Surgeons
33 years of experience

Accepting new patients
Oregon Neurosurgery Specialists
3355 Riverbend Dr
Suite 400
Springfield, OR 97477
541-686-8353
Locations and availability (4)

Education ?

Medical School Score Rankings
University of Nebraska (1977)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Awards  
Patients' Choice Award (2008 - 2011)
Associations
Cervical Spine Research Society
American Association of Neurological Surgeons
Depuymitek.com (back and Neck Pain)- (allaboutbackandneckpain.com)
American Board of Neurological Surgery

Affiliations ?

Dr. Hacker is affiliated with 11 hospitals.

Hospital Affilations

Score

Rankings

  • Sacred Heart Medical Center
    1255 Hilyard St, Eugene, OR 97401
    • Currently 4 of 4 crosses
    Top 25%
  • Cottage Grove Hospital
    1515 Village Dr, Cottage Grove, OR 97424
    • Currently 4 of 4 crosses
    Top 25%
  • Peace Harbor Hospital
    400 9th St, Florence, OR 97439
    • Currently 3 of 4 crosses
    Top 50%
  • McKenzie - Willamette Medical Center
    1460 G St, Springfield, OR 97477
    • Currently 2 of 4 crosses
  • McKenzie - Willamette Medical Center
    1460 G St, Springfield, OR 97477
    • Currently 2 of 4 crosses
  • Sacred Heart Medical Center At Riverbend
    3333 Riverbend Dr, Springfield, OR 97477
  • St John's Medical Center
  • St. Joseph's Hospital
  • Sacred Heart Medical Center - Riverbend 10/22/1991 Active Current Neurosurgery
  • Sacred Heart Medical Center - University Dist 8/10/2008 Educational Current Phys Med & Rehab
  • Sacred Heart-University Distr
  • Publications & Research

    Dr. Hacker has contributed to 14 publications.
    Title Comparison of Bryan Cervical Disc Arthroplasty with Anterior Cervical Decompression and Fusion: Clinical and Radiographic Results of a Randomized, Controlled, Clinical Trial.
    Date April 2009
    Journal Spine
    Excerpt

    A prospective, randomized, multicenter study of surgical treatment of cervical disc disease.

    Title Artificial Disc Versus Fusion: a Prospective, Randomized Study with 2-year Follow-up on 99 Patients.
    Date March 2008
    Journal Spine
    Excerpt

