Imaging in 2 planes (e.g., conventional X-rayElectromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc. of a short wavelength and high energy)

Model for assessing fracture stability in the thoracic and lumbar spine; according to this model, the spine is divided into three columns

Standard radiation therapyTherapeutic treatment of a disease by means of ionizing radiation with 3D acquisition of the volume

Imaging in three planes using slice images (e.g., computed tomographyThree-dimensional imaging using X-rays)

Radiation consisting of two protonsPositively charged particle as nuclear building block of an atom and two neutronsNeutrally charged particle as the nuclear building block of an atom

Benign bone tumor caused by a pathological change in osteoblasts

Imaging technique for the visualization of vessels (e.g., angio-CT)

Anterior 2/3 of the vertebral body

Artery ventral to the spinal cord, arising from the dorsal portion of the delivered branches of the spinal ramusArises from the intercostal artery and gives off two other branches (one dorsal, one ventral), which supply the vertebral body and spinal cord, respectively

In the region of the vertebral body (e.g., vertebral body replacementReplacement of a vertebral body in the context of a disease (fracture, tumor, etc.))

Group of drugs used to fight bacterial infections

Middle meninges

Vessels running in the intercostal space; gives off the ramus spinalis

In medicine, it is diagnostic error

Gait disorder in which the movement controlled by the brain is disturbed

First cervical vertebra

Second cervical vertebra

Object for detecting X-rays

Tumor with the following characteristics: slow growing, non-metastatic, displacing, regular growth

Tissue removal for examination

Fused section between two bone segments (e.g., in fusionGrowing together of two vertebrae, in fractures)

A procedure after or during the initial radiation therapyTherapeutic treatment of a disease by means of ionizing radiation; the radiation doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass is increased in the area from which the tumor was removed.

The Bragg curve represents the energy transfer of protonsPositively charged particle as nuclear building block of an atom as they travel through healthy and/or tumor tissue.

The Bragg peakThe Bragg curve represents the energy transfer of protons as they travel through healthy and/or tumor tissue. The Bragg peak occurs when the proton completely decelerates over a very short distance and its energy is depleted. This energy is transferred to the tumor tissue and leads to cell death. occurs when the proton completely decelerates over a very short distance and its energy is depleted. This energy is transferred to the tumor tissue and leads to cell death.

Technical device used between two vertebral bodies as a placeholder and maintenance of stability in spinal surgery (intervertebral cageTechnical device used between two vertebral bodies as a placeholder and maintenance of stability in spinal surgery (intervertebral cage, vertebral body replacement); in spinal surgery, the term "cage" usually refers to the intervertebral cage, which is used in degenerative diseases., vertebral body replacementReplacement of a vertebral body in the context of a disease (fracture, tumor, etc.)); in spinal surgery, the term “cageTechnical device used between two vertebral bodies as a placeholder and maintenance of stability in spinal surgery (intervertebral cage, vertebral body replacement); in spinal surgery, the term "cage" usually refers to the intervertebral cage, which is used in degenerative diseases.” usually refers to the intervertebral cageTechnical device used between two vertebral bodies as a placeholder and maintenance of stability in spinal surgery (intervertebral cage, vertebral body replacement); in spinal surgery, the term "cage" usually refers to the intervertebral cage, which is used in degenerative diseases., which is used in degenerative diseases.

Spongy inner bone substance

Cannulated instrumentCannulated instrument for percutaneous or K-wire guided surgery; e.g., percutaneous implantation of pedicle screws for percutaneous or K-wire guided surgery; e.g., percutaneous implantation of pedicle screws

Screw with a channel for different purposes; e.g., cannulated pedicle screwSurgical instrument used to stabilize the spine by means of a screw in the pedicle for percutaneous implantation (without a channel, percutaneous implantation would not be possible)

Carbon atoms with a changed number of electronsNegatively charged particles of an atom

Anatomical structure within the spinal canal formed by the spinal nerve roots running caudal to the lower end of the spinal cord in the dural sac (like a horse’s tail, hence the name)

