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The root term [-spondyl-] arises from the Greek [spondylos] meaning "vertebra", and suffix [-osis] means "condition", but with the connotation of "many". The word [spondylosis] means " condition of many vertebrae". This does not add much to the use of this word as an indicator of a pathology, but it does indicate that there is excess bone in a vertebral pathology.

Spondylosis is an osteoarthritic degeneration of the vertebrae and the spine characterized by abnormal bony growths  on the vertebrae that can impinge on nerves and other structures causing pain and mobility problems. The definition of spondylosis also includes degenerative changes in the intervertebral discs.

The abnormal growth of portions of the vertebral body, usually forms "bone spurs", also referred to as "spondylophytes". The accompanying image shows a lumbar vertebra with spondylophytes. 

Image property of: CAA, Inc. Photographer: David M. Klein 

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

Dr. Rudolph Nissen

Dr. Rudolf Nissen (1896 - 1981).  Dr Nissen’s life is extraordinary. Born in the city of Neisse, Germany in 1896, he was the son of a local surgeon. He studied medicine in the Universities of Munich, Marburg, and Breslau. He was the pupil of the famous pathologist Albert Aschoff (discoverer of the heart’s AV node, along with Sunao Tawara).

The suffix [-oma] means "tumor", "mass", or "growth". It should be noted that the word [tumor] is originally Latin, and means "swelling" or "bulging". Sometimes the plural form [-omata] can be used.

It is a general misconception that the suffix [-oma] or the term [tumor] are synonymous with "cancer". This is not so. [Tumor] only means a mass and the type of mass, benign or malignant is not implied in the term. A cancerous mass will be denoted by the addition of the root term [-carcin-] meaning "cancer" therefore the combined root and suffix will be [-carcinoma]. There are other root-suffix combinations that also mean "cancerous".

The suffix [-oma] can be found in many medical words, such as:

• Hematoma: from the Greek root [-hem-] meaning "blood". A mass of blood
• Myoma:  from the root [-my-] meaning "muscle". A mass, growth, or tumor of muscle
• Fibroma: from the root [-fibr-] meaning "fiber". A mass of fibers 
• Fibromyoma: the combining form of "muscle" is [myo-], therefore "a mass of fibers and muscle" (Pl. fibromyomata)
• Adenoma: from the Greek [aden-] meaning "gland". A mass that has a glandular look to it or a mass in a gland 

Sources:
1. "The Language of Medicine" John H. Dirckx Pub: Harper & Row 1976
2. "Medical Meanings" Haubrich, William S. Am Coll Phys Philadelphia 1997
3. "The origin of Medical Terms" Skinner, AH, 1970

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

Giovanni Batista Morgagni

Giovanni Battista Morgagni (1682 - 1771). Italian anatomist, physician, and pathologist, Morgagni was born in the city of Forli. He started his medical studies at the University of Bologna, graduating in 1701 with a degree in Medicine and Philosophy. In 1712 he became a professor of anatomy at the University of Padua, Italy, 175 years after Andreas Vesalius. Morgagni was offered and accepted the Chair of Anatomy in 1715 at the University of Padua. Although Morgagni held a position at the anatomy department of the University of Padua, his name is associated mostly with his pathological studies.

Morgagni was interested in the works of Theophile Boneti (1620 - 1689), who started analyzing the correlation between post-mortem anatomical findings and diseases. He tried to establish a relation between the disease and the cause of death. In 1761 Morgagni published his most influential work "De Sedibus et Causis Morburum Per Anatomen Indagatis"  (On the Sites and Causes of Diseases, Investigated by Dissection). His work was essential for pathological anatomy to be recognized as a science in itself.