    STUDY DESIGN: A total of 115 patients were randomized in a 1:1 ratio to a Bryan artificial disc replacement (56) or an anterior cervical fusion with allograft and a plate (59). OBJECTIVE: The purpose of this study is to examine the functional outcome and radiographic results of this prospective, randomized trial to determine the role of the Bryan artificial cervical disc replacement for patients with 1-level cervical disc disease. SUMMARY OF BACKGROUND DATA: Artificial cervical disc replacement has become an option for cervical radiculopathy. Previous studies have evaluated the efficacy of this alternative without the scientific rigor of a concurrent control population. This study is a pooled data set from 3 centers involved in the U.S. FDA Investigational Device Exemption trial evaluating the Bryan artificial cervical disc. METHODS: The purpose of this study is to examine the functional outcome and radiographic results of this prospective, randomized trial to determine the role of the Bryan artificial cervical disc replacement for patients with 1-level cervical disc disease; 12-month follow-up is available for 110 patients and 24 month follow-up complete for 99 patients. There are 30 males and 26 females in the Bryan group and 32 males and 27 females in the fusion group. The average age was 43 years (Bryan) and 46 years (fusion). Disability and pain were assessed using the Neck Disability Index (NDI) and the Visual Analog Scale (VAS) of the neck and of the arm pain. SF-36 outcome measures were obtained including the physical component as well as the mental component scores. Range of motion was determined by independent radiologic assessment of flexion-extension radiographs. We report a prospective, randomized study comparing the functional outcome of cervical disc replacement to an anterior cervical fusion with results of 99 patients at 2 years. Prospective data were collected before surgery and at 6 weeks, 3, 6, 12, and 24 months after surgery. RESULTS: The average operative time for the control group was 1.1 hours and the Bryan Group 1.7 hours.Average blood loss was 49 mL (control) and 64 mL (Bryan). Average hospital stay was 0.6 days (control) and 0.9 days (Bryan). The mean NDI before surgery was not statistically different between groups: 47 (Bryan) and 49 (control). Twelve-month follow-up NDI is 10 (Bryan) and 18 (control) (P = 0.013). At 2-year follow-up, NDI for the Bryan group is 11 and the control group is 20 (P = 0.005). The mean arm pain VAS before surgery was 70 (Bryan) and 71 (control). At 1-year follow-up, Bryan arm pain VAS was 12 and control 23 (P = 0.031). At 2-year follow-up, the average arm pain VAS for the Bryan group was 14 and control 28 (P = 0.014). The mean neck pain VAS before surgery was 72 (Bryan) and 73 (control). One-year follow-up scores were 17 (Bryan) and 28 (control) (P = 0.05). At 2 years: 16 (Bryan) and 32 (control) (P = 0.005). SF-36 scores: Physical component--Before surgery Bryan 34 and control 32. At 24 months: Bryan 51 and control 46 (P = 0.009). More motion was retained after surgery in the disc replacement group than the plated group at the index level (P < 0.006 at 3, 6, 12, and 24 months). The disc replacement group retained an average of 7.9 degrees of flexion-extension at 24 months. In contrast, the average range of motion in the fusion group was 0.6 degrees at 24 months. There were 6 additional operations in this series: 4 in the control group and 2 in the investigational group. There were no intraoperative complications, no vascular or neurologic complications, no spontaneous fusions, and no device failures or explantations in the Bryan cohort. CONCLUSION: The Bryan artificial disc replacement compares favorably to anterior cervical discectomy and fusion for the treatment of patients with 1-level cervical disc disease. At the 2-year follow-up, there are statistically significant differences between the groups with improvements in the NDI, the neck pain and arm pain VAS scores, and the SF-36 physical component score in the Bryan disc population.

    Title Clinical Outcomes of Bryan Cervical Disc Arthroplasty: a Prospective, Randomized, Controlled, Multicenter Trial with 24-month Follow-up.
    Date January 2008
    Journal Journal of Spinal Disorders & Techniques
    Excerpt

    STUDY DESIGN/SETTING: Prospective, randomized, 3-center, clinical trial. OBJECTIVE: To prospectively compare the outcomes of cervical arthroplasty with the BRYAN Cervical Disc Prosthesis (Medtronic Sofamor Danek, Inc, Memphis, TN) to anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: Surgical treatment of cervical disc pathology commonly involves techniques that employ discectomy and fusion (ACDF). This "gold-standard" technique has demonstrated good clinical and radiographic outcomes. Common adverse effects of this procedure are associated with the adjacent level degeneration and bone-graft harvest. Several investigators have independently reported successful short-term outcomes with the BRYAN Cervical Disc Prosthesis. In addition, a significant body of knowledge has been collected regarding the wear patterns and adjacent level effects of this device in human and animal models. METHODS: As part of an FDA IDE trial, 3 centers collected prospective outcomes data on 115 patients randomized in a 1:1 ratio to ACDF (Control group) or arthroplasty with the BRYAN Cervical Disc Prosthesis (Investigational group). RESULTS: Demographic and surgical data were generally similar in the 2 populations. Outcomes data collected at routine postoperative intervals for 24 months demonstrated that the Investigational group had statistically significant (P<0.05) improvements as assessed by the Neck Disability Index, the Neck Pain Score, and SF-36 Physical component scores. The improvement in the Mental Component Subscore values for the BRYAN and control groups was equivalent at 24 months (P=0.055). Arm pain relief was similar in both groups (P=0.152). During the course of the 2-year follow-up, 4 patients in the Control group required surgical intervention and 3 patients in the Investigational group required ACDF for adjacent level disease. CONCLUSIONS: At 24 months, cervical arthroplasty with the BRYAN Cervical Disc Prosthesis compares favorably with ACDF as defined by standard outcomes scores.