Plate for anterior stabilizationFixation of the spine in a designated position to minimize or eliminate mobility (using posterior or anterior measures) of the cervical spine

Drug treatment of cancer or infections (antibioticsGroup of drugs used to fight bacterial infections are also chemotherapeutics)

Malignant tumorTumor with the following characteristics: fast-growing, metastatic, growing into other tissue, unregular growth of the cartilage tissue

Malignant tumorTumor with the following characteristics: fast-growing, metastatic, growing into other tissue, unregular growth of the chorda dorsalis (= embryonically created primitive axial skeleton, which regresses in the course of time)

The clinical target volume (CTV) is an interrelated area that, in addition to the gross tumor volume, also includes areas with suspected proliferating tumor cells (tumor spread area).

In radiotherapy, it describes an area with too low radiation.

Vertebral body collapseCollapse of a vertebral body resulting from a compressive overload

Three-dimensional imaging using X-rays

Computed tomographyThree-dimensional imaging using X-rays (CT) is an imaging technique in which a particular region of your body is visualized layer by layer (cross-sectional imaging) using X-rays. Individual organs and the relationship between the organs can be visualized well at a very high resolution.

Cone beam: Cone-shaped beam that leads to greater inaccuracies in radiotherapy.

From birth on

Treatment of a disease with medication or physical measures

DelineationDelineation of the tumor from the surrounding tissue when planning radiation therapyTherapeutic treatment of a disease by means of ionizing radiation of the tumor and organs at risk when planning radiotherapy

Agent administered for contrasting tissue

Caudal end of the spinal cord

Conventional image acquired by means of X-rays

Balance of the spine in the coronal profile

Is the name given to the layer of bone that surrounds the sponge-like inner tissue (cancellous boneSpongy inner bone substance) of the bone on the outside. The tissue is particularly hard so that it can protect the bone from compressive, bending, and twisting forces.

Joint between a rib and the transverse process

Joint between a rib and the dorsal lateral portion of a vertebral body

Treatment aimed at a cure

Brand name of a radiation therapyTherapeutic treatment of a disease by means of ionizing radiation device for radiosurgery.

The CyberKnife® is a noninvasive, robot-controlled radiosurgery system for submillimeter accuracy in the radiotherapy of tumors in any part of the body. With this technology, tumors or metastases in very sensitive parts of the body can also undergo radiotherapy with maximum protection for the surrounding healthy tissue and with a greater degree of safety.

Term used in tumor surgery; means removal of the tumor

Relieving pressure from neural structures in the spine using various measures

Wear and tear

DelineationDelineation of the tumor from the surrounding tissue when planning radiation therapyTherapeutic treatment of a disease by means of ionizing radiation of the tumor from the surrounding tissue when planning radiation therapyTherapeutic treatment of a disease by means of ionizing radiation

Process at the front of the axisSecond cervical vertebra

Area of skin autonomously supplied by the sensory fibers of a spinal nerve root

Deoxyribonucleic acid; genetic information of a cell

Damage to the genetic information of a cell

Also “absorbed doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass”; physical quantity indicating the average energy delivered by ionizing radiationPhysical radiation (particle or energy) with the property to ionize another atom (= to change electron number); e.g., electromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc. to matter of mass

(Radiotherapeutic) Depiction of the volume obtained by a particular doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass. The doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass volume histogram aids the assessment of the doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass distribution of planned radiotherapy (tumor and organs at risk). Based on the DVH, the planning can be optimized with different beam directions.

Computed tomographyThree-dimensional imaging using X-rays in which images are produced with different energies

Computed tomogram with multiple radiation sources

Hard outer meninges of the brain

Form of radiation in which energy is transmitted in the form of waves or photonsPackets of energy that make up electromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc. (depending on energy: high energy = photonsPackets of energy that make up electromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc., low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc.

