Richard D. Guyer, MD's portrait
Richard D. Guyer, MD
Chairman, TBIRF
Texas Back Institute
Plano, TX
Dr. Guyer is a member of the SpineUniverse Editorial Board.

About Richard D. Guyer, MD

Dr. Richard D. Guyer is a Co-Founder and Fellowship Director at the Texas Back Institute and is an Associate Clinical Professor of Orthopaedics at the University of Texas Southwestern. He holds the medical appointment of Vice-Chairman in the Department of Orthopaedics at Presbyterian Hospital of Plano, TX. Additionally, Dr. Guyer is on staff at Lutheran Medical Systems, Trinity Medical Center, and Medical City Hospital of Dallas.

Dr. Guyer earned a medical degree from the University of Pennsylvania School of Medicine. His internship was at Parkland Memorial Hospital, followed by a residency program in orthopaedic surgery at the Hospital of the University of Pennsylvania. Dr. Guyer participated in two spine fellowships, one at Case Western Reserve University and the second in Long Beach, CA.

Serving on numerous committees, Dr. Guyer is an active member of professional societies including: American Academy of Orthopaedic Surgeons, North American Spine Society, International Intradiscal Therapy Society, International Society for the Study of Lumbar Spine, International Society for Minimal Intervention in Spinal Surgery, Institute for Spine & Biomedical Research. Dr. Guyer has published 55 peer-reviewed journal articles with current articles in press. He has presented 57 invited lectures and over 100 posters. He is the Associate Editor of Spine.



1. Guyer RD, Booth RE, Rothman RH: "Pulmonary Embolism Prophylaxis in Total Hip Patients: A study comparing low dose Coumadin and aspirin." J Bone Joint Surg 64- A: 1040-1044, 1982.

2. Guyer RD: "Total Joint Replacement: An Update". American Family Physician. XX: 196-201, 1982.

3. Heard CS, Guyer RD, Smith TK: "Intramedullary Rodding of the Femur: An Update". Med J St. Joseph's Hospital 17(l):29-37,1982.

4. Wiltse LL, Spencer CW, Guyer RD, Glenn WV, Porter IS: "Alar-Transverse Process Impingement of the L5 Spinal Nerve: The Far-Out Syndrome". Spine 9:31-41, 1984.

5. Barber FA, Guyer RD, Burton WC: "The Heparin-Induced Thrombocytopenia and Thrombosis Syndrome". J Bone Joint Surg 69-A: 1987.

6. Sachs BL, Vanharanta H, Spivey MA, Guyer RD, Videman T, Rashbaum RF, Johnson RG, Hochschuter SH, Mooney V: "Dallas Discogram Description: A New Classification of CT/Discography in Low-Back Disorders". Spine 12:287-294,1987.

7. Vanharanta H, Sachs BL, Spivey MA, Guyer RD, Hochschuler SH, Rashbaum RF, Johnson RG, Ohnmeiss DD, Mooney V: "The Relationship of Pain Provocation to Lumbar Disc Deterioration as Seen by CT/Discography". Spine 12:295-298, 1987.

8. Vanharanta H, Sachs BL, Spivey MA, Hochschuler SH, Guyer RD, Rashbaum R-F, Ohnmeiss DD, Mooney V: " A Comparison of CT/Discography, Pain Provocation and Radiographic Disc Height". Spine 13:321-324,1988.

9. Loguidice VA, Guyer RD, Stith WJ, Ohnmeiss DD, Hochschuler SH, Rashbaum RF: "Anterior Lumbar Interbody Fusion". Spine 13:366-369, 1988.

10. Hochschuler SH, Guyer RD, Stith WJ, Ohmneiss DD, Rashbaum RF, Johnson, RG: "Proplast Reconstruction of Iliac Crest Defects". Spine 13:378-379, 1988.

11. Guyer RD, Collier RR, Ohnmeiss DD, Stith WJ, Hochschuler SH, Rashbaum RF, Vanharanta H, Loguidice VA: "Extraosseous Spinal Lesions Mimicking Disc Disease". Spine 13:328-331,1988.

12. Guyer RD, Collier R, Stith WJ, Ohmneiss DD, Hochschuler SH, Rashbaum RF, Regan JJ: "Discitis After Discography". Spine 13:1352-1354,1988.

