SRS Newsletter
September 2012

President's Message

SRS president

Once again, greetings from Dallas, Texas, USA where we welcome autumn’s relief from the summertime heat. It has been a very busy summer for the Scoliosis Research Society with the 19th annual International Meeting on Advanced Spine Techniques (IMAST) in Istanbul, Turkey was a big success, final preparations have been made for the 47th Annual Meeting in Chicago, Illinois, USA, and many committees have completed their work (see the many accompanying committee reports). To all of the members of the SRS involved with this work, I sincerely thank you for your time and efforts. This will be my final newsletter to you as president, and I would like to summarize some of the more recent activities.

As you read this, our Annual Meeting in Chicago is about to begin. We have already confirmed a new record Annual Meeting attendance (1280 registrants). This outstanding response reflects our membership’s interest in high quality educational events. We’ll have the opportunity to see the best 129 abstracts presented from the podium, all from the pool of 1234 abstracts which were submitted. Many more presentations will be available in the electronic and paper poster format. A substantial number of registrants have signed up for the Pre-Meeting Course, Thursday’s Half-Day Courses, and Lunchtime Symposia. This overwhelming interest in extra educational sessions has lessened the demand for the usual afternoon recreational activities on Thursday. Nevertheless, for those interested in sightseeing in Chicago, we’ve reserved several opportunities. On Friday, the Farewell Reception, to be held at the Art Institute of Chicago, promises to be an enjoyable, but busy, evening with food, friends, and art. All in all, this year’s annual meeting will be an outstanding event. I especially thank Daniel J. Sucato, MD, MS (Program Committee Chair) and Mark B. Dekotowski and John Dimar (Education Committee Co-Chairs) for all of their work in preparing a wonderful program.

We have tremendous news from the CME Committee. On July 27th, the Accreditation Council for Continuing Medical Education (ACCME) granted provisional accreditation to the Scoliosis Research Society. This will now enable us to provide Continuing Medical Education (CME) credits for SRS-related educational activities. In the past, we’ve had to rely on outside agencies to provide our CME and therefore have had limited opportunities. We’ll start this new process by issuing the CME credits at next year’s Annual Meeting and IMAST, and will begin making preparations for increased opportunities for other SRS-related CME educational events such as webinars, E-Text reviews, tutorials, and international events such as worldwide courses. These will require some time to be organized properly, and will be done so over the course of the next two years, at which time we will be evaluated for reaccreditation. Congratulations go to Glenn R. Rechtine, II, MD; Lawrence G. Lenke, MD; Tressa Goulding, CAE, CMP and Courtney Kissinger for all of their detailed work in the pursuit of this accreditation.

The new SRS journal “Spine Deformity” has been making outstanding progress toward its formal initial publication date in January 2013. We will have the Preview Issue distributed during the Annual Meeting in Chicago, and you’ll get a sense of the high quality spinal deformity information that this journal will offer. John Lonstein, MD (Spine Deformity editor) has assembled an outstanding editorial board and reviewers. To this point in time, there have been 79 submissions. Seventeen articles will be published in the preview issue, seven other manuscripts have been accepted for the January issue, 22 more are being revised, and 25 manuscripts are currently under review. Through John’s enormous effort, this new “Official Journal of the SRS” promises to become the premier source of up-to-date information for spinal deformity.

Through the work of the Advocacy Committee, Joe O’Brien’s National Scoliosis Foundation, and SRS Program Manager, Brian Lueth, the SRS obtained an astounding forty formal State Proclamations signed by the Governors proclaiming June as Scoliosis Awareness Month. The benefit of this effort was to promote a high level of public awareness of scoliosis, and this was very successful. In addition, the Advocacy Committee (under the direction of Vishwas Talwalkar as Chair) completed a Pediatric Spine Deformity Fusion Indications Statement which can now be found under the Education Section in the Members Only portion of the SRS website. The adult spine deformity indications statement is forthcoming in the near future. These indications statements may be helpful to our members should they have the need to respond to inquiries from third party payers or policymakers regarding proposed treatment programs. Please take a moment to review this indications statement and be aware of its availability, should you need it.