The electron density of a material correlates to the Hounsfield units in computer tomography (CT) and is characteristic of the different tissues. The electron density also determines how much the photonsPackets of energy that make up electromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc. decelerate as they travel through the tissue.

Negatively charged particles of an atom

When, in addition to the actual findings (tumor, cyst), any affected neighboring tissue or lymph nodes are also removed “in one piece” in the same surgical procedure.

Spinal cord compression caused by epidural metastases (epidural spinal cord compression, ESCC) is the most common neurological complication of spinal metastases. The most common tumors in the context of ESCC are lung and breast cancer. ESCC constitutes a medical emergency as delayed treatment may result in irreversible deficits such as paralysisComplete paralysis of a body part. Patients with ESCC require a multidisciplinary diagnostic and therapeutic approach.

Malignant bone tumor originating from the bone marrow

The radiation doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass absorbed by healthy tissue after the radiation has actually reached the tumor

Stretching movement

Musculature for performing stretching movements

External body radiation therapyTherapeutic treatment of a disease by means of ionizing radiation –> Conventional radiation therapyTherapeutic treatment of a disease by means of ionizing radiation

Outside the dura

Tumor removal without cutting into the tumor; e.g., en-bloc resectionPartial removal of an organ or section of tissue by surgeryWhen, in addition to the actual findings (tumor, cyst), any affected neighboring tissue or lymph nodes are also removed "in one piece" in the same surgical procedure.

Outside the spinal cord

Vertebral arch joints; paired joints between the processus articulares superiores and inferiores

A flat, rough layer of connective tissue that envelops individual muscles, muscle groups, or entire body sections

Different fields converge in one area, so that a maximization of the radiation doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass occurs here.

An area that is treated by the radiation beam at a specific angle. Radiation therapyTherapeutic treatment of a disease by means of ionizing radiation can be performed with a single field or with several fields at different angles.

Bending movement

A distraction of the posterior columnFacet joints, spinous process either by the ligaments of the posterior columnFacet joints, spinous process or by the osseous structures

Muscles used to perform flexionBending movement movements

FluoroscopyFluoroscopy by means of X-rays, where dynamic processes can be visualized (e.g., placing a screw in a bone) by means of X-rays, where dynamic processes can be visualized (e.g., placing a screw in a bone)

Intervertebral hole formed by the arch roots, vertebral joints, parts of the vertebral body, and the intervertebral disc of two adjacent vertebrae. The intervertebral foramen serves as the passage point for the spinal cord nerves (also called spinal nerves).

Bony opening in the transverse processes of the cervical vertebrae

One part of radiation therapyTherapeutic treatment of a disease by means of ionizing radiation; e.g., 30 grays are administered in 10 sessions of 3 grays each. 1 session = 1 fractionOne part of radiation therapyTherapeutic treatment of a disease by means of ionizing radiation; e.g., 30 grays are administered in 10 sessions of 3 grays each. 1 session = 1 fraction

Division of the total radiation doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass into small “portions” that are received spread out over several days or weeks.

The total doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass is divided into small, daily, single doses (usually 1.5–2.5 Gy). Tumor cells cannot repair as well as physiological healthy cells.

Restriction of the physiological function of body systems or their sub-areas

Recording of various movement sequences with conventional X-rayElectromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc. of a short wavelength and high energy in order to assess dynamic processes (e.g., flexionBending movement/extensionStretching movement recording)

Growing together of two vertebrae

Contrast agentAgent administered for contrasting tissue for MRI

The brand name of a radiation therapyTherapeutic treatment of a disease by means of ionizing radiation device with which gamma rays from different directions meet in the target area (stereotaxis) and act like a surgical knife due to their high energy: the tissue is destroyed; application for brain tumors

The radiation sourceRadiation-generating object (e.g., X-rayElectromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc. of a short wavelength and high energy tube) called the “gantryThe radiation source called the “gantry” rotates 360 degrees around the patient during treatment so that the tumor can be irradiated from all directions.” rotates 360 degrees around the patient during treatment so that the tumor can be irradiated from all directions.

