Thomas Schuler, MD, is founder and CEO of the Virginia Spine Institute in Reston and was a spine consultant for the Washington Redskins for 20 years.
Dr. Schuler specializes in cervical and lumbar disc replacement and minimally invasive spine surgery.
He founded the Virginia Spine Institute in 1992, which has grown to include regenerative therapy, stem cell therapy as well as robotic and ultrasonic spine surgery.
Here, Dr. Schuler discusses the development of stem cell therapy in spine and how regenerative therapies are helping improve the quality of life for poor surgical candidates.
Note: Responses are lightly edited for style and clarity.
Question: What breakthrough or event in spine had the biggest impact on your practice last year?
Dr. Thomas Schuler: Last year has shown many advances that are changing and improving the way we practice spine. Robotic surgery, augmented reality and artificial disc replacement are areas that have progressed in 2019. However, the area that I find most promising is the use of bone marrow concentrate/stem cell therapy to stabilize injured discs and delay or, in some cases, prevent the need for surgery. We have been treating patients for over five years with bone marrow concentrate injections into discographically-proven painful discs. Our patients have not only avoided surgery, but regained full and active lifestyles and improved their quality of life.
This may not be the appropriate treatment for every case or every situation, but for those who are candidates it is truly life changing. The most exciting cases are not the patients with one or two degenerative discs, but those with their entire lumbar spine degenerated, who ultimately because of that, are extremely poor surgical candidates. The ability to return these patients back to full and active lives is impressive and promising, especially since there are no reasonable surgical options for these patients. Realizing the significant positive impact of the use of bone marrow concentrate/stem cells intradiscally in the properly selected and rehabilitated patient is truly a game changer for spinal healthcare moving forward. 2019 marks the year that this great advance became a clinical reality. Healing patients naturally with regenerative medicine, while avoiding surgery in individuals who did not benefit from traditional nonoperative treatments, is truly an exciting paradigm shift.