Dr. Thomas C. Schuler

Michael Howland has been a member of the board of directors of the Reston-based Spinal Research Foundation since its inception two years ago.

"But I'm a patient as well," he said in noting the five back operations he has had since his release from Tehran as a hostage on Jan. 20, 1981.

"I was being beaten on the way to the airplane," he recalled recently of that day.

According to Howland, 55, his back finally "crashed" in September 2000, resulting in a trip by ambulance to Reston Hospital.

"It was my lucky day when I found Tom," Howland said in recalling how he first learned of Dr. Thomas Schuler while in the emergency room.

President and founder of the Virginia Spine Institute, Schuler, 43, an internationally known expert in spinal surgery, had set up shop literally across the street from the hospital eight years earlier.

Schuler has operated on Howland twice since that trip to the hospital, with "absolutely tremendous results," Howland reported.

Though Howland, the diplomat, was in the wrong place at the wrong time in 1979, his trip to the hospital 20 years later from his home in Reston coincided with what Schuler described as the "biggest breakthrough" in spinal fusion technology at the time: bone morphogenetic protein, or BMP.

The Virginia Spine Institute was one of only 16 centers in the United States conducting clinical trials in the late 1980s that led to the FDA's approval of the use of BMP nationwide in July 2002.

"BMP is the new gold standard," Schuler said in comparing it to the more routine method up to that point of repairing degenerative or damaged disks by taking bone from a patient's pelvis and fusing it to two adjacent vertabrae.

According to the spine institute's Web site, http://www.spinemd.com , BMP is a naturally occurring protein that stimulates bone to form. During surgery, a BMP-soaked collagen sponge is inserted into the spine at the point of degeneration or injury.

The FDA trials showed that the genetically engineered protein led to a fusion success rate of greater than 95 percent, compared to an 88-percent successful fusion using harvested pelvis bone.

Moreover, a patient avoids having to recover from painful pelvic surgery.

"It's exciting stuff," Schuler declared.

Schuler and his colleagues, Drs. Michael Hasz and Brian Subach, along with five physician assistants, have since performed more than 300 operations using BMP.

"We pride ourselves in setting the trends," Schuler said, but he readily admitted that "it's really about seeing the lives that it has changed."

Great Falls resident Bill Evers, 61, had been an active tennis player and runner who, in 1995, began experiencing back problems and pain in his legs so severe that he could not bear to sit in his car for longer than 20 minutes.

Referred to the Virginia Spine Institute by his internist, Evers recalled Schuler telling him, "I think I can fix it."

After microsurgery to repair a bone spur between two discs, Evers said the difference in how he felt was like "night and day" and allowed him to follow through on a long-planned trip to the Far East.

"I was riding an elephant in Chiang Mai two weeks later," Evers recalled.

But, as predicted by Schuler, Evers would eventually need spinal fusion surgery.

"The displacement doubled from 8 to 16 millimeters from 1995 to 2001," Evers said in describing the area of slippage between deteriorating discs in his back.

Because BMP was still six months away from FDA approval, Schuler used cadaver bone to fuse Evers' vertebrae while also employing the latest technology in bone graft cages.

As Evers recalled, "The surgery was on a Monday afternoon. By Tuesday afternoon I was up and about with minimal pain medication. By Wednesday, I was home."

“I was scuba diving in Jamaica three months later,” he said.

'A feather in Reston's cap'

"Spinal care and surgery in the area was not very progressive," Schuler said in describing why he founded the Virginia Spine Institute in Northern Virginia.

Today, the clinic, he said, is one of only five "true" spine centers in the United States specializing in neurosurgery, orthopedic and spinal surgery.

Further, its proximity to Dulles International Airport has allowed patients from as far away as Taiwan, Saudi Arabia, Germany, England and Ecuador to benefit from the clinic's advances in spinal repairs.

"This is truly a feather in Reston's cap," said Schuler, a one-time Reston resident now living in Great Falls who proudly noted he will always remain a "committed Restonian."

The term cutting-edge technology belies Schuler's goal of also having his clinic renowned for its nonsurgical care. He noted proudly that 85 to 95 percent of the clinic's patients are treated nonoperatively.

But in also noting that 90 percent of the population is predicted to at some time suffer from chronic neck and lower back problems, Schuler set up the nonprofit Spinal Research Foundation two years ago to stay abreast of the latest in patient care and surgical research.

"It struck all of us," said board member Howland, that it was not until the mid-1990s that any "real" clinical trials were under way.

"That's the reason I am associated with the foundation," Howland said.

And to have such trials and Schuler's institute here prompted Howland to add, "Reston is very fortunate."

More information on the Spinal Research Foundation can be found at http://www.SpineRF.com

The Virginia Spine Institute is also currently seeking candidates to support clinical trials of an application to the FDA that could allow the future use of the first lumbar artificial disc.