Revolutionizing Spine Care…Changing Lives

Three Men Who Changed Back Surgery Forever – Part Two “Our biggest disappointment”

As noted in a previous post, the pioneering work done 15 years ago by three spine surgeons at Texas Back Institute on the artificial disc replacement procedure has been nothing short of ground-breaking. The three surgeons responsible for the first artificial disc replacements were Dr. Jack Zigler, Dr. Richard Guyer and Dr. Scott Blumenthal.


As is the case with many scientific breakthroughs, these physicians have seen both miraculous patient recoveries and a disappointing lack of acceptance by the business entities most people rely on to cover the expense of these procedures – health insurance companies. More on this later.

In spite of the procedure still being categorized as “experimental” by many insurance companies and therefore not eligible for coverage, the artificial disc replacement procedure has proven to be extremely safe, clinically effective and cost-effective over the long-term.

As Dr. Guyer noted, “Though the short term results may be similar to fusion, the real difference comes with long term follow-up of greater than 5 years. The fusion patients are up to 3 times more likely to have surgery at the next level compared to the disc replacement patients.”

Dr. Zigler added, “In general, the artificial disc patients recover more quickly and do better earlier.  Long term, my published research has shown that the patients with artificial discs show less degeneration at their adjacent levels on x-ray, and require less additional surgery.  Disc replacement surgery, most patients tell me, was a life-changing event for them.”

The time period between the first artificial disc replacement procedure in the United States and today – 15-years – has allowed for extensive patient data-collection leaving no doubt of the efficacy of the procedure. Over the long-term, patients who undergo this procedure get back to their lives quicker, have reduced pain and experience more mobility than those who had other surgeries.

The Proof is With the Patient

Scientific advances in medicine are not judged in a sterile laboratory. Human beings are involved in this calculus. With regard to patients, the artificial disc replacement procedure has been immensely successful among this most important group…our TBI patients.

Gara Little was just 22-years old when she first started noticing a pain in her back that was to become excruciating. The artificial disc replacement procedure would forever change her life for the better!


“My son Pierce is 4-years old and my little girl, Lillie, is 1,” Gara said. “I carried them both through the pregnancy and there were no back problems, whatsoever. This is unusual for even a completely healthy woman’s back.”

“Now, I can lift Lillie and play baseball with Pierce in the backyard and I have no back pain,” she said. “I also participate in dance aerobics with no pain. This procedure changed my life.”

The Greatest Disappointment

In a “perfect world,” a medical breakthrough such as the artificial disc replacement procedure, which has been so thoroughly studied – over more than 15 years –  and proven to dramatically improve the lives of patients while saving health care dollars, would be embraced by the insurance companies on which most patients rely for the health care. This has not been the case with the artificial disc replacement procedure.


“My greatest disappointment has been the reluctance of the insurance industry to approve the use of artificial disc replacement in appropriately selected patients, noted Dr. Zigler in speaking for his other, pioneering colleagues. “For example, multicenter, highly-regarded scientific studies have clearly shown the safety and effectiveness of lumbar disc replacement as an alternative to fusion and have received approval by the FDA after its own careful review of the scientific evidence.” 

“Despite that, the insurance industry has made its own determination, and to this day, major companies have policies that declare these devices to be – “investigational and experimental” – even after 15 years of clinical use in the U.S. and hundreds of scientific publications demonstrating clinical success,” he noted.

“Thousands of patients have been denied access to this preferred surgical treatment method by the capricious decisions of insurance company executives that have no basis in fact.  Having to explain this to deserving patients every day in my Texas Back Institute clinic remains my single biggest disappointment,” he said.

The Future is Bright

As more and more patients seek alternatives to insurance-paid healthcare, the future for those who can benefit from the artificial disc replacement procedure is bright. The three spine surgeons who first performed the procedure and their colleagues at Texas Back Institute continue to successfully employ this surgery to alleviate back pain while enhancing patient mobility. There is also exciting news on the ADR horizon.

“We are very excited about the soon-to-be-released Activ-L lumbar disc replacement from Aesculap spine, Noted Dr. Blumenthal. “It is truly a next generation disc combining the best features of the Charite and Prodisc. Since we participated in the FDA trial of the Activ-L, Texas Back Institute will be the first to offer it in our market later this year.”

The spine specialists at Texas Back Institute have successfully treated thousands of patients with back pain and they are available to help you. To set an appointment, click here.  

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