Thomas Schuler, M.D., F.A.C.S is an American spinal surgeon, researcher and educator in the treatment of neck and low back conditions. He was an early adopter of stem cell therapy, [1] biologics, [2] robotics, laser and hybrid surgery and augmented reality for spinal surgery. [3] Schuler specializes in cervical and lumbar disc replacement procedures, minimally invasive spine surgery and robotic spine surgery. [4] He performed the first hybrid multi-level cervical artificial disc replacement with spinal fusion in the country. [5] He founded a practice that has performed some of the first robotic [6] [7] and augmented reality spinal surgeries in the world. [3] In 2002 he created and currently serves as President of the National Spine Health Foundation, a national non-profit focused on education, research and patient advocacy of neck and back health. [8]
Thomas Schuler was born in 1960. He became an Eagle Scout in 1977, went to college at the University of Notre Dame, and attended medical school at Indiana University School of Medicine. He completed his residency in Orthopaedic Surgery at Beaumont Hospital, Royal Oak and did his fellowship in spinal surgery at Kerlan - Jobe Orthopaedic Clinic in Los Angeles, California. [9]
Dr. Schuler is Double board certified and a Diplomat in spine surgery and orthopedic surgery of the spine. [9] In 1998, he was one of the first doctors to use biologics in surgery [8] when the practice he founded in 1992, The Virginia Spine Institute (VSI) [8] in Reston, Virginia, served as the 3rd largest site in the nation for the trial of bone morphogenetic protein (BMP) – the first use of biologics in surgery.
Since 1998, Schuler speaks and teaches about spine surgery globally. [10] [11] He performed the first hybrid multi-level cervical artificial disc replacement with spinal fusion in the country. [3] He leads a team of surgeons at VSI who performed the first robot-guided spine surgery in the Mid-Atlantic region, were the first in the world to perform Open Robotic Sacroiliac joint fusion [12] and the first in Washington, D.C., and Virginia [13] to perform Augmented Reality spinal surgery. [14] [15] [16]
In 1993, Schuler became the spine consultant to the Washington Football Team (formerly known as The Washington Redskins) [17] [18] and served in that role for 22 seasons. He continues to treat professional athletes. [19] Schuler has authored and co-authored numerous research papers about the spine in areas such as Discogenic Lumbar Disease, [20] the minimum clinically important difference in lumbar spine surgery patients [21] and six-year outcomes of anterior lumbar interbody arthrodesis. [22] A frequent lecturer, presenter, and educator, [23] Schuler has been named among the 100 Best Spine Surgeons and Specialists in America. [24] He has been a member of the Board of Trustees of HCA Reston Hospital Center since 2018. [25]
In 2002 he founded the National Spine Health Foundation. [8] In addition to its education and advocacy work, the foundation designates spine “Centers of Excellence” across the U.S. [26] Schuler has been President of the Foundation since 2004 [8] and is also Chairman of the group's Medical and Scientific Board. [27]
A laminectomy is a surgical procedure that removes a portion of a vertebra called the lamina, which is the roof of the spinal canal. It is a major spine operation with residual scar tissue and may result in postlaminectomy syndrome. Depending on the problem, more conservative treatments may be viable.
Lordosis is historically defined as an abnormal inward curvature of the lumbar spine. However, the terms lordosis and lordotic are also used to refer to the normal inward curvature of the lumbar and cervical regions of the human spine. Similarly, kyphosis historically refers to abnormal convex curvature of the spine. The normal outward (convex) curvature in the thoracic and sacral regions is also termed kyphosis or kyphotic. The term comes from the Greek lordōsis, from lordos.
Ralph Bingham Cloward was an American neurosurgeon, best known for his innovations in spinal neurosurgery. Cloward is known for the development of the Posterior Lumbar Interbody Fusion and Anterior Cervical Discectomy and Fusion. Cloward moved from Chicago to Hawaii in 1938, becoming the state's lone neurosurgeon. He is well known for his work treating victims of brain injuries after the Pearl Harbour attack in 1941.
Bone morphogenetic proteins (BMPs) are a group of growth factors also known as cytokines and as metabologens. Originally discovered by their ability to induce the formation of bone and cartilage, BMPs are now considered to constitute a group of pivotal morphogenetic signals, orchestrating tissue architecture throughout the body. The important functioning of BMP signals in physiology is emphasized by the multitude of roles for dysregulated BMP signalling in pathological processes. Cancerous disease often involves misregulation of the BMP signalling system. Absence of BMP signalling is, for instance, an important factor in the progression of colon cancer, and conversely, overactivation of BMP signalling following reflux-induced esophagitis provokes Barrett's esophagus and is thus instrumental in the development of adenocarcinoma in the proximal portion of the gastrointestinal tract.
Spinal fusion, also called spondylodesis or spondylosyndesis, is a neurosurgical or orthopedic surgical technique that joins two or more vertebrae. This procedure can be performed at any level in the spine and prevents any movement between the fused vertebrae. There are many types of spinal fusion and each technique involves using bone grafting—either from the patient (autograft), donor (allograft), or artificial bone substitutes—to help the bones heal together. Additional hardware is often used to hold the bones in place while the graft fuses the two vertebrae together. The placement of hardware can be guided by fluoroscopy, navigation systems, or robotics.