13. Vanharanta H, Guyer RD, Ohnmeiss DD, Stith WJ, Sachs BL, Aprill C, Spivey M, Rashbaum RF, Hochschuler SH, Videman T, Selby DK, Terry A, Mooney V: Disc Deterioration in Low-Back Syndromes: A Prospective, Multi-Center CT/Discography Study". Spine 13:1349-1351, 1988.

14. Guyer RD, Flemming J: "Laminectomy-Indications, Techniques and Complications". Spine State of the Art Review: Lumbar Disc Disease. Hanley & Belfus; Philadelphia, January 1989. Pages 91-102.

15. Flemming J, Guyer RD: "Diagnostic Dilemmas". SPE@;E - State of the Art Review: Lumbar Disc Disease. Hanley & Belfus; Philadelphia, January 1989. Pages 153-172

16. Guyer RD (Editor): SPINE - State of the Art Review: Lumbar Disc Disease. Hanley & Belfus, Inc., Philadelphia; January, 1989.

17. Vanharanta H, Sachs BL, Ohnmeiss DD, Spivey M, Guyer RD, Rashbaum RF, Hochschuler SH, Stith WJ, Mooney V: "Pain Provocation and Disc Deterioration by Age: A CT/Discography Study in Low Back Pain Population." Spine 14:420-423, 1989.

18. Sachs BL, Spivey MA, Vanharanta H, Guyer RD, Rashbaum RF, Hochschuler SH, Smith GV, Scala AD: "Techniques for Lumbar Discography and CT/Discography in Clinical Practice". J Applied Radiology, Nov. 1989.

19. Guyer RD: "Lumbar CT/Discography." In P Kambin (ed) Percutaneous Approach to the Lumbar Spine. Urban & Schwarzenberg Medical Publishers, Inc. 1990.

20. Guyer RD, Ohnmeiss DD, Triano JJ, et al: "Nonsurgical management of Sports-Related Spine Injuries." In SH Hochschuler (ed) SPINE- State of the Art Review: Spinal Injuries in Sports. Hanley & Belfus, Inc., Philadelphia; May 1990.

21. Guyer RD, Ohnmeiss DD, Triano JJ, et al: "Nonsurgical management of Sports-Related Spine Injuries." In SH Hochschuler (ed) The Spine and Sports. Hanley & Belfus, Inc., Philadelphia; August 1990.

22. Guyer RD: "The CT/Discography Identifies Recurrent Disk Herniation Not Seen With MRI. Radiology Today 7(11):34-35,1990.

23. Guyer RD: "The CT/Discography Identifies Recurrent Disk Herniation Not Seen With MRI. Orthopaedics Today 10(l1):21, 1990.

24. Sachs BL, Spivey MA, Vanharanta H, Guyer RD, Rashbaum RF, Hochschuler SH, Scala AD: "Techniques for lumbar discography and computed tomography-discography in clinical practice." Orthop Rev 19(9):775-778,1990.

25. Stith WJ, Judy MM, Hochschuler SH, Guyer RD: "Choice of Lasers for Minimally Invasive Spinal Surgery." Orthopaedic Review 22(2):137-142, 1991.

26. Sasso RC, Cotter HB, Guyer RD: "Diagnostic Imaging Studies for Low Back Pain." The Journal of Musculoskeletal Medicine. 8(5):21-37, 1991.

27. Guyer RD, Ohmneiss DD: "Lumbar Discography and CT/Discography". The University of Pennsylvania Orthopaedic Journal. 7:61-63, 1991.

28. Shea DD, Ohnmeiss DD, Stith WJ, Guyer RD, Hochschuler SH, Rashbaum RF: "The Effect of Sensory Deprivation on the Reduction of Pain in Chronic Low Back Patients." Spine 16(5):560-561,1991.

29. Guyer RD: Selective Discography, CT/Discography, and Pain Provocation Testing. Seminars in Orthopaedics. 6(2):90-91, 1991.

30. Matwijecky C, Guyer RD: "Cervical Discectomy and Fusion." In JJ Regan (ed) SPRTE- State of the Art Review: Cervical Spine Disease. Hanley & Belfus, Inc., Philadelphia. 5(2):259-271, 1991.

31. Guyer RD, Hochschuler SH, Spivey MA, Ohnmeiss DD, Castleman C: "Case Report: The Use of Dynamic MRI to Identify Cervical Spine Disc Herniation and Cord Compression." Spine 17(5):596-597, 1992.

