray, 122; posterior-anterior (PA) X-ray, 122; risks associated with, 131; spine carpentry, 207; spine series of X-rays, 122; surgery preparations, 174
Xanax, 37
xenografts, 202-3
Y
yoga, 2, 18-19, 58, 61, 62
Z
Z-plates, 219
Zanaflex (muscle relaxant), 31
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