Morgagni was elected to become a member of several Academies of Science and Surgery: The Royal Society of London, The Academy of Science in Paris, The Berlin Academy of Science, and the Imperial Academy of Saint Petersburg in Russia. He is remembered today by several eponyms in anatomy and pathology:

• Morgagni's caruncle or lobe, referring to the middle lobe of the prostate
•  Morgagni's columns: the anal (or anorectal) columns
•  Morgagni's concha, referring to the superior nasal concha
• Morgagni's foramina: two hiatuses in the respiratory diaphragm allowing for passage of the superior epigastric vessels
• Morgagni's hernia: an hiatal hernia through Morgagni's foramen, in the respiratory diaphragm
• Morgagni's ventricle: an internal pouch or dilation between the true and false vocal cords in the larynx
• Morgagni's nodules: the nodules at the point of coaptation of the leaflets (cusps) of the pulmonary valve. Erroneously called the "nodules of Arantius", which are only found in the aortic valve

Sources:
1. "A Note From History: The First Printed Case Reports of Cancer" Hadju, S.I. Cancer 2010;116:2493–8
2. "Giovanni Battista Morgagni" Klotz, O. Can Med Assoc J 1932 27:3 298-303
3. "Morgagni (1682 -1771)" JAMA 1964 187:12 948-950
Original image in the public domain, courtesy of National Institutes of Health.

Hover for "Lumen"

The term [lumen] is Latin and means "light". It is an international measure of light intensity. The plural form is either [lumens] or the Latin version [lumina].

The question is how did this term end up meaning the "internal opening or cavity of a hollow organ"? Dr. J. Dirckx (1976) explains that the term [lumen] in gastrointestinal anatomy was not used until the late 19th century, but it was initially used by microscopists looking at cross sections of small vessels. Since the empty interior of the vessel was represented on the histological slide as a clear, lighted region, they started calling that the "light" of the vessel, or [lumen].

The root term for [lumen] is [-lumin-] and can be found in over 30 words in English and related to light, such as luminosity, luminaria, luminescent, luminous, illumination,  illuminator, intraluminal, transluminal, endoluminal, etc.

The correct adjective form for [lumen] is [luminal], as stated by Haubrich (1997). The point is that the use of the term "lumenal" as an adjective form for lumen is not correct. This term can be seen wrongly used in many textbooks today. The proper form for the NOTES acronym is "Natural Orifice Transluminal Endoscopic Surgery"

If you hover over the image you will "illuminate" this article!

Original image courtesy of Wikipedia.org

An esophageal hiatus hernia (also known as a hiatal hernia) eventually may require surgery. In this case, the objective is three-fold: To bring the abdominal viscera to its proper intraabdominal position (reduction) , to create a pseudovalve to prevent gastroesophageal reflux, and to prevent a recurrence of the herniation.

There have been different  procedures developed to this effect. One of the most popular has been the Nissen fundoplication either trough the open surgery approach or by way of a minimally invasive laparoscopic procedure.

This procedure was pioneered by Dr. Rudolf Nissen (1896 - 1981) in 1955.  After reducing the hiatal hernia and repairing the dilated esophageal hiatus, the surgeon creates a gastric wrap around the abdominal esophagus by bringing the fundus of the stomach through a retroesophageal passage, and suturing the fundus to the stomach. (see image). One of the concerns of the procedure is the ligation and transection of the short gastric vessels that pass within the gastrosplenic ligament to allow greater mobility of the gastric fundus and prevent potential avulsion of the short gastric vessels.

Since the introduction of this open procedure in 1955 there have been several variations, such as the "Nissen-Rosetti" procedure, a "loose" fundoplication; the "Toupet" procedure, an "incomplete" fundic wrap, and others, including laparoscopic procedures.

The advent of NOTES (Natural Orifice Transluminal Endoscopic Surgery) has brought a new procedure: Transoral Incisionless fundoplication (TIF), where a pseudovalve is created using an endoscope inserted into the esophagus and stomach through the oral cavity without abdominal  incisions or trocar ports. For more information on this procedure, click here. Clicking on the inferior image will start a six-minute video of the TIF procedure and the EsophX device.