The 20th Anniversary of Artificial Disc Replacement at Texas Back Institute: What This Means for the Future

By the rediscover Patient Education Team


Recently, the Texas Back Institute (TBI) celebrated a major milestone: 20 years of having been involved with total disc replacements. 2000 marked the first year of their journey with disc replacements, and since then they’ve helped more than 3,500 patients with these devices.

The three disc replacement pioneers at TBI include Drs. Scott Blumenthal, Richard Guyer, and Jack Zigler. Each surgeon brings a different perspective on this treatment alternative. Dr. Guyer stated, “An artificial disc is very much like a hip or knee prosthesis which is made out of metal and plastic—we surgically remove the diseased or injured disc and put this artificial disc in its place. This allows the patient to avoid having a fusion of two discs and they can return to normal movement.”

“Discs are spacers between the bones, which are the building blocks of our spine,” Dr. Zigler added. “Sometimes our natural disc will wear out, which can cause a pinched nerve or reduce its ability to absorb shock. An artificial disc allows us to replace a damaged disc with one that will not stiffen up the spine, which occurs with the fusion process.”

“One of the advantages of a disc replacement rather than a fusion procedure is that we can preserve motion in the neck or lower back of the patient,” Guyer said. “This is a huge benefit to the patient. Additionally, we know that fusions will often cause degeneration in the next vertebra level up, but we now have 10 years of research that suggests that the chances of this occurring in a replacement is about one-third or one-quarter the chance of a fusion procedure.”

Dr. Blumenthal commented on the ideal patient, “The ideal patient for the cervical disc replacement is someone who has already been told they need a fusion. Over time, our natural discs can become ruptured or bulged and touch a nerve which can lead to severe neck and/or arm pain. If a patient’s pain does not respond to conservative treatment, disc replacement is considered.”

The surgeons at TBI have participated in 14 FDA trials, including all of the prodisc FDA studies. They have authored many of the studies that have been published to better understand the clinical benefits to patients for these newer device alternatives to fusion. In addition to medical device funded studies, TBI has funded their own research for lumbar disc replacement.

Guyer concluded: “I am particularly proud of the work we three have done. We started 20 years ago on this journey, and this means we’ve been around the block a time or two. We’ve all had patients who have come back to us after having disc replacement and said ‘Doc, you’ve changed my life.’ This is the type of feedback that keeps us going. This is why we have committed decades of our career to this specialty!”


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Important Note: The patient information presented is for general education purposes only. As with any spine surgery, there are potential benefits, complications, and risks associated with disc replacement and spinal fusion procedures. Individual results may vary. It is important that you discuss the possible risks and potential benefits of various procedures with your doctor prior to receiving treatment, and that you rely on your physician’s best judgment. Only your doctor can determine whether you are a suitable candidate for a specific surgical procedure.

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