Artificial Disc Replacement

Texas Back Institute is a global leader and pioneer in spine care, having performed more than 1,400 artificial disc replacement procedures with 14 different types of ADR devices, beginning in 2000 with the first ever performed in the United States. One of the latest advancements in spine surgery, artificial disc replacement gives our patients an opportunity to retain mobility and resume their lives with minimal pain or discomfort. Led by the world-renowned spine surgeons at our Center for Disc Replacement, we perform this motion-preserving, life-changing procedure on patients from around the globe each year. If you’re suffering from chronic back or neck pain, our concierge services team will help you coordinate all aspects of your visit to TBI so you can receive treatment from some of the best spine surgeons in the world. It’s your time to get back to life.

Patient of the Month

Robbin Hallford went from unable to stand to increasing the number of yoga classes she teaches thanks to the miracle of 360 fusion.

Baby Boomer Robbin Hallford is a teacher and yoga instructor who can proudly state she is more active now than in her 20’s thanks to the miracle of modern surgery. Hallford, a 48-year old mother of three, underwent a 360 fusion around her L4 and L5 vertebrae in March of 2011. Since that time, she has proven daily that she can stay active and continue teaching yoga. In fact, she is planning to increase the number of classes she is teaching this summer, only a year after surgery.

Surgery was not Hallford’s first choice. After several days of pain and the inability to move her left leg, she attempted to manage the pain with chiropractic treatments. It was during these treatments that x-rays showed the lumbar area to be foggy. The chiropractor suggested an MRI, which Hallford took to a physician who recommended Dr. Michael Duffy of the Texas Back Institute.

Dr. Duffy made every effort to help me control the pain, including steroid shots, pain control and anti-inflammatory drugs. Unfortunately, I had reactions to the medications, particularly the anti-inflammatory,” said Hallford.

Hallford collapsed in her class, which was the final straw. She decided to move forward with back surgery at Texas Back Institute. Dr. Duffy assembled a team of experts to ensure that Hallford’s surgery went smoothly. In March of 2011, they performed a 360 fusion on L4 and L5, giving Hallford much needed relief.

“We knew that Robbin’s condition would be considerably improved by a 360 degree fusion,” said Dr. Duffy. “Having a patient who was so dedicated to post-operative physical therapy certainly expedited her recovery.”

Hallford’sbackground is in physical therapy and kinesiology, so she was well aware of the effort it would take to recover from surgery.

“I was in devastating pain, thinking of giving up my yoga practice and going on disability,” said Hallford. “Thanks to Dr. Duffy and his great team, I am 100% better. I got the life back that I wanted. For me, surgery was the answer.”

Like many baby boomers, Hallford wants to continue an active life on her own terms and not let injuries or aging slow her down.

“My 48 does not look like my mother’s 48 or my grandmother’s. I do more now than I did when I was 20 years old. I’m stronger now. The surgery helped me to be able to keep that,” said Hallford.

Hallford is not a proponent of choosing surgery first. In fact, she chose to use her own knowledge and skills in yoga to postpone surgery as long as possible. In the end, it was the miracle of back surgery that gave her the life she wanted.

“If there is any way, do it without surgery. But it you cannot avoid it – go to TBI. I highly recommend Michael Duffy. To take me from where I was to where I am now, he’s a very skilled physician. The team they put together was top-notch. If you are facing [spine] surgery, I can tell you with all confidence you will get the best treatment and honestly I believe the best outcome.”

Guest Blogger, Jennifer Sanders, Surgery Scheduler and Administrative Assistant for Dr. Lieberman, loves her job!

Not all people can truly say that they love their job. Some people might say that they like their job, but they don’t truly love going into work every day. I happen to love my job and honestly enjoy what every new day brings.

 I’m Jennifer Sanders and I have been working at TBI for a little over a year. My previous employers have all been small companies with no more than 20 employees. I’ll admit it, I was nervous to work for a company so much larger.  Our Plano office seemed so big with so many people and at first I was intimidated.  I soon learned I had nothing to be nervous about; I joined a great company. Although there are close to 100 people working in our Plano office, it still feels like a family environment.  The management makes a point to put on fun events, like pot-luck lunches, casual days and Sonic Boom!- to help with our overall health and wellness. I have never worked in a place where I felt so at home and valued.

 What makes this job different from anywhere else I’ve ever worked is you can literally witness our doctors “getting our patients back to life”.  The majority of Dr. Lieberman’s patients have scoliosis or curvature of the spine and we see a dramatic physical and emotional change in many of our patients after surgery.