Benign primary tumorFirst occurrence of a tumor in a specific area of the body of bone originating from connective tissue cells

Replacement material (in the spine, e.g., bone substitute)

Unit for the absorbed doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass of radiation. It indicates the absorbed doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass caused by ionizing radiationPhysical radiation (particle or energy) with the property to ionize another atom (= to change electron number); e.g., electromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc. and describes the absorbed energy per mass.

The gross tumor volume (GTV) denotes the volume that can be observed using clinical diagnostics.

IonAtom with changed electron number with a particularly large mass

Benign tumorTumor with the following characteristics: slow growing, non-metastatic, displacing, regular growth of the vascular tissue

Examination of microscopic tissue sections (actually: science of biological tissue)

Treatment of diseases by means of hormones or anti-hormonal substances

In radiotherapy, it describes an area with too much radiation.

The Hounsfield scale describes the attenuation of X-rayElectromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc. of a short wavelength and high energy radiation (radiopacity) in different tissue types in computed tomographyThree-dimensional imaging using X-rays (CT) in relation to water and air as reference values.

Further division of a day/week fractionOne part of radiation therapyTherapeutic treatment of a disease by means of ionizing radiation; e.g., 30 grays are administered in 10 sessions of 3 grays each. 1 session = 1 fraction into several lower-doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass subfractions with the same overall radiotherapy time; a higher total radiation doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass is possible

Higher doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass per fractionOne part of radiation therapyTherapeutic treatment of a disease by means of ionizing radiation; e.g., 30 grays are administered in 10 sessions of 3 grays each. 1 session = 1 fraction, shorter overall radiotherapy time
Indication: E.g. patient’s desire (palliativeTreatment aimed at alleviating suffering situation in which the length of the hospital stay should be reduced)

Caused by a physician

Cause not proven or cannot be identified

Imaging errors that do not correspond to reality

Image-guided radiation therapyTherapeutic treatment of a disease by means of ionizing radiation (IGRT) involves using common imaging techniques during radiation therapyTherapeutic treatment of a disease by means of ionizing radiation with the aim of improving the precision and accuracy of the radiation therapyTherapeutic treatment of a disease by means of ionizing radiation.

IGRT is used to treat tumors in parts of the body that are prone to movements as well as tumors located close to critical organs and tissues. It is often used in conjunction with intensity-modulated radiation therapyTherapeutic treatment of a disease by means of ionizing radiation (IMRT), proton beam therapy, stereotactic radiosurgery, or stereotactic body radiation therapyTherapeutic treatment of a disease by means of ionizing radiation (SBRT), for which computer-controlled X-rayElectromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc. of a short wavelength and high energy accelerators are used to irradiate a malignant tumorTumor with the following characteristics: fast-growing, metastatic, growing into other tissue, unregular growth or specific areas inside the tumor with precise doses of radiation.

Therapies that strengthen or activate the patient’s own immune system to fight diseases

Frequency of new occurrence

In tumors, this refers to ingrowth into other tissue.

Mobility outside the norm in the corresponding segment

IMRT/IMPT is a form of radiation therapyTherapeutic treatment of a disease by means of ionizing radiation that generates irregular radiation intensities through the irradiation of several small fields from different radiation directions that produce a doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass distribution that conforms as much as possible to the three-dimensional overlay.

In addition to enabling a doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass escalation in areas particularly at risk of relapse, IMRT/IMPT also provides better protection of the healthy tissue surrounding the tumor. In summary, IMRT/IMPT provides higher tumor effectiveness with a reduced rate of side effects.

Ligaments between spinous processes

Inside the dura

Tumor removal with incision into the tumor; e.g., piece-meal resectionPartial removal of an organ or section of tissue by surgeryRemoval of a tumor piece by piece

Within the spinal cord

Atom with changed electron number

Physical radiation (particle or energy) with the property to ionize another atom (= to change electron number); e.g., electromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc.