    Title Cervical Disc Arthroplasty: a Controlled Randomized Prospective Study with Intermediate Follow-up Results. Invited Submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2005.
    Date January 2006
    Journal Journal of Neurosurgery. Spine
    Excerpt

    OBJECT: The authors of studies of anterior cervical fusion for disc-related disease have documented satisfying clinical results and infrequent complications. Recently, cervical disc arthroplasty has entered clinical trials as an alternative to fusion. Although the results of anecdotal reports and prospective studies support this procedure, these studies have not conferred the validity of a controlled randomized study. In the present study, the author presents data obtained in such a study. METHODS: After symptoms failed to respond to conservative therapy, 46 patients with one-level discogenic cervical radiculopathy and/or myelopathy were randomized to undergo arthroplasty or fusion as part of a US Food and Drug Administration medical device study. In all patients there was a minimum follow-up duration of 1 year. Equivalent results for the relief of arm pain and neck pain were noted in both treatment groups. Treatment parameters other than operative time were similar. No neurological or serious systemic complications occurred. CONCLUSIONS: Although extended follow-up data and larger patient populations are needed, the results of this study indicate that arthroplasty is a viable alternative to cervical fusion.

    Title Failed Anterior Cervical Foraminotomy.
    Date April 2003
    Journal Journal of Neurosurgery
    Excerpt

    OBJECT: Anterior cervical foraminotomy has been advocated as a procedure that preserves the motion segment while treating radiculopathy due to degenerative cervical disc disease. Because the medical literature contains no long-term follow up or randomized studies related to this procedure, the authors reviewed their results, specifically examining cases of failure to determine the efficacy of the approach. METHODS: The authors identified 23 patients in whom unilateral cervical radiculopathy due to degenerative cervical disc disease was refractory to conservative therapy and in whom anterior cervical foraminotomy was performed between 1998 and 2000. The procedure involves ipsilateral exposure, microsurgical removal of the uncovertebral joint to identify the nerve root, and partial removal of the lateral anulus and or disc fragments. Data in those patients who underwent reoperation(s) were reviewed specifically for the procedure type, interval between index procedure and reoperation, and whether multiple procedures were performed. Of the 23 patients, 30% required at least one additional procedure. A good or excellent outcome at last follow-up examination was achieved in only 12 patients. CONCLUSIONS: In the current study the authors found a reoperation rate that is considerably higher than that in most series of anterior cervical surgery for radiculopathy. The presumed benefit of anterior cervical foraminotomy is preservation of the disc interspace; however, in this study, a significant number of patients failed to experience a satisfying outcome. Currently the authors do not recommend anterior cervical foraminotomy as a stand-alone procedure.

    Title Threaded Cages for Degenerative Cervical Disease.
    Date February 2002
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    Multiple techniques are used to accomplish anterior interbody fusion in the cervical spine. These various options reflect the lack of any one approach to obtain superior results. Extrapolating from the lumbar spine experience, a cervical cage was proposed as an alternative to the status quo. A device evaluation study was done to determine the safety and efficacy of the cage with a comparison with current allograft or autograft fusion techniques. The study resulted in two publications. One study is a multicenter trial whereas the other is a one-author study with long-term results. A review of the data from both studies follows. Comparable outcomes were seen with the allograft and autograft control group and the experimental group in the multicenter trial. However, that study reported significantly better fusion rates for the patients with cervical cages compared with the control group. Both studies reported a high percentage of donor site morbidity in the patients in the control group who had autograft fusion. A trend toward better outcomes for patients who received a cervical cage was seen in the long-term followup study. The data presented suggest interbody fusion cages are a safe and effective treatment of degenerative cervical disc disorders and avoid iliac crest donor site morbidity.

