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    Golfer utilizes titanium for relief

    Using a new procedure, a doctor screws a titanium implant into a Tarpon Springs resident's spine to relieve his chronic neck and shoulder pain.

    [Times photo: Jim Damaske]
    Dr. Andrew Maser, an orthopedic surgeon at Helen Ellis Memorial Hospital, points to an X-ray image of the titanium implant he placed in William Thornton's spine on Monday.

    By ROBERT FARLEY

    © St. Petersburg Times, published May 22, 2001


    TARPON SPRINGS -- Many golfers these days have turned to titanium for an edge. William Thornton is no different.

    For most, that titanium is in the shaft of their driver. But for Thornton, the titanium advantage comes from a small, cylindrical device that a surgeon screwed into his neck Monday morning. Thornton of Tarpon Springs had been suffering from chronic shoulder and neck pain for months and like many, opted for cervical spine fusion surgery.

    The Food and Drug Administration approved the "titanium cage" implant less than a month ago. On Monday, Dr. Andrew Maser, an orthopedic surgeon at Helen Ellis Memorial Hospital, became the first doctor in the Tampa Bay area to use it.

    The cervical fusion procedure using the titanium cage employs the same principles doctors have been using for more than 40 years, Maser said. But the new device has several advantages over the old method, he said.

    Typically, surgeons had two options. The first was to harvest bone from the patient's hip, a separate surgical procedure in which a patient runs the risk of infection or future hip pain. The second option was to use bone from a cadaver, which risks that a patient's body could reject the new bone.

    Using the titanium device takes less time, Maser said. Thornton's surgery took about 45 minutes. Because it was his first time, Dr. Maser said it may have taken a bit longer. In the future, he expects it will take 30 to 35 minutes. The old procedure took about an hour.

    The titanium cage device, called the BAK/C system, is the first and so far the only cervical fusion system available for use in the United States. It was developed by Minneapolis-based Sulzer Spine-Tech. Company spokeswoman Barb Peterson said it was tested for seven years on 600 patients by neurosurgeons and orthopedic surgeons throughout the United States.

    "I think it's a slick device," Maser said. "It shortens the time of surgery and it eliminates the need and concern factors with taking your own bone or bone from a cadaver."

    About 118,000 people had some form of cervical spine fusion surgery in 1999, and the number is expected to increase greatly as baby boomers age, according to a Merrill Lynch market study.

    Chronic neck pain typically is associated with aging, but it also affects athletes whose sport puts excessive stress on the neck and upper body, and it affects people who suffer traumatic injuries like those in a car accident.

    Thornton, 48, who works in his home as a computer software designer, isn't sure what caused his neck and shoulder pain. He only knows that it began in November and has been fairly constant ever since. He tried physical therapy and medication, "but that only helped a little," he said.

    Even driving a car was painful when he had to turn to look left.

    "Most importantly, I couldn't take a full golf swing," he said.

    An MRI revealed a herniated disc.

    After talking to Maser about the titanium cage procedure, Thornton did some research on the Internet and decided to go for it.

    Maser, 39, of Palm Harbor learned about the device at a North American Spinal Society meeting three years ago, and he recently attended a course to become certified to do the procedure.

    The surgery requires the doctor to make a small incision in the front of the neck, pull the muscle aside and insert the device. As it is being threaded into place, the porous titanium cylinder acts almost like a cheese grater, Peterson said, filling itself with small pieces of bone. It is inserted between two vertebrae and acts like a wedge to push them apart, thereby relieving pain.

    "Everything went perfect," Maser said of Thornton's surgery.

    By late morning, Thornton was sitting up, alert and able to talk with ease about the procedure.

    "To tell the truth, as soon as I woke up I noticed the pain in my shoulder had gone," Thornton said.

    He is expected to leave the hospital today. He had a bit of a sore throat, which Maser said should last a few days. And he'll have to wear a neck collar for four to six weeks. While it should take nine months to a year for the bone to heal fully, Maser said, Thornton should be able to return to his normal routine much sooner.

    Put it this way, Maser said: Thornton should be on the putting green in four to six weeks and then on the regular course two weeks after that.

    - Staff writer Robert Farley can be reached at (727) 445-4185.

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