When a young Olympic gold-winning gymnast turned to medicine to specialise in orthopaedics, she never foresaw that one day, she would help develop the world’s first total disc replacement, and forever change the standard of spine surgery. Karin Buettner-Janz, outgoing president of Spine Arthroplasty Society (SAS), told Spinal News International about her journey.
From gymnastics to medicine, why did you change careers?
At a very young age ( I was about eight years old) I started to think about my profession. About two years later I thought I should become a physician. As a gymnast, I was injured, not severely, but that made me think that I should know a bit about orthopaedics. So I decided to study medicine and later to specialise in the orthopaedic field. At the beginning, I did not realise how wide-ranging medicine is and how varied and responsible daily work in a hospital is. Later, it was important for me to work on a new idea and to develop a new implant for treatment of patients with severe pain, that was able to stabilise the spinal segment and preserve mobility at same time.
What have been some of the most memorable moments in your professional life?
Probably the most memorable moment was when Rick Guyer spoke about my work on motion retaining devices, especially my input on the development of the Charité Artificial Disc, the world’s first total disc replacement. It was at the North American Spine Society meeting 2004 in Chicago in front of a big audience, after the approval of the Charité disc by the Food and Drug Administration. He said that the disc, and my work for it, opened up many new options for patients and for spine care professionals, and that it would be the basis for many new companies to be founded and that the standard of spine surgery was changed. It was a big celebration, and I was very happy for the others who profited from that development.
Could you describe how the Charité Artificial Disc was developed?
It all began in 1982, in Berlin, Germany, at the Charité hospital, when Kurt Schellnack and I had first ideas of how an artificial disc could look. Very quickly, we concluded from research that we should take known material from total hips and knees and create a special design to replace a lumbar disc. Model III was finally developed with a company located in Hamburg, Germany. The first implantation happened in 1987. 17 years later, the same disc, with further sizes and other improvements was approved by the FDA. With that disc, a new, worldwide strategy for treatment of degenerative disc disease was born.
What role do you think spine societies play in the field?
The role of spine societies is getting bigger. Societies have been responsible for education on high scientific and ethical standard. It was probably last year that spine societies became involved in reimbursement issues, for example. I believe the role of spine societies will further increase, depending, of course, on financial ability and the society’s structure. Spine societies could independently lead competitive evaluations between different spinal devices and other treatments to support healthcare decisions, especially in new and expansive treatments with high risk for patients.
What have you achieved as the outgoing president of the SAS?
I hope that in the eyes of SAS members and others, the last year has been a successful year for the Spine Arthroplasty Society. I’d like to place on record the work done by some former and current directors ofthe SAS board, like Hansen Yuan, Stephen Hochschuler, Thomas Errico, and Steven Garfin, and the administrative staff.
In my Annual Global Symposium address, I tried to define the Spine Arthroplasty Society: who does SAS belong to, for what does the SAS stand, who is invited to work with and for SAS. The basic structure of SAS was clarified.
Last year I founded two regional SAS chapters, the Middle East Chapter and the India Chapter, with the support of Kristy Radcliffe, the Executive Director of SAS. Together with Charlie Ray, the first SAS president, and others the SAS bylaws were finalised. At the SAS8 congress, I proposed that we create an SAS fellowship programme for young spine surgeons and scientists, and we are still working on that programme.
What are the most exciting technologies that have revolutionised treatment of the spine in your career?
To my mind, the most exciting spine technologies are implants and materials for motion and, at the same time stabilisation of the spinal functional unit. But, there are many other important developments on the way to improve spine care results, for example, minimally invasive surgical procedures and biologics. I am also keen to see what role genetics will play for the spine in the future.
Please share some of your experiences of working in your current role as Director of the Vivantes Orthopaedic Clinic and Director of the Vivantes Traumatologic and Orthopaedic Clinic
My daily life is not easy! I often work 12-16 hours a day, doing surgery, having meetings and dealing with lots of administrative work. But I also enjoy that work, and find time for studies and other important topics, together with my team of 25 surgeons in both clinics. Since taking on these roles, I have learnt how valuable every hour is!
What are the major challenges facing treatment of the spine today?
There are many devices on market, for fusion, motion retaining, and other targets. It is time to look for classifications and structured treatments, always with the aim of doing the most successful surgeries with the smallest risk for patients.
What is the focus of your current research?
I am working on more physiological and truly total disc replacements. I would like to continue to treat patients at the beginning of painful disc degeneration by CT-guided injections of special material to remove or to reduce pain-causing microinstability. Facet replacement, especially in cases of facet arthritis after disc replacement is also a big challenge.
Outside of medicine, what other interests do you have?
I enjoy skiing! This year, I have also restarted sports-centred activities like modern and Latin dance and upper and lower body gymnastics. Up until the end of last year, I thought I have done enough sport in my early career for the rest of my life! But now I enjoy exercising again, and it makes me happy and hopeful at same time.
Hartmannsdorf, Luebben, Germany
1982 Medical Doctorate
1987 Fellowship in USA (ESKA/AOSSM)
1989 PhD thesis: “The functional intervertebral disc prosthetics SB Charité – development of the implant, biomechanics, patient analysis, perspectives.”
1990-2004 Director of the Orthopaedic Clinic of the Hellersdorf Hospital, Berlin
Since 2004 Director of the Vivantes Orthopaedic Clinic im Friedrichshain, Berlin
Since 2005 Professor of Orthopaedics at the Charité Hospital, Medical Faculty of the Humboldt University and of the Free University, Berlin
2008-present Director of the Vivantes Orthopaedic Clinic im Friedrichshain and Director of the Vivantes Traumatologic and Orthopaedic Clinic Am Urban, Berlin
- Member of the Board of Directors of the Spine Arthroplasty Society
- Spine Arthroplasty Society President 2008/2009
- Honorary member of the American Orthopaedic Society of Sports Medicine
Approximately 250 publications, oral presentations, posters, patents (as
author or co-author)
1986 National Award for science and technology of the former “German Democratic Republic” for the development of the Charité Artificial Disc
1987 Award of the International Olympic Committee (IOC) for outstanding sporting and academic achievement
2003 Induction into the “International Gymnastics Hall of Fame”