    Title A Prospective Randomized Multicenter Clinical Evaluation of an Anterior Cervical Fusion Cage.
    Date December 2000
    Journal Spine
    Excerpt

    STUDY DESIGN: A prospective, concurrently controlled, randomized, multicenter trial of an anterior Bagby and Kuslich cervical fusion cage (BAK/C; Sulzer Spine-Tech, Minneapolis, MN) for treatment of degenerative disc disease of the cervical spine. OBJECTIVES: To report clinical results with maximum 24-month follow-up of fusions performed with the BAK/C fusion cage. SUMMARY OF BACKGROUND DATA: Threaded lumbar cages have been used during the past decade as a safe and effective surgical solution for chronic disabling low back pain. Threaded cages have now been developed for use in anterior cervical interbody fusions to obviate the need for allografts or autogenous bone grafting procedures while providing initial stability during the fusion process. METHODS: Patients with symptomatic cervical discogenic radiculopathy were treated with either anterior cervical discectomy with uninstrumented bone-only fusion (ACDF) or BAK/C fusion cage(s). Independent radiographic assessment of fusion was made and patient-based outcome was assessed by visual analog pain scale and a Short Form (SF)-36 Health Status Questionnaire. RESULTS: Data analysis included 344 patients at 1 year and 180 at 2 years. When the two cage groups (hydroxya, patite-coated or noncoated) were compared with the ACDF group, similar outcomes were noted for duration of surgery, hospital stay, improvements in neck pain and radicular pain in the affected limb, improvements in the SF-36 Physical Component subscale and Mental Component subscale, and the patients' perception of overall surgical outcome. Symptom improvements were maintained at 2 years. A greater percentage of patients with ACDF needed an iliac crest bone harvest than did BAK/C patients (67% vs.- 3%). Successful fusion for one-level procedures at 12 months was 97.9% for the BAK/C groups and 89.7% for the ACDF group (P < 0.05). The complication rate for the ACDF group was 20.4% compared with an overall complication rate of 11.8% with BAK/C. There was no difference in complications that necessitated a second operative procedure. CONCLUSIONS: These results demonstrate that outcomes after a cervical fusion procedure with a threaded cage are the same as those of a conventional uninstrumented bone-only anterior discectomy and fusion with a low risk of complications and rare need for autogenous bone graft harvest.

    Title A Randomized Prospective Study of an Anterior Cervical Interbody Fusion Device with a Minimum of 2 Years of Follow-up Results.
    Date October 2000
    Journal Journal of Neurosurgery
    Excerpt

    OBJECT: Despite variations in technique, inherent problems persist with current approaches to anterior cervical fusion. This study was performed to determine whether anterior cervical fusion performed using an investigational device was safe and effective in the treatment of degenerative cervical disc disorders and whether this device offered advantages over current techniques. METHODS: Fifty-four patients with radiculopathy with or without mild myelopathy due to one- or two-level cervical degenerative disc disease were randomized as part of a Food and Drug Administration device study. Following microsurgical discectomy, the control group was treated with iliac crest graft fusion; the experimental study group underwent insertion of an interspace cage and placement of a local autograft. All patients received postoperative follow-up care for at least 2 years. Good or excellent results were found in approximately 97% of the experimental group and 88% of the control group. A solid fusion was achieved in all patients who underwent one-level cage placement, and a solid fusion at one or both levels was achieved in over 90% of both groups. Chronic donor site pain was reported by 31% of the control group. CONCLUSIONS: In this study, the use of an interbody fusion cage avoided donor site morbidity and placement of autograft achieved a high rate of good or excellent results. Interbody fusion cages appear safe and effective, and their use helps to avoid some of the inherent problems in performing current anterior cervical fusion techniques.