A performance status that quantifies the general well-being and activities of daily living of cancer patients

Sideways bending (related to the spine: with the upper body)

Mortality rate

Anterior longitudinal ligament on the spine, attached to the ventral surfaces of the vertebral bodies

Posterior longitudinal ligament on the spine, attached to the dorsal surfaces of the vertebral bodies

At the spine, this is the environment around a stabilizationFixation of the spine in a designated position to minimize or eliminate mobility (using posterior or anterior measures), consisting of bone, musculature, vascular system, etc., which influences the movement processes.

Therapeutic measure directly at the site of the disease

Long course radiotherapy is hyperfractionated radiotherapy with many sessions over a long period of time (>20 fractionated doses and treatment days).
Long course radiotherapy means that the tumor cells receive a sufficient doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass of radiation during all the cell division cycles.

State of the space around magnets in which forces are exerted on other magnets or any other bodies

Strength and direction of a point in space of the magnetic fieldState of the space around magnets in which forces are exerted on other magnets or any other bodies generated by the magnetic voltage (unit: ampere/meter)

Areal density of magnetic flux passing perpendicularly through a given surface element (unit: tesla = kg/ampere * second squared)

Examination method that generates slice images of the inside of the body; it works using a strong magnetic fieldState of the space around magnets in which forces are exerted on other magnets or any other bodies; tissues and structures can be delineated based on their different water content; the patient is not exposed to any radiation.

Tumor with the following characteristics: fast-growing, metastatic, growing into other tissue, unregular growth

Bony connection between the upper and lower articular processes in the cervical spine

Software for the reduction of image artifacts

Settlement of a secondary tumor outside of the primary tumorFirst occurrence of a tumor in a specific area of the body

Metastatic spinal cord compression (MSCC) is a known complication of cancer and usually constitutes an oncology emergency. Metastases in the spine occur in 3–5% of all patients with cancer and occur more commonly in patients with breast, prostate, and lung cancer, for which the incidenceFrequency of new occurrence is 19%.

MSCC is generally caused by the collapse or compression of a vertebral body that contains metastatic disease; however, in rare cases it can also be caused by the tumor expanding directly into the spine.

Classification system for spondylolisthesisSlipped vertebrae

Small movements

Posterior 1/3 of the vertebral body

Generally referred to as gentle approaches with less tissue destruction (e.g., percutaneous, mini-open, etc.)

Minimally invasive surgery by means of a small portal, e.g., pedicle screwSurgical instrument used to stabilize the spine by means of a screw in the pedicle placement in a mini-open variant.

Restoration of the ability to move (e.g., after an operation)

Computer tomogram with several imaging slices

Disease of plasma cells with uncontrolled proliferation in the bone marrow

Part of the oblique abdominal muscles

Muscle dorsal to the spine; belongs to the autochthonous back musculature

Part of the oblique abdominal muscles

Muscle dorsal to the spine; belongs to the autochthonous back musculature

Muscle dorsal to the spine; belongs to the autochthonous back musculature

Muscle dorsal to the spine; belongs to the autochthonous back musculature

Part of the hip flexor musculature

Straight abdominal muscles

Imaging procedure with contrast medium in the spinal canal (e.g., myelo-CT)

The NOMS decision framework consists of neurological, oncological, mechanical, and systemic considerations and incorporates the use of conventional external radiation therapyTherapeutic treatment of a disease by means of ionizing radiation, spinal stereotactic radiosurgery, and minimally invasive and open surgical interventions. Application of the NOMS paradigm integrates multimodal therapy to optimize local tumor control, pain relief, and the restoration or preservation of neurological function and minimizes morbidity in this often systemically ill patient population.