In July, IMAST proved to be an overwhelming success in Istanbul, Turkey. Under the direction of Christopher Shaffrey, MD (IMAST Chair), his committee, and SRS Meetings Director, Megan Kelley, we had an outstanding program and social events. Nine-hundred sixty-one registrants came from around the world (33% from North America, 27% from the Asia Pacific, 24% Europe, 11% from Africa/Middle East, and 5% from South America). You can find more details under Dr. Shaffrey’s IMAST Report which is included in this newsletter.  Once again, congratulations to Dr. Shaffrey and colleagues for an outstanding success. Please mark July 10-13, 2013 in your calendar for next year’s IMAST in Vancouver, Canada.

With the changing environment for healthcare and the increasing need to substantiate our proposed care for patients, we have moved forward with the concept of developing an Appropriate Use Criteria (AUC) for lumbar degenerative scoliosis. Following our Board of Directors’ request, the widely respected RAND-UCLA organization submitted an outstanding proposal which was carefully reviewed, and subsequently approved. The American Academy of Neurological Surgeons (AANS) has joined us to make this a collaborative effort. Through the efforts of the Presidential Line, external funding for this project has been secured and the SRS will be responsible for just 10% of the expenses. Once this AUC for lumbar degenerative scoliosis has been completed, it may prove to be of substantial benefit to our members in future interactions with third party payers and policymakers. Work on this AUC will formally begin in the fall of 2012. 

The SRS continues to work closely with the AAOS and, in particular, with its Board of Specialty Societies. To enhance our depth of interaction we have appointed four SRS members to be official BOS representatives (Baron S. Lonner, MD in Research, Mark Weidenbaum, MD in Education, Vishwas R. Talwalkar, MD in Health Policy, and Clifford B. Tribus, MD in Communications). This will allow our society to make a greater impact with the American Academy Orthopaedic Surgeons (AAOS), and other subspecialty societies in orthopaedics.

The Research, Education, and Outreach Fund (REO Fund), established one year ago as our society’s investment fund for designated giving and large donations, has been extremely beneficial. For those who make donations to the SRS, please know that our society is 1) in control of the entire REO Fund’s principal, and not just the yearly distributions, and 2) can control the percent distributions from the Fund for research and educational events. These two points represent advantages to the SRS when compared to the OREF. Regardless of your choice (REO Fund or OREF), the goal of the SRS leadership is to achieve 100% society participation in making a financial contribution to the SRS for research or education. Please consider making a donation to our REO Fund as it reflects well on your commitment to our society and provides important additional financial resources for many deserving research proposals.

I wish to close by expressing my deep gratitude to you for having the opportunity to serve as President for this past year. This allowed me to make acquaintances and friendships with many spine deformity surgeons throughout the world, oversee the global progress of our society, and try to enhance the SRS’ stature in spinal deformity care. I’m honored to have been given the chance to contribute to this wonderful society. The SRS Board of Directors is composed of members with great knowledge, expertise, organizational ability, and the desire to always improve the SRS. The SRS administrative staff, led by Tressa Goulding, CAE, CMP, is an exceptional group of people who work endlessly to make every aspect of this society successful. We are very fortunate to have them.

I especially thank Kamal N. Ibrahim, MD, FRCS(C), MA, Steven D. Glassman, MD and Lawrence G. Lenke, MD of the Presidential Line for all of their insightful advice and guidance during our weekly conference calls. Collectively, we have been able to reach decisions we feel have helped the SRS. President-Elect Kamal Ibrahim, MD, FRCS(C), MA, will assume the responsibilities of president at the conclusion of the 48th Annual Meeting and you can rest assured that he will do an excellent job in this capacity. Thank you for my opportunity to officially serve as the 42nd President of the Scoliosis Research Society.

My very best to you,

B. Stephens Richards

B. Stephens Richards, III, MD
2011-2012 President

Letters to the Editor

Dear Dr. Kalen,

It was nice to see the historical article in the SRS Newsletter, but I have to make some comments:

  1. The names in the photo are translated. Dr. Blount is on the left, sitting, and Dr. Schmidt is standing. I knew them both personally.
  2. You say "bracing was begun for treating scoliosis in the 1950's." Bracing for scoliosis is an ancient art, beginning in the 16th century with Ambrose Pare, the famous French army surgeon. It became highly developed in the 18th and 19th centuries, especially in France and Germany. As seen in the photo of the Hessing brace from Germany circa 1888.