    Title Spinal Instability.
    Date October 1999
    Journal Journal of Neurosurgery
    Title The Ray Threaded Fusion Cage for Posterior Lumbar Interbody Fusion.
    Date January 1999
    Journal Neurosurgery
    Title Comparison of Interbody Fusion Approaches for Disabling Low Back Pain.
    Date June 1997
    Journal Spine
    Excerpt

    STUDY DESIGN: This is a study comparing two groups of patients surgically treated for disabling low back pain. One group was treated with lumbar anteroposterior fusion (360 degrees fusion), the other with posterior lumbar interbody fusion and an interbody fixation device. OBJECTIVES: To determine which approach provided the best and most cost-effective outcome using similar patient selection criteria. SUMMARY OF BACKGROUND DATA: Others have shown that certain patients with disabling low back pain benefit from lumbar fusion. Although rarely reported, the costs of different surgical treatments appear to vary significantly, whereas the patient outcome may vary little. METHODS: Since 1991, 75 patients have been treated Starting in 1993, posterior lumbar interbody fusion BAK was offered to patients as an alternative to 360 degrees fusion. The treating surgeon reviewed the cases. The interbody fixation device used (BAK; Spine-Tech, Inc., Minneapolis, MN) was part of a Food and Drug Administration study. Patient selection criteria included examination, response to conservative therapy, imaging, psychological profile, and discography. North American Spine Society outcome questionnaires, BAK investigation data radiographs, chart entries, billing records and patient interviews were the basis for assessment. RESULTS: Age, sex compensable injury history and history of previous surgery were similar. Operative time; blood loss, hospitalization time, and total costs were significantly different. There was a quicker return to work and closure of workers compensation claims for the posterior lumbar interbody fusion-BAK group. Patient satisfaction was comparable at last follow-up. CONCLUSIONS: Posterior lumbar interbody fusion-BAK achieves equal patient satisfaction but fiscally surpasses the 360 degrees fusion approach. Today's environment of regulated medical practice requires the surgeon to consider cost effectiveness when performing fusion for low back pain.

    Title Screw Fixation for Odontoid Fracture; a Comparison of the Anterior and Posterior Technique.
    Date October 1996
    Journal The Nebraska Medical Journal
    Excerpt

    Surgical treatment of atlantoaxial instability resulting from Type II odontoid fracture has evolved in recent years with newer approaches offering the surgeon more options. Our experience with anterior odontoid screw fixation and transarticular C1-2 fusion has exposed us to complications, indications, and contraindications different from those of more traditional posterior arch fixation and fusion procedures. The value and versatility of these two approaches were recently demonstrated in one case: a patient with a Type II odontoid fracture was treated with anterior odontoid screw fixation, suffered a second injury with dislocation and neurologic deficit and responded well to transarticular C1-2 fusion with decompression. A description of our surgical technique and a comparison of the two procedures is presented.

    Title Ct Directed Stereotactic Biopsy, a New Neurosurgical Tool.
    Date October 1986
    Journal The Nebraska Medical Journal
    Title Surgical Treatment of Brain Stem Carcinoma: Case Report.
    Date September 1980
    Journal Neurosurgery
    Excerpt

    An unusual case of adenocarcinoma metastatic to the pontomedullary region of the brain stem is presented. When the floor of the 4th ventricle was exposed at operation, this intramedullary tumor was found to be cystic. The patient died of septic complications after an uneventful decompression of the cyst and a subtotal excision of the neoplasm. The rational for surgery (tissue diagnosis and decompression) in some of these cases is discussed.


    Similar doctors nearby

    Dr. John Dickinson

    Surgery
    41 years experience
    Springfield, OR

    Dr. Charles Stanton

    Surgery
    28 years experience
    Springfield, OR

    Dr. Craig Seidman

    Surgery
    16 years experience
    Springfield, OR

    Dr. Duc Vo

    Surgery
    5 years experience
    Springfield, OR

    Dr. Andrew Kokkino

    Neurological Surgery
    18 years experience
    Springfield, OR

    Dr. Daniel Cusati

    Surgery
    8 years experience
    Springfield, OR
    Search All Similar Doctors