 Several months after starting at TBI, I met with a patient who had a severe kyphotic deformity. She was bent forward almost 90 degrees, had to use a walker to move around and had a hard time with day-to-day activities, including laying down.  Dr. Lieberman ended up performing surgery on her and it went very well.

 I didn’t see this patient again for approximately 9 months. One day I was walking through our lobby and I was stopped by this sweet women. “Jennifer?” I paused and looked at the women trying to figure out how I knew her. She said, “You don’t recognize me, do you?” After a couple of seconds, I realized who she was and I was astonished….almost speechless. There standing before me was our patient from 9 months ago who at the time, saw the world completely bent over.  Not only had she changed her hair and lost weight, but she was standing up almost completely straight and without the aid of a walker. It brought tears to my eyes seeing just how good (and tall) she looked. She expressed heartfelt gratitude for what Dr. Lieberman was able to do to help her. I really liked working at TBI before this day, but after seeing that patient I knew I really loved where I was and I was surrounded by people and doctors who were able to improve other people’s lives.

 Since that day, I have witnessed countless other success stories like this patient.

I love my job but I also love my time outside of work. I am a wife, daughter and sister! This is my husband, Trace  and I.

 I am a Texas A&M graduate and I love cheering on the Aggies when I’m not at work.  This is my family and I getting ready to watch the Aggies win!

Seeing the good we are doing with my own two eyes, truly makes me want to come to work everyday. I wake up and say who are we going to help today? Whose life can we change for the better? And what can I do to help our patients get back to life?

I would love to know what you love about your job.  Please feel free to leave your comments here.

Patient of the Month – Felix Gonzales

At 58 years old, Felix Gonzalez, Jr. was a quadriparetic from severe repetitive stress injuries incurred while employed as an aircraft assembly worker. He was confined to a wheelchair and could barely use his arms and legs.

Today, he’s living independently in the Dallas area – thanks to what spine surgeons call a miraculous recovery from modern surgery.

“When I came to TBI, I could not even tie my shoes,” said Gonzalez. “Now I use a walker to walk, have my own apartment, can drive and shop for my groceries. I am slowly gathering my independence.”

Last year, Gonzalez was living with his parents in Washington State, unable to care for himself. Fortunately, his sister-in-law found a place that would treat Gonzalez’s injuries and provide him with relief – Texas Back Institute.

“We knew we could help,” said Dr. Daniel Bradley, a spine surgeon at Texas Back Institute, “but we had no idea how well Felix would recover.”

Gonzalez met with Dr. Bradley and his team to outline a treatment schedule. Dr. Bradley is a pioneer in minimally invasive spine surgery at the Texas Back Institute in Denton, Texas. He performed the cervical fusion first to give Gonzalez relief by alleviating pressure in his spine. Gonzales made what the staff called a miraculous recovery during therapy due to his discipline and diligence.

Next, Dr. Bradley performed the lumbar decompression surgery on Gonzalez. Again, after extraordinary progress in physical therapy, Gonzalez was walking.

Gonzalez does not plan to stop his progress any time soon. He is hoping to be using just a cane in the next month. And he has other plans.

“I want to get back on a Harley and join my friends in Arizona. We used to ride the Four Corners. I will do that again,” said Gonzalez.

Denys Kendall….Back to Feeling Like a Person!

Denys Kendall never thought he would need spine surgery.  He was jumping out of airplanes, serving his country in Iraq and living the life of a true adrenaline junkie.  Denys served in the Army for 4 years, starting off in Special Forces and eventually moving into the First Cavalry at Fort Hood in Killeen, TX. 

Unfortunately for Denys, while receiving a series of vaccines to protect him from contracting anthrax, he developed a severe staph infection. The infection settled in his hip eventually eating away at the sacroiliac joint and the lower area of his lumbar spine. During the removal of an abscess, by surgeons outside of Texas Back Institute (TBI), one of his nerves was severed causing pain and weakness in his leg.

Denys’s pain got to a point where he knew he needed to seek attention from an expert and he began seeing Dr. James Cable, a pain management specialist at the Texas Back Institute to help determine what treatment options were available for his specific condition.  After performing a physical evaluation and reviewing Mr. Kendall’s case Dr. Cable referred him to his colleague Dr. Ralph Rashbaum, co-founder and orthopedic spine surgeon at the Texas Back Institute specialized in chronic pain management and interventional pain management.

Dr. Rashbaum and Denys discussed the possible treatment options and determined a spinal cord stimulator was going to give him the best possible results.  Luckily for Denys, the FDA had just approved the use of a new stimulator device that automatically adjusts to movements in his posture, making it virtually effortless to use.

