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Glossary - P


pain fibers: Axons of pain sensitive nerve cells.


pain generator: Abnormal tissue or joint responsible for the pain that affects a larger area.


parasympathetic nerves: Part of the autonomic nervous system.


pars interarticularis: The part of a vertebra between the lamina and the superior facet; this may be abnormal in the condition called spondylolysis.


PCA (patient controlled analgesia): Method of pain treatment after surgery that allows the patient to self-administer pain medication under a controlled regimen.


pedicle: Portion of the vertebra that connects the lamina (posterior part of the vertebra) to the body anteriorly and helps forms the walls of the spinal canal. 


pedicle screws: Fixation screws that are placed through the pedicle of the vertebra.


peptides: Small proteins.


percutaneous: Procedure done through a puncture in the skin, typically by a needle or through a very narrow cannula. 


perineum: The skin and tissues between the legs. 


periosteum: The lining of the bone. It has sensation and it helps control the shape and growth of bone.


peripheral nerves: The nerves after the departure from the spinal canal, proceeding out to their end point in the skin and muscles. 


periphery: The parts of the body furthest away from the spinal cord and brain. 


peritoneum: The internal lining of the abdominal cavity.


peroneal nerve: A nerve that commences just above the knee, passes along the lateral aspect of the lower leg and helps activate muscles that lift the foot. 


phased-array coils: Equipment used in MRI scanning to improve the signal to noise or image quality of the MRI scan.


Pilates: An exercise based treatment for the spine and for overall body maintenance. 


pinched nerve: Entrapment or mechanical pressure affecting a nerve.


piriformis muscle: A muscle that runs from the sacrum to the top of the femur, that can cause buttock pain and entrap the sciatic nerve. 


placebo: A pill that carries no actual medicine.


placebo effect: Improvement of a condition experienced by a patient who believes a treatment has been administered even if the treatment was not actually done.


plantarflexion:  Bending the ankle to move the toes downwards  


plasticity: It is adaptation of the nervous system to new connection patterns. 


pleural lining: A thin lining of the lungs.


pneumonia: An infection of the lungs.


Point of Service (POS) Insurance: A plan in which the patient can enter either an HMO plan, a PPO (a preferred provider) or a non-contracted plan depending on how they commenced care for any given condition they experience. 


point based treatments: Acupuncture or acupressure for a nonsurgical treatment of back pain.


polymers: Complex molecules with many individual parts, typically such as plastics or other complex absorbable molecules used in surgical treatment and implants.


posterior: Towards the back of.


posterior longitudinal ligament: A ligament behind the vertebral bodies and anterior to the spinal dura and spinal cord.


posterior-anterior X-rays: Images obtained with the X-ray source in front of the spine and the film behind the spine. 


posterolateral fusion: A lumbar fusion done from a posterior approach and incorporating the transverse processes of the lumbar vertebrae.


PPO (preferred provider organization): Type of health insurance in which patients may choose from a physician from a list of providers who have agreed to offer care at a discount. 


prognosis: Expectation of the outcome of treatment.


preemptive anesthesia: The administration of pain medication before surgery in an attempt to prevent the pain from becoming intense as the surgery progresses. 


prophylactic: Something administered to prevent the development of a problem such as antibiotics given to prevent the possibility of an infection. 


prospective cooperative study: Test to evaluate the efficacy of a treatment, typically done by determining the clinical plan before any of the patients commence treatment and involving many different hospitals. 


provocative discogram: A test to evaluate whether an intervertebral disc is a pain generator.  Fluid is injected into the disc to learn whether the resulting pain is similar to the patient's usual pain.


pseudoarthrosis: Literally "false joint" - a painful contact between two bones that develops at the site of a failed fusion.


pus: A reactive material produced in an infection by the accumulation of the body's white cells attempting to digest bacteria.