When selecting Iowa Orthopaedic Center, P.C., for your musculoskeletal spine care, you can have confidence in our board certified orthopaedic surgeons, including IOC’s fellowship trained spine surgeon.  Our surgeons have extensive knowledge and education in diagnosing, treating and managing all spine conditions including congenital deformities, degenerative diseases, spinal tumors, spine trauma and fractures.  IOC’s orthopaedic surgeons strive to continually increase their knowledge of new advancements in their field by attending special courses to learn and train in the latest developments including spine care and surgery, and minimally invasive techniques.  IOC was proud to perform the first minimal access spinal fusion surgery in Iowa (see the website Orthoscope link and click on the Winter 2006 issue for more information regarding this ground breaking procedure).

IOC offers an integrated approach to spine care by having many of the different spine specialists working collaboratively in one clinic providing pain management and rehabilitation services as well orthopaedic spine care, giving patients a comprehensive approach to spine pain.

The back is the structure that supports your upper trunk, houses and protects the spinal cord, and helps you move. A healthy back is strong and pain free. The low back area bears the most stress of movement and, therefore is usually the site of most problems. The low back is made up of four parts:
The discs are the cushiony material between the vertebrae. The center of the disc is jellylike, and the outer part is made up of slightly elastic woven bands. They act as shock absorbers and permit movement between the vertebrae.

The vertebrae are the bony segments of the spine. The vertebrae are stacked one upon another, forming three large curves. The low back area curves forward or inward. This is called lumbar lordosis. The purpose of the vertebrae is to house and protect the spinal cord and its nerve roots and give support to the body.

The sacrum is the large triangular-shaped bone at the base of the spine.

The coccyx is the small bone at the end of the spine. It is also called the tailbone.

Though humans are born with 33 separate vertebrae, by adulthood most only have 24. Physicians use a code to identify the vertebrae. The seven in the neck, the cervical vertebrae that support and provide movement for the head, are called C1 to C7. The thoracic vertebrae numbered T1 to T12, join with and are supported by the ribs, which protect the heart and lungs. Because they are fairly rigid, thoracic vertebrae don't permit much movement and consequently, aren't injured as often as the other vertebrae. The lumbar vertebrae, below the thoracic vertebrae and above the sacrum, are most frequently involved in back pain because they carry most of the body's stress. They are known as L1 to L5.

Sandwiched between each pair of adjacent vertebrae is a spinal disc, 23 discs in all. Discs are flat, round structures-about one-quarter of an inch thick-of tough outer rings of tissue that contain a soft, white jelly center. Each disc is connected to the vertebrae above and below it by flat, circular plates of cartilage. The discs not only keep the vertebrae apart, but act as shock absorbers. They compress when weight is put on them, and spring back when the weight is removed.

The spinal cord, an extension of the brain, extends as far as L1, where it ends in a sheaf of nerves. Throughout the length of the spine, 31 pairs of nerves branch off from the spinal cord and serve all parts of the body, transmitting sensory messages to the brain, and messages from the brain to the muscles.

The 33 vertebrae, 23 discs, 31 pairs of spinal nerves, 140 muscles that hook on to the vertebrae, plus ligaments, tendons, cartilage are all very complicated and are potential sources of back trouble.

Common Spine and Disc Problems
Torn Annulus
A sudden movement may cause a tiny tear in the tough outer ring of your disc. Nearby ligaments may also stretch. Since the annulus and ligaments contain pain fibers, a tear may cause pain.

Bulging Disc
Repeated movement may cause a disc to dry out and degenerate earlier than normal. As the disc wears out, the inner jelly like center begins to bulge, pressuring the outer ring causing pain.

Ruptured Disc
As a disc bulges, its center (nucleus) moves closer to the outer ring (annulus). Sometimes a sudden movement will cause the annulus to rupture and the nucleus squeezes out and irritates the nerve, causing pain.

Arthritis
Bone spurs can form at the joint between your vertebrae as discs wear out over time. Poor posture can contribute to the degeneration of your discs earlier than usual. These problems may cause a narrowing of the space where your nerve runs and cause pain.

Instability
As a disc stretches and flattens, the vertebrae can slip back and forth, creating an unstable spine which puts pressure on the annulus causing pain.

Treatments
Every patient is an individual who will be treated in a variety of ways. In general, conservative treatments such as medications, changes in lifestyle, and a physical therapy regimen will be tried before more invasive treatments such as injections or surgery would be considered.