Hessing Brace

Sorry to bother you, but the newsletter should be corrected.

Sincerely,

Robert B. Winter, MD


A Letter to the Editor: Additional Historical Information

Dear Dr. Kalen,

I just read the SRS June newsletter containing some mistakes in the Historian Corner, which I think deserve to be corrected.

Turnbuckle cast:
From January 1, 1958 to January 24, 1959, I was the John Cobb Scoliosis Fellow at the Hospital for Special Surgery in New York. During that time I was responsible for the care of patients on the Scoliosis Wards and had the opportunity to perform myself exactly 60 spine fusions for scoliosis, to assist him on many others and to make several hundreds of turnbuckle casts.

Dr. Cobb was fully active as Chief of the Scoliosis Service. Shortly after I left, his health began to deteriorate and eventually caused his death. This makes me the very last true Cobb scoliosis fellow at Special Surgery. The Cobb type of turnbuckle cast, which included also one thigh, was used to gradually correct the deformity pre-operatively, not as stated in the newsletter. This took from three to six weeks, depending on the magnitude and rigidity of the curves. The patient was then operated through a large posterior window in the cast. Right after wound healing the window was closed by plaster and the patient had to stay in bed for six months. Normal body casts (usually two) followed for a total of 12 months from surgery, with the patient now allowed to walk.

Milwaukee brace:
During the whole month of February 1959, I was visiting Dr. Walter Blount in Milwaukee, being his guest at his distinguished gentlemen’s club, scrubbing in with him at surgery and watching him using the Milwaukee brace. He repeatedly gave the main credit for developing the brace to Dr. Albert Schmidt, whom of course I saw daily. In the photo you showed Dr. Blount is the one sitting down and Dr. Schmidt standing in front of the brace.

With all good wishes,

Alberto Ponte, MD

IMAST Committee Update

Christopher I. Shaffrey, MD
IMAST Committee Chair

Christopher I. Shaffrey, MD

The Scoliosis Research Society has just completed the very successful 19th International Meeting on Advanced Spinal Techniques (IMAST) in historic and beautiful Istanbul, Turkey. This year, the IMAST Committee substantially restructured the program to enhance and broaden international involvement and to focus on evidence-based spine care, complication avoidance, emerging technologies, and surgical technique pearls from recognized international leaders in spinal surgery. The ability to easily access the broad variety of educational choices including general session podium presentations, instructional course lectures, debates and hands on workshops was facilitated by the convenient Istanbul Congress Center (ICC). One hundred-thirty-four oral presentations and 791 electronic posters were presented during the course of the meeting. The social programs were exceptionally well-attended, including the Course Reception held at the Halic Congress Center, highlighted by the Fire of Anatolia performance in the Sadabad Auditorium. This Turkish dance group consisted of more than 120 performers.

The group has performed in more than 85 countries from the U.S. to China and Japan, and holds two Guinness World Records, one for fastest dance performance with 241 steps per minute and another for largest audience.

The SRS Presidential Line's goal of both further growing participation at IMAST and broadening international participation was reflected in the faculty and medical attendees at this year's program. There were 961 registered attendees, including 643 surgeons, 171 exhibitors and 147 guests. The international scope of the meeting was demonstrated by 27% of attendees from Asia/Australia/NZ, 24% from Europe, 11% from Africa/Middle East, 5% from South America and 33% from North America. The medical attendees included 76% orthopaedic surgeons, 14% Neurosurgeons and 10% other medical specialties.

The Whitecloud Awards for Best Clinical Paper and Best Basic Science Paper were awarded at the close of the meeting on Saturday, July 21. Praveen Mummaneni, MD accepted the Whitecloud Award for the Best Clinical Paper on behalf of his co–authors on Paper #7, "Cost Effectiveness of Single-Level Anterior Cervical Discectomy and Fusion Five Years after Surgery." The Whitecloud Award for Best Basic Science Paper was accepted by Peter O. Newton, MD on behalf of the authors of Paper #13, "Three Dimensional Visualization of the Intervertebral Disc: The Effects of Growth Modulation."

