Spine
At The Iowa Clinic Neurological & Spinal Surgery Department, we pride ourselves on being the best at coordinated care for our patients. And that is one reason why The Iowa Clinic Spine Center was formed - to offer a more collaborative approach and comprehensive surgical and non-surgical treatment options.
Our strong relationships with many respected experts in our field both at the University of Iowa and others across the nation means if we have a case beyond our scope, we have no hesitation about getting you to the best surgeon for your condition.
We are located in Iowa Methodist Medical Center in Des Moines, and perform hundreds of procedures annually at these two hospitals:
Conditions & Diseases Treated
Facet joint syndrome is an arthritis-like condition of the spine that can be a significant source of back and neck pain. It is caused by degenerative changes to the joints between the spine bones. The cartilage inside the facet joint can break down and become inflamed, triggering pain signals in nearby nerve endings. Medication, physical therapy, joint injections, nerve blocks, and nerve ablations may be used to manage symptoms.
Cancer (Cervical, Thoracic, Lumbar)
A rare disease where abnormal cells grow out of control in the spinal cord or the bones, tissues, fluid or nerves that comprise it, forming a tumor. Symptoms include numbness or muscle weakness in the chest, legs, or arms, difficulty walking, pain, loss of bowel control, incontinence, paralysis, pain, and neurological problems. Treatments may include medications, radiation therapy, chemotherapy, or surgery.
Cauda equina syndrome is a rare condition most often caused by a large disc herniation in the lower back that compresses the nerve roots at the end of the spinal cord. Sudden back pain with numbness in the genital area, difficulty urinating, and weakness in the legs is a medical emergency. Prompt surgery to relieve the pressure may prevent permanent damage and restore bladder and bowel function.
Carpal tunnel syndrome causes tingling, numbness, or pain in the hand. The wrist bones and ligament form a tunnel, a passage for the median nerve and finger tendons. Repetitive strain may cause swelling that traps the nerve within the tunnel. Treatments include modifying activities, physical therapy, a wrist brace, or medications. Surgery that re-opens the space and frees the nerve may be an option.
Degenerative disc disease affects the discs that separate the spine bones. As you age, the spine begins to show signs of wear and tear as the discs dry out and shrink. These age-related changes can lead to arthritis, disc herniation, or stenosis. Pressure on the spinal nerves may cause pain. Physical therapy, self-care, medication, and spinal injections are used to manage symptoms. Surgery may be an option if the pain is chronic.
Degenerative Deformities of the Spine (Cervical, Thoracic, Lumbar), Including Scoliosis
Spinal deformity is an abnormal alignment or curve of the bony vertebral column. Adult scoliosis and kyphosis can be caused by age-related wear and tear on the back or complications from past surgeries. Moderate deformity occurs when the facet joints and discs deteriorate over time and are no longer able to support the spine's normal posture. Pain results from stressed joints and pinched nerves, not the abnormal curve. Treatment can include medications, physical therapy, injections, or surgery.
Herniated or Prolapsed Disc (Cervical, Thoracic, Lumbar)
A herniated disc occurs when the gel-like center of a disc ruptures through a weak area in the tough outer wall.
Neck or arm pain, numbness or tingling may result when the disc material compresses a spinal nerve. Treatment with medication, spinal injections, and physical therapy is the first step to recovery. Most people improve in 6 weeks and return to normal activity. If symptoms continue, surgery may be an option.
Herniated or Prolapsed Thoracic Disc
Back pain that may also travel around the body and into one or both legs, numbness or tingling may result when the disc material compresses a spinal nerve. Treatment with medication, spinal injections, and physical therapy is the first step to recovery. Most people improve in 6 weeks and return to normal activity. If symptoms continue, surgery may be an option.
Back or leg pain, numbness or tingling may result when the disc material compresses a spinal nerve. Treatment with medication, spinal injections, and physical therapy is the first step to recovery. Most people improve in 6 weeks and return to normal activity. If symptoms continue, surgery may be an option.
Spinal Cord / Root Tumors
An abnormal mass of tissue within or surrounding the spinal canal and can be malignant (cancerous) or benign (non-cancerous). Spinal cord / root tumors can include numbness or muscle weakness in the chest, legs, or arms, difficulty walking, pain, loss of bowel control, incontinence, paralysis, pain, and neurological problems. Treatments may include medications, radiation therapy, chemotherapy, or surgery.
A fracture of a vertebra can cause bone fragments to pinch and damage the spinal nerves or spinal cord. Most spinal fractures occur from car accidents, falls, gunshot, or sports. Injuries can range from mild ligament and muscle strains, to fractures and dislocations of the bones, to debilitating spinal cord damage. Many fractures heal with conservative treatment; some may require surgery to realign the bones.
