E.B. Writers of Dallas

PULSE Magazine, Dallas Morning News, Feb. 2003

By Wayne Epperson, Correspondent,

David Yoder, 52, has lived with back pain for much of his adult life. It got so bad in the last two years that he constantly wore a pain patch in order to do simple things like bending down and tying his shoes.
Mr. Yoder had his first back surgery in 1985 to repair a ruptured disc. Three years later he ruptured another disc and underwent a posterior spinal fusion – bone grafts from his hips fused three vertebrae. Seemingly, he would be able to cope with his degenerative disc disease.
"But about five years ago, two of the grafts broke loose [after] I fell down some stairs," says Mr. Yoder. "So for five years I have had what was supposed to be solid, moving around, which caused excruciating pain."
Mr. Yoder began hearing good reports about spine surgeon Michael Hisey, M.D., of the Texas Back Institute in Plano and saw him for an initial consultation last November. Dr. Hisey recommended a new spinal fusion technology for Mr. Yoder's third back surgery. The Federal Drug Administration had just approved the use of PathFinder Minimally Invasive Surgery pedicle screws, manufactured by Spinal Concepts of Austin.
Dr. Hisey believed the device, which requires a smaller incision and less tissue trauma than other procedures, would solve Mr. Yoder's problem and result in less pain after surgery.
Mr. Yoder had the surgery on Dec. 9 at Presbyterian Hospital of Plano. Three days later, he was discharged from the hospital. Four weeks after that, he was back at work as administrator of Fort Worth Surgery Center, a part of HealthSouth Corporation.
"I'm feeling very good and I'm taking just Tylenol for pain management," says Mr. Yoder. "When I was released they had me doing some minimal exercises in the bed and then start walking. At two weeks post-surgery, I was started on physical therapy. My recovery is going very well."
His recovery from the lumbar fusion procedure in 1988 required a weeklong hospital stay, followed by bed rest for six weeks.
"I wore a brace that went under my arms to my hips. It was like a huge plastic corset and I wore it for six months," recalls Mr. Yoder.
The usual way of doing a lumbar fusion is to take the muscles and strip them all the way off the bone to get a look at where to place screws that then connect with a metal rod, explains Dr. Hisey, who is board-certified in spinal and orthopedic surgery. The PathFinder, he says, stabilizes the spine from behind without doing as much damage to the muscles.
The PathFinder creates a little channel through the muscle, between the plains of the muscle, that does not strip it off the bone, he says.
"So you are not losing all those attachments. You don't have that soreness immediately after the surgery. You don't have that disability from having the muscles taken off," says Dr. Hisey.
From a surgeon's standpoint, "when we do the normal approach to the spine, it is very destructive," says Dr. Hisey. "You take a lot of normal structures and damage them. With this technique, you really don't, at least not to the same degree."
Mr. Yoder's surgery lasted an hour, less than half the time of his previous operations. Dr. Hisey placed thimble-looking devices between the vertebrae that were moving; 45-millimeter-long screws then were inserted and joined with a rod to stabilize the spine.
This was the first of two surgeries using the PathFinder at the Texas Back Institute. Dr. Hisey's associate, Dr. Barton Sachs, performed a similar procedure on the same day.
Todd Fanning, vice president of sales at Spinal Concepts, says the PathFinder is the latest result of the company's research and development efforts. The company was founded in 1996 with the objective of developing innovative spine products.
Currently, Spinal Concepts has 10 products on the market and plans to announce another 10 this year, according to Mr. Fanning.
"Development of the PathFinder was in response to the rise in the demand for minimally invasive surgery and trying to do more through a smaller incision," says Mr. Fanning. "The device is more than an incremental innovation; it has the potential to be a game changer."
Dr. Hisey says back pain is a common problem, with no indication of a decrease in incidence.
"I think people are getting less tolerant of it. People who used to say I'm disabled and I'm going to sit home with my back pain and not do anything now want to get something done and get back to their lives," he says.
Mr. Yoder is ready to do just that. His goal is "to get back to doing what I love to do. I like to hunt, fish, work on antique cars and run my surgery center. Those were things that were getting pretty impossible to do."
Come spring, he hopes to take that first step. He's looking forward to bending down in his garden and digging in the dirt again.