32. Guyer RD: "Laboratory Testing." In SH Hochschuter, RD Guyer, HB Cotler (eds) Rehabilitation of the Spine: Science and Practice. Mosby Year Book, Chicago, 1993.

33. Hochschuler SH, Guyer RD: "Arthroscopic Microdiscectomy." In SH Hochschuler, RD Guyer, HB Cotler (eds) Rehabilitation of the Spine: Science and Practice. Mosby Year Book, Chicago, 1993.

34. Vanharanta H, Floyd T, Ohnmeiss DD, Guyer RD, Hochschuler SH: "The Relationship Between Facet Tropism and Degenerative Disc Disease". Spine 18(8):1000-1005, 1993.

35. Guyer RD, Ohnmeiss DD: "The Role of Discography and Interdiscal Therapy." Current Opinion in Orthopaedics. 5(11):49-53, 1994.

36. Guyer RD, Hochschuler SH: "Minimally Invasive Surgical Techniques for the Treatment of the Herniated Lumbar Disc". Seminars Spine Surg 6(4):256-261, 1994.

37. Ohnmeiss DD, Guyer RD, Hochschuler SH: "Laser Disc Decompression: The Importance of Proper Patient Selection." Spine 19(18):2054-2059, 1994.

38. Moneta GB, Videman T, Kaivanto K, Aprill C, Spivey M, Vanharanta H, Sachs B, Guyer RD, Hochschuler S, Rashbaum R: "Reported pain during lumbar discography as a function of anular disruption and disc degeneration." Spine 19:1968-1974, 1994.

39. Weinhoffer SL, Guyer RD, Herbert M, Griffith SL: "In-Vitro Intradiscal Pressure Measurements Above a Simulated Instrumented Fusion." Spine 20(5):526-531, 1995.

40. Ohnmeiss DD, Vanharanta H, Guyer RD: "The Association Between Pain Drawings and CT/Discographic Pain Responses." Spine 20(6):729-733, 1995.

41. Bogdanffy GM, Ohmneiss.DD, Guyer RD: "Early Changes in Bone Mineral Density above a Combined Anterior-Posterior L4-SI Lumbar Spinal Fusion: A Clinical Investigation." Spine 20(15)-1674-1678,1995.

42. Guyer RD, Ohnmeiss DD: "Contemporary concepts in spine care: Lumbar discography. Position Statement from the North American Spine Society Diagnostic and Therapeutic Committee." Spine 20(18):2048-2059,1995.

43. Griffith SL, Weinhoffer SL, Shelokov AP, Guyer RD, Contiliano J, Geiger J: "Biomechanical Comparison of Anterior Instrumentation for the Cervical Spine". J Spinal Disord 8(6):429-438, 1995.

44. Block AR, Vanharanta H, Ohnmeiss DD, Guyer RD: "Discographic Pain Reports: Influence of Psychological Factors." Spine 21(3):334-338, 1996.

45. Gronblad M, Virri J, Ronkko S, Kiviranta 1, Vanharanta H, Seitsalo S, Rashbaum R, Guyer R: 1996 Volvo Award "A Controlled Biochemical and humunohistochemical Study of Human Synovial Type (Group II) Phosholipase A2 and Inflammatory Cells in Macroscopically Normal, Degenerated and Herniated Human Lumbar Disc Tissue." Spine 21(22):2531-2538, 1996.

46. Regan JJ, McAfee PC, Guyer RD, Aronoff RJ: "Laparoscopic fusion of the lumbar spine in a multicenter series of the first 34 consecutive patients." Surg Laparosc Endosc 6(6):459-68, 1996.

47. Guyer RD, Ohnmeiss DD: "Invasive Radiology and Pain Location." In: SPINE: State of the Art Review: Adult L5-St Surge . Edited by J Margulies. Hanley & Belfus, Philadelphia. Jan. 1997, pp 59-68.

48. Guyer RD, Ohmneiss DD, Mason SL, Shelokov AP: "Complications of Cervical Discography: Findings in a Large Series." J Spinal Disord 10(2):95-101, 1997.

49. Jarolem K, Tucker WA, Fulp T, Guyer RD: "Rigid Intrasegrnentat Fixation for Repair of a Syrnptomatic Pars Defect in a Young Athlete: A Case Report and Description of Technique". J Spin Disord 10(3):253-255, 1997.