Also, on behalf of the IMAST Committee, and the SRS Presidential Line, I would like to extend sincere and profound thanks to the Local Host Committee in Istanbul, headed by Azmi Hamzaoglu, MD and Ahmet Alanay, MD. The success of this year's IMAST meeting is largely attributable to their dedicated and substantial work on behalf of SRS. We offer sincere appreciation for all they have done in support of the meeting and of the Society.

The 20th IMAST will be held July 10-13, 2013 in Vancouver, British Columbia, Canada. The meeting hotels include the Pan Pacific which is connected to the Vancouver Convention Center (VCC) and the Fairmont Waterfront and Fairmont Pacific Rim which are a three-minute walk VCC. Vancouver International Airport was recently named "The Best Airport in North America" and is an ideal port of entry for international visitors. Vancouver attractions include Stanley Park near downtown with a 13-mile "seawall" trail, the internationally renowned Vancouver Aquarium, the Granville Island Public Market and some of the best restaurants in North America.

The evaluations from the 19th IMAST meeting will used by the Program Committee to further improve and broaden the educational offerings in Vancouver. The abstract submission open date for 20th IMAST is November 1, 2012 and the abstract deadline is February 1, 2013. Registration will open in January 2013. It is the goal of the IMAST program committee to further build on the successes of the previous IMAST meetings. The IMAST Committee would especially like to thank Todd J. Albert, MD for the dedication, leadership and mentoring as the past IMAST Committee Chair. The success of the 19th IMAST can be almost entirely be attributed to the always outstanding SRS administrative team, especially Executive Director, Tressa Goulding CAE, CMP and Megan Kelley, Meetings Director.

Committee Chair: Christopher I. Shaffrey, MD Committee Members: Todd J. Albert, MD; Jacob M. Buchowski, MD; Charles H. Crawford, III, MD; Benny T. Dahl, MD; Morio Matsumoto, MD; Justin S. Smith, MD; Mark B. Dekutoski, MD; John R. Dimar, MD; Michael F. O'Brien, MD.

SRS 2012 Spring Grant Recipients Receive Over $119,000

John M. (Jack) Flynn, MD
Research Grants Committee Chair

John M. (Jack) Flynn, MD

The 20 members of the Research Grants Committee have been hard at work identifying the best ideas and research teams to push forward spine deformity care for the future. In the spring grant cycle, SRS received 34 grant applications from six countries, requesting a total of $1,273,138.33. The total available for funding in this cycle was $119,448.

The Committee received four evidence-based medicine grant requests, seven new investigator requests, five small exploratory requests, and 18 standard investigator requests. Four teams divided up the grants, studied the applications, debated the merits of each grant, and reached consensus decisions. Four grants were funded, awarding the entire $119,448 budget.

The winners were:

  1. Small Exploratory
    1. Kathy J. Simpson, PhD. - University of Georgia
      1. Fully Funded at $9,846.00
      2. “Movement techniques used by individuals with adolescent idiopathic scoliosis (AIS) during high-effort activities and the effects of spinal fusion surgery on compensatory adaptations.”
  2. New Investigator
    1. Samer M. Adeeb,  PhD. - University of Alberta
      1. Fully Funded at $25,000.00
      2. “A novel approach to use surface topography results for assessing scoliosis”
  3. Standard Investigators
    1. Mikkel O. Andersen, MD -Lillebaelt Hospital - Denmark
      1. Partially Funded at $39,086.00
      2. “Adolescent idiopathic scoliosis in twins - a study based on the Danish Twin Registry”
    2. Michael G. Vitale, MD, MPH - Children's Hospital of NY Presbyterian
      1. Fully Funded at $45,516.00
      2. “Spine-Based vs. Rib-Based Anchors in Growth-Sparing Constructs for Young Children with Scoliosis”

At the 47th Annual Meeting and Course in Chicago, Illinois, USA,  the Research Grants Committee Lunchtime Symposium will occur on Wednesday, September 4, 2012 under the Title "Breaking News: Initial Presentations from Recent SRS Grant Winners". The one-hour program will allow six recent grant winners to show their preliminary data and get feedback from the audience.