Neutrally charged particle as the nuclear building block of an atom

Up to five metastases in up to three organ systems

In the radiation therapyTherapeutic treatment of a disease by means of ionizing radiation of malignant tumors (cancer), an organ at risk is a healthy organ or tissue with a certain sensitivity to radiation, which is located close to a tumor or in the irradiated volumes. It is therefore subject to specific radiation exposure. It is necessary to know the tolerance doses of the organs at risk as part of the radiotherapy planning and also to adjust the positioning and the application duration of the prescribed therapy doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass. The aim is to protect the healthy tissue as much as possible, whilst achieving the maximum destruction of the malignant tumorTumor with the following characteristics: fast-growing, metastatic, growing into other tissue, unregular growth.

Bone-building

Benign tumorTumor with the following characteristics: slow growing, non-metastatic, displacing, regular growth originating from osteoblasts

Benign primary tumorFirst occurrence of a tumor in a specific area of the body of cartilage tissue

Degenerative change in the spine with formation of osseous protrusions and loss of disc elasticity

Bone-promoting material structure

Bone dissolving

Malignant bone tumor originating from the bone-forming cells

Questionnaire used to assess functional status and quality of life impairment in patients with back pain and spinal cord disorders and injuries in research and clinical settings

In statistics, one speaks of an outlierIn statistics, one speaks of an outlier when a measured value or finding does not fit into an expected series of measurements or generally does not meet expectations; in relation to spinal tumors, this refers to patients in whom the predicted prognosis does not occur. when a measured value or finding does not fit into an expected series of measurements or generally does not meet expectations; in relation to spinal tumors, this refers to patients in whom the predicted prognosis does not occur.

Treatment aimed at alleviating suffering

Pathological sensation in the area supplied by a cutaneous nerve without recognizable adequate physical stimuli

Complete paralysisComplete paralysis of a body part of a body part

Complete paralysisComplete paralysis of a body part of both legs

Partial loss of motor function of a single muscle, muscle group, or limb

Bone fracture that occurs during normal weight-bearing due to weakening of the bone as a result of disease

Surgical instrument used to stabilize the spine by means of a screw in the pedicle

Pencil beamPencil beam scanning, also called scanning beam, is an advanced type of photon or proton therapy. With a width of only a few millimeters (the width of a pencil), pencil beamPencil beam scanning, also called scanning beam, is an advanced type of photon or proton therapy. With a width of only a few millimeters (the width of a pencil), pencil beam scanning is used to treat complex cancer types with unprecedented precision. Compared to cone beam, pencil beam is deflected using magnetic scanners in order to irradiate the entire tumor. scanning is used to treat complex cancer types with unprecedented precision. Compared to cone beam, pencil beamPencil beam scanning, also called scanning beam, is an advanced type of photon or proton therapy. With a width of only a few millimeters (the width of a pencil), pencil beam scanning is used to treat complex cancer types with unprecedented precision. Compared to cone beam, pencil beam is deflected using magnetic scanners in order to irradiate the entire tumor. is deflected using magnetic scanners in order to irradiate the entire tumor. scanning, also called scanning beam, is an advanced type of photon or proton therapy. With a width of only a few millimeters (the width of a pencil), pencil beamPencil beam scanning, also called scanning beam, is an advanced type of photon or proton therapy. With a width of only a few millimeters (the width of a pencil), pencil beam scanning is used to treat complex cancer types with unprecedented precision. Compared to cone beam, pencil beam is deflected using magnetic scanners in order to irradiate the entire tumor. scanning is used to treat complex cancer types with unprecedented precision.

Compared to cone beam, pencil beamPencil beam scanning, also called scanning beam, is an advanced type of photon or proton therapy. With a width of only a few millimeters (the width of a pencil), pencil beam scanning is used to treat complex cancer types with unprecedented precision. Compared to cone beam, pencil beam is deflected using magnetic scanners in order to irradiate the entire tumor. is deflected using magnetic scanners in order to irradiate the entire tumor.

Minimally invasive surgery using instrumentation through the skin; e.g., percutaneous placement of pedicle screws

Radiation consisting of photonsPackets of energy that make up electromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc.

Packets of energy that make up electromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc.

