History of Texas Back Institute


n 1971, Dr. Stephen Hochschuler and Dr. Ralph Rashbaum met while stationed in Wichita Falls, Texas, as general medical officers in the United States Air Force. During this time, both men saw a number of their patients suffering from various types of back pain all being diagnosed and treated as if they had the same exact problem. These doctors knew there were different potential reasons for patients’ pain, and so they began a logical diagnostic systematic approach to targeting the pathology responsible for symptoms. This experience led them to pursue orthopedic residencies once they had completed their military service to allow further study of the musculoskeletal system and the spine.

After residency, Dr. Hochschuler created the spine program at the VA hospital at the University of Texas Southwestern Medical School, and Dr. Rashbaum completed two fellowships – one with Dr. Henry Bohlman and the other as the first spine surgery fellow with Dr. Richard Rothman. The two doctors stayed in touch, and when the time was right, Dr. Hochschuler reached out to his military friend and asked that he come back to Texas to establish a spine institute.

In 1977, when they reconnected in Dallas, they developed their vision by creating a new model for helping patients conquer back and neck pain: an integrated multispecialty spine clinic that included prevention, conservative care, surgical care, rehabilitation and research and development. Shortly afterward, Drs. Hochschuler and Rashbaum founded Texas Back Institute. Their goal was on its way to becoming a reality: take the narrow niche of spine specialty and integrate it vertically by incorporating ergonomic analysis, fellowship training, research and new product development.

As with any new business venture, many lessons were learned along the way, which helped Texas Back Institute grow and evolve over time. From performing their own diagnostic and therapeutic procedures to learning about new instrumentation appearing on the spine care scene, the doctors continued implementing new protocols for conservative care and physical therapy, as well as new surgical procedures.

In 1982, Dr. Richard Guyer joined Drs. Hochschuler and Rashbaum as the third founding partner. During the process of building and refining Texas Back Institute, the doctors wanted to create an academic component to their private practice, so they established a nonprofit research foundation in 1985, led by Dr. Barton Sachs. One year later, Dr. Donna Ohnmeiss joined the Foundation to fulfill its mission of incorporating research, education and development.

History of Disc Replacement

In the late 1980s, a Texas Back Institute medical team went to Germany to research and better understand the Charité technology already in use there. Drs. Blumenthal and Guyer played leadership roles in clinical trials of the Charité device in the United States.

In March 2000, as part of an FDA-regulated trial, Dr. Blumenthal performed the first total disc replacement procedure in the United States with this device at Texas Back Institute. Dr. Guyer performed the third Charité device procedure in the country. In October 2001, Dr. Zigler performed the first ProDisc-L lumbar ADR in the United States.


Texas Back Institute Research Foundation

The primary focus of the Texas Back Institute Research Foundation has been to promote the study of the spine, including diagnostic evaluations and treatment outcomes. Clinical studies have involved discographies, MRIs, minimally invasive procedures and total disc replacement. Peer-reviewed medical literature has been published extensively as a result of the Foundation’s studies. Hundreds of published articles and several textbooks, including Rehabilitation of the Spine, The Spine in Sports, Lumbar Disc Disease, Cervical Disc Disease and Spinal Arthroplasty: A New Era in Spine Care have been made possible through TBIRF resources. Patient education publications, including Back in Shape and Treat Your Back Without Surgery also have been produced.

In 1986, under the leadership of Dr. Richard Guyer, the Texas Back Institute Spine Surgery Fellowship Program was born. Dr. Guyer, alongside Dr. Jack Zigler, continues to lead the Fellowship Program. Together they have supervised formal training for more than 70 spine surgeons. Surgeons regularly come from all over the world to visit TBI and observe the latest in new technologies. TBI surgeons serve on boards of directors and committees of international spine societies, are on the editorial boards of several prestigious spine journals, and are actively involved with development of editorial content for Web-based SpineUniverse.com and Spine-Health.com. TBI surgeons have served as presidents of NASS (North American Spine Society), ASIA (American Spinal Injury Association) and SAS (Spine Arthroplasty Society).

Looking Forward

With its unparalleled commitment to the world of spine care, Texas Back Institute surgeons led the first FDA studies of the artificial disc, performed the first artificial disc replacements in the United States, and were primary authors on the first major scientific papers reporting the FDA study results of the Charité and ProDisc-L implants. Historically, Texas Back Institute was one of the first centers in the country to develop a back school, to perform outpatient myelography, and to utilize multiplanar reconstruction of CT scans. The founders played an instrumental role in the development of the North American Spine Society and the Spine Arthroplasty Society. Recognizing the importance of international scientific organizations, TBI surgeons also have participated actively in the International Society for the Study of the Lumbar Spine, the Cervical Spine Research Society, the American Spinal Injury Association, the Scoliosis Research Society, and the International Association for the Study of Pain, to name a few.

Throughout its history, the goal to perform as a center of excellence integrating the best of science and education with the best business practices has served Texas Back Institute well, and continues to be the foundation of Texas Back Institute’s success. Now, more than 30 years later, Texas Back Institute is one of the largest freestanding multidisciplinary academic spine centers in the world, providing internationally cost-competitive treatments that require minimal post-procedure hospitalization. Utilizing the latest technological advancements and medical breakthroughs, leading and participating in numerous FDA trials, developing surgeons through its Fellowship Programs and employing an expert medical team and compassionate support staff, Texas Back Institute remains dedicated to helping patients get back to life.