Dr. Rashbaum recalls, “Denys came to Texas Back Institute with unrelenting pain radiating down his leg. He was the perfect candidate for the RestoreSensor because he is a very active gentleman and the sensor works well for people with active lifestyles.”

The decision to undergo the spinal cord stimulator implant was not an easy one for Denys, however, after doing his own research and his trust in Dr. Rashbaum Denys moved forward with the procedure.  “Dr. Rashbaum was very straightforward with me, and I love that,” said Denys. “He gave me realistic expectations but he was very confident this was going to be a life changer. Since my procedure the device has been doing its job like a champ.”

When asked what he most looks forward to doing now that his back pain is under control Denys states, “to me, it’s not so much about what activity, it’s about getting a life back! I can be a person again and that for me is invaluable. Dr. Rashbaum is a savior! He saved me.”

Questions to ask your spine surgeons about neck or back pain

Many people assume that if they are going to see a spine surgeon that they are going to need surgery.  This couldn’t be further than the truth.  Actually, 90% of the people with back pain and/or neck pain will recover without surgical intervention.  Therapy, medication management and injections are all conservative treatment options which are explored.

At the Texas Back Institute we want you to get the most out of your appointment with one of our spine surgeons.  Dr. Richard Guyer, orthopedic spine surgeon and founding partner of Texas Back Institute in Dallas, TX tells us what questions you should ask your surgeon and what you should know before making the decision to have spine surgery.  

  • Ask your surgeon to clearly explain your diagnosis.
    • Make sure you understand your diagnosis, exactly what your diagnosis means, and what your treatment options are. 
  • Ask your surgeon what conservative treatment options are available.
    • Exhaust all conservative treatment options before considering surgery, including medication management, physical therapy and injections.
  • Ask your surgeon if you really need surgery.
    • Know what the progression of your condition may be. 
    • Make sure you know what makes a patient a good candidate for the surgery you are considering, and if you fit the criteria.
  • Find out if there is a minimally invasive option for your surgery. 
    • Minimally invasive spine surgery is about doing as little damage as possible to the tissues of the body but still getting optimal results.  It’s not necessarily about the use of lasers which are just one of many tools used for this surgery
  • Ask the basic complications of any surgery. 
    • This includes the expected infection rate, the expected chance of injury to the nerve, the expected relief of  pain and recovery of nerve function.
  •  Ask what your recovery will be like.
    • What will your activities immediately after surgery and in the weeks after surgery be like?

Overall, we want to make sure that all our patients have their questions answered and are comfortable with their decision to have spine surgery.  If you have specific questions that you would like answered please visit and submit your questions.  We look forward to hearing from you!

BW Beasley…Back to Racquetball!  

BW Beasley came to the Texas Back Institute after suffering from chronic back pain symptoms for years. Ten years earlier, Mr. Beasley had undergone a microdiscectomy with a different physician which only temporarily relieved his pain. He was anxious for a chance to get back to an unrestricted and active lifestyle, as he had been an active golfer and racquetball player before his pain had become too severe. Additionally, he was required to travel for work as a sales manager, and this was becoming increasingly difficult due to his back pain symptoms.

After conservative treatments proved unsuccessful, BW decided to go through with disc replacement surgery with Dr. Jack Zigler at TBI.  Shortly after surgery, the hospital staff had him up walking and into the artificial disc replacement physical therapy program.  BW progressed rapidly and by his 6 month follow-up visit, he was scuba diving and golfing again. Travel was no longer an issue, which made work much more manageable.  At his 12 month follow-up visit, he arrived at TBI with a copy of the Summer 2009 Racquetball magazine that featured an article he had written about playing the perfect game. He had just played in the US Open for Racquetball in his age group—an amazing feat, for someone who was seeking back pain treatment had undergone back surgery less than a year before. He stated that people were amazed to hear that he had an artificial disc and asked many questions about it, his surgeon, and where he had his surgery. “I refer patients to TBI and Dr. Zigler all the time!” he says.

Three years later, he won a national Racquetball tournament for his age group. “I have some trouble with my shoulder and my elbow at times, but not really my back,” he said. He can’t believe that three years have passed and that he continues to do so well after back surgery and feels so good.

“I never thought I’d be able to get my life back,” he says, “but if I can do it, I know others can too.” When asked what BW would tell others worried about undergoing spine surgery, he says, “If you do nothing else, just go see the spine surgeons at Texas Back Institute.  You owe yourself at least that!”

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