Soft inner meninges, directly attached to the brain and spinal cord

Removal of a tumor piece by piece

The planning target volume (PTV) generally adds a safety margin to allow for spatial displacements of the clinical target volume, e.g., due to breathing, but also the limited accuracy of reproducing the patient’s position in fractionated radiation therapyTherapeutic treatment of a disease by means of ionizing radiation.

TraumaDamage or wounding of living tissue caused by external force in which at least one injury, or the combination of multiple injuries, is life-threatening

Imaging method with registration of decay activities; the physical basis is not in gamma rays, but in the so-called annihilation (electron and positron, which is a positively charged electron, meet and cancel each other out; this releases energy, which is measured)

Facet joints, spinous process

Artery dorsal to the spinal cord, arising from the dorsal portion of the delivered branches of the spinal ramusArises from the intercostal artery and gives off two other branches (one dorsal, one ventral), which supply the vertebral body and spinal cord, respectively

In the region of the vertebral arch (e.g., posterior instrumentation)

First occurrence of a tumor in a specific area of the body

Articular processes of a vertebra, four per vertebra (two upward, two downward)

Lower joint processes

Upper joint processes

Bilateral bumps on the cranial surface of the body of cervical vertebrae 3–7

Radiation consisting of protonsPositively charged particle as nuclear building block of an atom

Positively charged particle as nuclear building block of an atom

Tissue that is damaged only at high doses, or not at all

Tissue that experiences damage even at low doses

Radiation-generating object (e.g., X-rayElectromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc. of a short wavelength and high energy tube)

Therapeutic treatment of a disease by means of ionizing radiationPhysical radiation (particle or energy) with the property to ionize another atom (= to change electron number); e.g., electromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc.

The application of high-energy rays to destroy tumor tissue.

During radiation therapyTherapeutic treatment of a disease by means of ionizing radiation (radiotherapy), rays are directed at the tumor. Tumor cells are cells that divide quickly and uncontrollably. They react sensitively to radiation therapyTherapeutic treatment of a disease by means of ionizing radiation. The division of the tumor cells is inhibited by the radiation, and it dies away. Thus prohibiting or slowing the growth of a tumor.

In radiobiology, the relative biological effectiveness (RBE) is a differentiating factor for types of radiation in terms of their biological effects.

The same physical radiation doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass can have different degrees of effectiveness with different types of radiation. Reasons for this may include the different consistency of the tissue, the different doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass rate over time, or the different local doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass distribution and ionization density of the radiation.

Partial removal of an organ or section of tissue by surgery

Restoration of the physiological shape of the spine

Complex new surgery after a previous surgery in the same surgical area

Rotational movement

Balance of the spine in sagittal profile

Deflected radiation

Imaging method in which the decay activity of certain radionuclides in the body is measured

Bone hardening in the context of excessive growth (hypertrophy; without proliferation of bone cells) of bone tissue

The segmentation of the organs at risk and the tumor is a time-consuming part of computer-aided radiation therapyTherapeutic treatment of a disease by means of ionizing radiation planning.
The different organs are distinguished from one another based on CT and MRI images. Due to image artifacts, this is often still a manual procedure.

Restriction of perception with the physical senses

Creation of a tumor-free corridor between tumor and spinal cord; usually with subsequent radiation of the tumor

Short course radiotherapy is radiotherapy with fewer fractionated doses and fewer sessions over a short period of time (<5 fractionated doses and treatment days).

Imaging method in which decay activities are registered in the form of gamma rays (combined nuclear medicine/radiological examination method; quasi as an advanced scintigraphyImaging method in which the decay activity of certain radionuclides in the body is measured)

One metastasisSettlement of a secondary tumor outside of the primary tumorFirst occurrence of a tumor in a specific area of the body

Arises from the intercostal artery and gives off two other branches (one dorsal, one ventral), which supply the vertebral body and spinal cord, respectively

A spinal segmentA spinal segment includes an intervertebral disc, two adjacent vertebral bodies, two facet joints. includes an intervertebral disc, two adjacent vertebral bodies, two facet joints.