50. Regan JJ, Guyer RD: "Endoscopic Techniques in Spinal Surgery." Clin Orthop (335):122-39, 1997. Guyer RD, Delamarter RB, Fulp T, Small SD: "Complications of Cervical Spine Surgery." In The Spin . Edited by H Herkowitz et at. WB Saunders Company; Philadelphia, Pennsylvania 1999; pp 540-557.

51. Guyer RD, Ohnmeiss DD: "Pain Evaluation, Invasive Radiology, and Patient Selection in Previously Operated Patients." In: Revision in Spine SurgML Edited by J Margulies. St. Louis, Missouri 1999; pp 201-210.

52. Guyer R, Fulp T- "Minilaparotomy: Perirectus Retroperitoneal Approach for Anterior Lumbar Interbody Fusion." In Anterior Approaches in Spine Surge . Edited by TA Zdeblick. Quality Medical Publishing, Inc., St. Louis, Missouri 1999; pp 205-207.

53. Goodwin CB, Brighton CT, Guyer RD, Johnson JR, Light KI, Yuan HA: "A Double- Blind Study of Capacitively Coupled Electrical Stimulation as an Adjunct to Lumbar Spinal Fusion." Spine 24(13):1349-1357,1999.

54. Ohnmeiss DD, Guyer RD, Mason SL: "Relationship of Cervical Discographic Pain Responses to Radiographic Images." Clin J Pain 16(l):1-5, 2000.

55. Ohnmeiss DD, Guyer RD: "Provocative Discography for Diapostic Purposes in Patients With Discogenic Pain - Its Therapeutic Implications." Current Anesthesiology Reports: Pain Management, in press.

Articles Written by Richard D. Guyer, MD

Boutique Spine Care for Patients with Back Problems

Here, Dr. Richard Guyer, a spine surgeon talks about his boutique spine practice.

Low and Lower Back Pain Center

Low and lower back pain can vary from dull pain that develops gradually to sudden, sharp or persistent pain felt below the waist.

Low Costs, High Quality: Are Ambulatory Surgery Centers (ASCs) the Spine Care Solution?

Patients seeking spine care at ambulatory surgery centers (ASCs) should expect lower costs but not lower quality compared to an inpatient hospital setting.

Cervical Disc Replacement Considerations and Surgery

Margaret's neck and arm pain was relieved after cervical disc replacement surgery performed as a minimally invasive spine surgery procedure. Q&A with orthopaedic spine surgeon, Richard Guyer, MD.

Sciatica Relief: Epidural Steroid Injection or Oral Steroids?

Sciatica treatment may include a steroid medication to reduce inflammation that causes low back and leg pain. An oral (by mouth) steroid pill (prednisone) may be prescribed or medication may be administer by spinal injection called an epidural or transforaminal steroid injection.

Sciatica in Winter: Does Cold Weather Make Back and Leg Symptoms Worse?

Do cold temperatures worsen sciatica? Most people with sciatica pain say that winter makes sciatic symptoms worse. But is that just anecdotal or are there solid reasons why your sciatica acts up when the mercury goes down?

Spine Specialists On-Call: Charité Artificial Disc

"Disc replacement is the most significant advancement since the modern treatment of spinal disorders began 70 years ago" as stated by Richard Guyer, MD.

Recovery From Cervical Artificial Disc Replacement

Dr. Richard Guyer, a spine surgeon at the Texas Back Institute shares his thoughts about patient recovery after cervical artificial disc replacement Surgery. .

Cervical Artificial Disc Replacement Technology: An Overview

Richard D. Guyer, MD, Chairman of the Texas Back Institute Research Foundation spoke with SpineUniverse about cervical artificial discs.Learn More.

Cervical Artificial Disc Preserves Neck Mobility: Part 2

The early results of the PRODISC-C artificial disc are promising. Patients return to activity sooner with pain relief and neck mobility.

Cervical Artificial Disc Preserves Neck Mobility

A cervical artificial disc may be implanted to relieve pressure on spinal nerves. Spine specialists refer to this condition as nerve root compression.

Cervical Artificial Disc Replacement vs. Spinal Fusion

Dr. Guyer discusses the differences between cervical (neck) artificial disc replacement and spinal fusion.

