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Glossary

Understanding the medical jargon - commonly used terms

Headaches affect almost everybody from time to time, the most common types being “tension” or “migraine” headaches. This is no different for patients with degenerative disease of the cervical spine. However, degenerative changes in the neck in rare cases, can cause a less common subtype of headache called a ‘cervicogenic’ headache.

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The spine is divided up into 5 different sections; cervical, thoracic, lumbar, sacram and coccyx. The basic arrangement of structures is largely unchanged between segments but there are important differences between the levels.

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Babinski’s sign (also known as the plantar reflex) can be a feature of myelopathy involving the cervical spinal cord.

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Myel [‘spinal cord’] opathy [‘problem’] is a disease of the spinal cord. This can be distingiushed from a radiculopathy or neuropathy based on the symptoms and findings during a doctors examination.

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Radicul [‘spinal nerve root’] opathy [‘problem’] refers to a disease of the spinal nerve root as it leaves the spinal cord. The symptoms and findings during a doctor’s exmaination can distinguish this from a myelopathy.

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Osteo [‘bone’] phyte [‘growth’] is an abnormal protrusion or outgrowth of bone. They are commonly referred to as bony spurs. They can occur from any bone. They are a feature of osteoarthritis, ‘wear and tear’. It is commonly thought that they represent an attempt by the body to limit movement in a joint, in an attempt to halt further joint damage.

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The spinal cord, along with the brain, makes up the central nervous system. For the most part, the spinal cord processes information from body before it is sent on to the brain for decision making, but some basic decisions are made by the spinal cord; we call these basic decisions reflexes.

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Myelo [‘spinal cord’] malacia [‘softening’] is a descriptive term for changes seen within the spinal cord on MRI images which indicate a loss of spinal cord volume. As a descriptive term there are a variety of disease processes which can cause this and it would generally be considered a significant finding, as the spinal cord does not repair itself readily, and therefore loss of spinal cord tissue is permanent.

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The spinal cord lies within a sac called the ‘dura’ or ‘dural sheath’ or ‘meninges’. Epi [‘outside’] dural [‘the casing around the spinal cord’] haematoma [‘blood clot’] is a description for a blood clot forming around this sheath. This can happen for a variety of reasons, however because these structures lie within a bony canal, if a blood clot forms here it has now where to expand to and will therefore compress the spinal cord causing neurological symptoms.

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The spine is made up of a number of different structures. These include bones, ligaments and intervertebral discs. All components work in harmony to provide the combination of strength and flexibility required to function.

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CSF or cerebrospinal fluid, is the water in which the brain and spinal cord sits. It is contained by the dural sheath. CSF is made deep within in the brain, and flows like a river. It is then drained downstream by the veins which overly the dura. If an openning in the dura is made and fails to close, fluid can leak out. 

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Hoffman’s sign can be a feature of myelopathy involving the cervical spinal cord. It is a test performed by doctors during their neurological examination. By holding a patient’s hand so that it is weightless, and flicking the nail of their middle finger, a positive test (i.e. one suggesting central nervous disease) causes a reflex to make their thumb and index finger contract spontaneously as per this video.

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Lhermitte’s sign, the phenomenon of an electric shock passing down your spine, and/or into your limbs, can be a feature of central nervous system disease. It is typically triggered by bending the neck forward (putting your chin to your chest). It was named after Jean Lhermitte, a French Neurologist, who established its significance in 1924.

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