Spinal stenosis is the narrowing of your spinal canal and nerve root canal along with the enlargement of your facet joints. Most commonly it is caused by osteoarthritis and your body's natural aging process. As the spinal canal narrows, there is less room for your nerves to branch out and move freely. As a result, they may become swollen and inflamed, which can cause pain, cramping, numbness or weakness in your legs, back, neck, or arms. Mild to moderate symptoms can be relieved with medications, physical therapy and spinal injections. Severe symptoms may require surgery.
Spondylolysis (spon-dee-low-lye-sis) and spondylolisthesis (spon-dee-low-lis-thee-sis) are conditions that affect the moveable joints of the spine that help keep the vertebrae aligned one on top of the other. Spondylolysis is actually a weakness or stress fracture in one of the facet joints. This weakness can cause the vertebrae to slip forward out of their normal position, a condition called spondylolisthesis. Treatment options include physical therapy to strengthen the muscles surrounding the area. Sometimes the patient is placed in a brace. In severe cases, surgery is also an option.
Surgical Services & Treatments
Artificial Discs (Cervical)
An artificial disc is composed of two endplates that slide and move on a central core and are composed of titanium, cobalt, polyethylene, or polyurethane. This supports the vertebrae while also allowing turning, side-to-side bending and back and forward bending. This treatment is still fairly new, although it is approved by the FDA.
Decompression Surgery
There are different types of decompression surgeries. Laminectomy involves the complete removal of the bony roof covering the spinal cord and nerves to create more space for them to move freely. Laminotomy involves a partial removal. Narrowing or stenosis of the spinal canal can cause chronic pain, numbness, and muscle weakness in the arms or legs. Surgery may be recommended if your symptoms have not improved with physical therapy or medications.
Discectomy (Cervical, Thoracic, & Lumbar)
Lumbar discectomy is a surgery to remove a herniated or degenerative disc in the lower spine. The incision is made posterior, through the back muscles, to reach and remove the disc pressing on the nerve. Discectomy may be recommended if physical therapy or medication fail to relieve leg or back pain caused by pinched spinal nerves. The surgery can be performed in an open or minimally invasive technique.
Fusions (Cervical, Thoracic, & Lumbar)
Our team offers both minimally invasive and open surgical options for anterior, posterior and lateral fusions.
Anterior cervical discectomy and fusion is a surgery to remove a herniated or degenerative disc in the neck. An incision is made in the throat area to reach and remove the disc. A graft is inserted to fuse together the bones above and below the disc. ACDF may be an option if physical therapy or medications fail to relieve your neck or arm pain caused by pinched nerves. Patients typically go home the same day.
AxiaLIF is a minimally invasive spinal fusion to treat disc problems in the low back. Fusion stabilizes the spine to stop the painful motion and decompress pinched nerves. Through a small incision at the tailbone, the damaged disc is removed and a rod placed to correct the spacing between the vertebrae. During healing, the bones will fuse together. The back muscles are avoided, so recovery is quicker.
Lateral interbody fusion is a minimally invasive surgery to treat disc problems in the low back. In spinal fusion, two or more bones of the spine are joined to stop painful motion, decompress pinched nerves, and correct scoliosis. Through a small incision at the side of the waist, the disc is removed and a bone graft is inserted to restore the height and relieve nerve pinching. During healing, the bones will fuse together.
Transforaminal lumbar interbody fusion is a surgery used to treat disc problems in the low back. Fusion locks together two or more bones to stop painful motion, relieve pinched nerves, and correct scoliosis. Through small, minimally invasive incisions in the back, the disc is removed. A bone graft spacer is placed in the space to restore the height and relieve nerve pinching. During healing, the bones fuse together.
Spinal cord stimulation delivers low voltage current to block the feeling of pain. A small device implanted in the body transmits an electrical current to the spinal cord. When turned on, the stimulation feels like a mild tingling in the area where pain is felt. It helps patients with chronic pain better manage symptoms and potentially decrease use of pain medications.
Vertebroplasty and kyphoplasty are minimally invasive procedures performed to treat vertebral compression fractures (VCF) of the spine. These fractures, which can be painful and limit spine mobility, are commonly caused by osteoporosis, spinal tumors, and traumatic injury. Traditional treatments of bed rest, pain medication, and braces are slow to relieve the pain. By injecting bone cement into the fractured bone and restoring the vertebra height, these procedures offer patients faster recovery and reduce the risk of future fractures in the treated bone.
* If these treatments are necessary for your care, we will refer to the top surgeons or specialist for the procedure, in order to offer the patient the best outcome. We will coordinate care and scheduling of these as well as follow-up care.
Non-Surgical Services & Treatments
The Iowa Clinic offers over 40 specialties, which means our neurosurgeons have immediate access to non-surgical care for patients. Those non-surgical needs may include:
Learn more about The Iowa Clinic Spine Center.