Cervical Artificial Disc Replacement: What You Need To Know

A good surgical candidate would have neck and arm pain. Artificial disc replacement in the kyphotic spine exacerbates existing instability and doesn’t help the situation at all. Learn More.

Artificial Discs: Real Reconstructive Surgery for the Low Back

Artificial disc replacement surgery offers the very latest technology in spine surgery.

Recent blog posts from Richard D. Guyer, MD

December 29, 2010

Degenerative Disc Disease Treatments

"I have degenerative disc disease at C5-C7. I'm going to have a cervical epidural steroid injection to see if that helps relieve my pain, but my doctor told me that it would be beneficial to have the surgery to fuse the damaged discs and vertebrae."

March 23, 2010

Artificial Disc Replacement

"I want to learn more about artificial disc replacement surgery. It seems like this is a fairly new technique, but are there any updates I should know about?"

More from Dr. Guyer's blog "How to Deal with Disc Pain"

Articles Reviewed by Richard D. Guyer, MD

Care for Your Low Back According to Traditional Chinese Medicine (TCM)

There are many different therapies within the specialty of Traditional Chinese Medicine (TCM) for the treatment of low back pain.

Traditional Chinese Medicine (TCM) and Back Pain

Acupuncture specialist discusses Traditional Chinese Medicine (TCM) and provides an alternative angle of understanding low back pain through the model of TCM.

Sciatica: Symptoms and Possible Causes

Sciatica is a symptom of a lumbar spinal disorder in the low back causing compression of the sciatic nerve. Leg pain is the most common symptom that may be accompanied by leg numbness and tingling sensations.

Reasons for Selecting ACDF Over Total Disc Replacement in Cervical Spine Surgery

Study outcomes revealed reasons for choosing anterior cervical discectomy and fusion (ACDF) over cervical total disc replacement in a consecutive series of patients undergoing cervical spine surgery.

Cervical Total Disc Replacement and Routine Osteoporosis Screening

While osteoporosis is a contraindication for total disc replacement both in the lumbar and cervical spine, new findings suggest that routine DEXA scans may not be necessary for all cervical total disc replacement candidates.

Cervical Spine Surgery: An Overview

Cervical spine surgery is performed by removing a disc or a bone and fusing the vertebrae together with a bone graft either in front of or behind the spine.

ISASS Recommends Lumbar Decompression with Interlaminar Stabilization in Select Patients with Lumbar Spinal Stenosis

The International Society for the Advancement of Spine Surgery (ISASS) released a Policy Statement covering interlaminar stabilization in the treatment of lumbar spinal stenosis.

Artificial Disc Surgery in the Cervical Spine

Cervical disc replacement is a new technique that is becoming more available worldwide. In Part 1 of his article, Dr. Lali Sekhon discusses cervical discs and fusion.

Cervical Spine Surgery: Home Care and Neck Health Maintenance

How to maintain your neck health for a lifetime. Tips for neck health.

Mattresses Matter: Ergonomic Guidelines

This article includes clinical data about the impact of a mattress in reducing or preventing back and neck pain.

Cervical Artificial Disc Surgery

The experience for the patient undergoing implantation of the Bryan artificial cervical disc is remarkably similar to that for a patient undergoing an anterior cervical decompression and fusion.

Sciatica: Treatment and Recovery

Sciatica is a painful symptom indicating compression of the sciatic nerve. Learn how this condition can be treated without spine surgery.

Cervical Spine Surgery: Recovery

What to expect immediately after surgery. Personal hygiene, sutures, IV therapy, diet and breathing are some of the topics covered in this article.

Artificial Disc Surgery: Cervical Spine

If you need cervical spine surgery, you may be able to have an artificial disc put in. A neurosurgeon explains how artificial disc surgery differs from traditional fusion, and he reviews one artificial cervical disc.

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Author's Statement

I, or an immediate family member, have a financial interest(s) or affiliation(s) with the following commercial companies whose products and / or services may be mentioned in the materials I have authored, edited or reviewed for presentation on Remedy Health Media, LLC’s websites.

Disclosed Relationships

Consultant/Independent Contractor
Stock Options/Shareholder
Stock Ownership: Spinal Motion
Private Investment
Spinal Ventures I and II
Scientific/Other Advisory Board
K2M; Spinal Kinetics; Nanovis; Crocker Technologies; MiMedx
Other Relationships/Disclosures
Royalties: Alphatec; Fellowship Support: NuVasive