Narrowing in the spinal column (neuroforamen, spinal canal, etc.)

The SINS score was published in 2010 and helps to assess the indication for surgical stabilizationFixation of the spine in a designated position to minimize or eliminate mobility (using posterior or anterior measures) in cases of spinal neoplasms. This is determined using six parameters (location, load-dependent pain, bone lesion, vertebral body collapseCollapse of a vertebral body, radiographic spinal alignment, and posterolateral involvement).

Computed tomographyThree-dimensional imaging using X-rays in which the source and detector rotate around the patient

Stiffening of the spinal column

Inflammation of an intervertebral disc and adjacent vertebral areas

Slipped vertebrae

Disease of a vertebra in which a crack or fissure forms in the vertebral arch

Fixation of the spine in a designated position to minimize or eliminate mobility (using posterior or anterior measures)

Stereotactic radiotherapy or “stereotaxis” is when a relatively small, clearly delimitable finding is irradiated with the greatest precision using a high single doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass in a few fractions.
It stands to reason that the accuracy of this treatment type is of even greater importance than with all other radiotherapy options. This starts with the exact diagnostic localization of the finding and continues throughout the entire treatment chain including positioning and immobilizing the patient.
Traditionally, the tumor is positioned in the therapy beam via external systems that are attached rigidly to the patient (hence the name stereotaxis from the Greek “stereós” meaning “hard, rigid” and “táxis” meaning “arrangement/installation”).

The specific stopping power of different tissues (bones, lungs, etc.) causes a higher or lower deceleration of protonsPositively charged particle as nuclear building block of an atom. It can therefore be calculated how deeply a proton beam will penetrate the tissue and reach the tumor.

Lying under the fasciaA flat, rough layer of connective tissue that envelops individual muscles, muscle groups, or entire body sections

Ligament between the tips of the spinous processes

Describes the path through the surrounding tissue to reach the surgical site (posterior access, anterior, lateral, etc.)

Drug therapy of a disease

Time duration for the re-alignment of the nuclear spin of the atoms along the externally applied magnetic fieldState of the space around magnets in which forces are exerted on other magnets or any other bodies (longitudinal magnetization) after the end of the radiofrequency pulse

Time duration for the desynchronization of the nuclear spin of the atoms from the transverse magnetization after the end of the high-frequency pulse

Targeted specific treatment of cancer using antibodies

Time between excitation and measurement of the MR signal; influences the T2 contrast

Complete paralysisComplete paralysis of a body part of all four extremities

Goal that should be achieved by therapy

Scoring system used to assess prognosis in patients with spinal metastases

Side effects of radiation therapyTherapeutic treatment of a disease by means of ionizing radiation. The side effects affect all healthy tissue around the tumor and predominantly exhibit clinical effects in the organs at risk.

Time between two excitation pulses; affects T1 contrast

Injury to all three columns of the spine due to translational forces

Paired transverse processes of a vertebra

Damage or wounding of living tissue caused by external force

Processus spinosus of the seventh cervical vertebra

Collapse of a vertebral body

Fracture of a vertebra

Replacement of a vertebral body in the context of a disease (fracture, tumor, etc.)

Visual analog scale: scale for measuring primarily subjective attitudes; it is frequently used in pain research and pain therapy

Volumetric modulated arc therapy (VMAT), also known as rapid arc, shortens the treatment time and enables better doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass distribution. The tumor doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass can be maximized, and the doseAlso “absorbed dose”; physical quantity indicating the average energy delivered by ionizing radiation to matter of mass can be minimized for the organs at risk thanks to the numerous radiation directions and fields.

Grid point in a three-dimensional grid

Electromagnetic radiationForm of radiation in which energy is transmitted in the form of waves or photons (depending on energy: high energy = photons, low energy = waves); examples: X-rays, gamma rays, radio waves, microwaves, etc. of a short wavelength and high energy

Ligaments attached dorsally in the spinal canal between two adjacent vertebral arches