Failed back syndrome or post-laminectomy syndrome is a condition characterized by chronic pain following back surgeries. Many factors can contribute to the onset or development of FBS, including residual or recurrent spinal disc herniation, persistent post-operative pressure on a spinal nerve, altered joint mobility, joint hypermobility with instability, scar tissue (fibrosis), depression, anxiety, sleeplessness, spinal muscular deconditioning and even Cutibacterium acnes infection. An individual may be predisposed to the development of FBS due to systemic disorders such as diabetes, autoimmune disease and peripheral blood vessels (vascular) disease.
Bone morphogenetic protein 2 or BMP-2 belongs to the TGF-β superfamily of proteins.
Anterior cervical discectomy and fusion (ACDF) is a surgical procedure to treat nerve root or spinal cord compression by decompressing the spinal cord and nerve roots of the cervical spine with a discectomy, followed by inter-vertebral fusion to stabilize the corresponding vertebrae. This procedure is used when other non-surgical treatments have failed.
Artificial disc replacement (ADR), or total disc replacement (TDR), is a type of arthroplasty. It is a surgical procedure in which degenerated intervertebral discs in the spinal column are replaced with artificial disc implants in the lumbar (lower) or cervical (upper) spine. The procedure is used to treat chronic, severe low back pain and cervical pain resulting from degenerative disc disease. Cervical disc replacement is also an alternative intervention for symptomatic disc herniation with associated arm and hand symptoms.
An interbody fusion cage is a prosthesis used in spinal fusion procedures to maintain foraminal height and decompression. They are cylindrical or square-shaped devices, and usually threaded. There are several varieties: the Harms cage, Ray cage, Pyramesh cage, InterFix cage, and lordotic LT cage, all of which are made from titanium; the Brantigan cage, made from carbon fibre; and the Cortical Bone Dowel, which is cut from allograft femur. The cages can be packed with autologous bone material in order to promote arthrodesis.
Sean E. McCance, M.D., is an American orthopedic surgeon and Co-Director of Spine Surgery in the Leni and Peter W. May Department of Orthopaedics at the Mount Sinai Medical Center in New York City. Additionally, he is Associate Clinical Professor of Orthopaedics at the Mount Sinai School of Medicine and Attending Spine Physician at Lenox Hill Hospital.
Spinal stenosis is an abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots. Symptoms may include pain, numbness, or weakness in the arms or legs. Symptoms are typically gradual in onset and improve with bending forwards. Severe symptoms may include loss of bladder control, loss of bowel control, or sexual dysfunction.
Andrew C. Hecht, M.D., is an American orthopaedic surgeon and a nationally recognized leader in surgery on the spine.
The TESSYS method is a minimally-invasive, endoscopic spinal procedure for the treatment of a herniated disc. It was a further development of the YESS method by the Dutch Dr Thomas Hoogland in the Alpha Klinik in Munich in 1989 and was first called THESSYS. The procedure involves performing a small foramenotomy and removal of soft tissue compressing the nerve root.
Minimally invasive spine surgery, also known as MISS, has no specific meaning or definition. It implies a lack of severe surgical invasion. The older style of open-spine surgery for a relatively small disc problem used to require a 5-6 inch incision and a month in the hospital. MISS techniques utilize more modern technology, advanced imaging techniques and special medical equipment to reduce tissue trauma, bleeding, radiation exposure, infection risk, and decreased hospital stays by minimizing the size of the incision. Modern endoscopic procedures can be done through a 2 to 5 mm skin opening. By contrast, procedures done with a microscope require skin openings of approximately one inch, or more.
The Bumin Hospital Group is the leading general hospital group specializing in orthopedic treatment of spine and joint disorders in Korea. The group operates four hospitals of 1000 beds in Seoul and Busan. Bumin was designated as a “Joint Specialized Hospital” by the Ministry of Health and Welfare, and it is the largest joint specialty hospital in Korea. Bumin Hospital was also accredited as the “Official Orthopedic Teaching Hospital” and “Certified Medical Institution for Patient Safety and Healthcare Quality” by the Ministry of Health and Welfare of Korea.
The minimal important difference (MID) or minimal clinically important difference (MCID) is the smallest change in a treatment outcome that an individual patient would identify as important and which would indicate a change in the patient's management.
Instrumented posterior lumbar interbody fusion (iPLIF) is a common spinal fusion surgical technique for addressing low back pain resulting from degenerative lumbar spine disorders. It has a theoretical advantage over instrumented posterolateral fusion (iPLF) in that it provides better support for the vertebra along with several potential neurological benefits, but as of 2011 evidence demonstrating actual improved clinical outcomes was lacking.
The sacroiliac joint is a paired joint in the pelvis that lies between the sacrum and an ilium. Due to its location in the lower back, a dysfunctional sacroiliac joint may cause lower back and/or leg pain. The resulting leg pain can be severe, resembling sciatica or a slipped disc. While nonsurgical treatments are effective for some, others have found that surgery for the dysfunctional sacroiliac joint is the only method to relieve pain.
NuVasive is a medical devices company based in San Diego, California. The company primarily develops medical devices and procedures for minimally invasive spine surgery. NuVasive's products include software systems for surgical planning and monitoring, access instruments, and implantable hardware. Conditions that NuVasive products help treat are: degenerative disc disease, lumbar spinal stenosis, degenerative spondylolisthesis, cervical disc degeneration, early onset scoliosis, and limb length discrepancy.