SRS Members should be proud of the hard work that the grant reviewers have done, and their careful stewardship of precious research funds currently available in this difficult economic environment.

Committee Chair: John M. Flynn, MD Committee Members: Dilip K. Sengupta, MD; Michelle S. Caird, MD; Kota Watanabe, MD, PhD; Rajiv K. Sethi, MD; Burt Yaszay, MD; Saumyajit Basu, MD; Frederico P. Girardi, MD; Siavash Haghighi, DMV, PhD; Kirkham B. Wood, MD; Lori Dolan, PhD;  Jonathan H. Phillips, MD; Charles E. Johnston, II, MD; Michelle C. Marks, PT, MA; Jonathan E. Fuller, MD; Virginie C. Lafage, PhD; Andrew G. King, MD; Joseph H. Perra, MD; James O. Sanders, MD; Carol A. Wise, PhD.

Spinal Surgery at Boston Children's Hospital – 140 Years

Lawrence I. Karlin, MD
Historical Committee Member

Lawrence I. Karlin, MD

The annual reports for the early years of the Children's Hospital have recently been placed on pdf and make fascinating reading. One is struck by the tremendous advances in medicine over a relatively short time. Of special interest to Scoliosis Research Society (SRS) members is the dramatic change in the field of spinal surgery that occurred rather abruptly in the early 1970's.

The hospital began in a converted private home in 1869 and the managers summarized the first year's record "with more than a formal acknowledgment of the divine favor." Apparently the founders maintained the Puritan quality of thrift, for a "distinctive feature of the plan" was that the hospital be "under the charge of voluntary nurses, who are willing to engage in the work for no other recompense than the satisfaction of ministering to the physical and spiritual comfort of the sick and suffering."

The administration seemed quite proud of the fledgling institution, for the "whole air is cheerful and gladsome" and when on the "general ward one almost forgets that he is in the midst of the sick and suffering, as he sees on all sides smiling faces, little hands playing with toys, or turning over pages of illustrated books, and hears cheerful voices prattling merrily, or singling alone or together pleasant songs."

Apparently the founders were well versed in the art of massaging their donors. The reports provide an exhaustive list of individuals and their specific gifts. Thanks went out to Mrs. S. for her $25, but also to Mrs. R. for 1 pair of socks, Miss F. for a jar of quince jam, and, of course, to Miss B. for lint.

During 1870, the first full year of service, there were 83 admissions. The most common orthopaedic condition was morbus coxae, with eight patients. It would appear that the concept of outcomes-based medicine was already established in 1870 with each discharge graded as well relieved, not relieved, or dead. The exact list of criteria for each category was not stated. By 1880 there were 199 admissions of which 69 were diseases of the musculoskeletal system. Two patients had caries of the spine, while 14 were listed as diseases of the spine.

By 1902 admissions were divided by specialty. There was a total of 3269 admissions of which 792 were orthopaedic in nature. The 459 orthopaedic surgical procedures included a single Albee spinal fusion. In 1941 there were 478 orthopaedic procedures: four were spinal fusions.

By 1965, surgery for scoliosis was being performed. This was primarily idiopathic scoliosis with a single case each of post-irradiation and myelomeningocele scoliosis. Of 1209 orthopaedic procedures, 57 were fusions for scoliosis. There were two fusions performed with and 55 without Harrington instrumentation.

Historical Chart

In 1975 there were 1617 orthopaedic procedures which included 200 scoliosis surgeries. Now the types of scoliosis included a wide spectrum: idiopathic, cerebral palsy, myelomeningocele, congenital, sacral agenesis, and myopathy. As noted in the table the entire range of surgical interventions were employed. In 2010 there were 339 surgeries for scoliosis and 3970 in-patient orthopaedic procedures.

It is clear that a sea change in the treatment of spinal deformity occurred between 1965 and 1975. The development of spinal instrumentation takes some credit, but Harrington began his work in 1954 and published it in 1962. Yet three years later only two instrumented procedures were performed at Children's Hospital, Boston. The Scoliosis Research Society first met in 1966 and this format undoubtedly helped disseminate knowledge.

It takes an individual open to new ideas to implement them. The deciding element responsible for the dramatic change in spinal surgery at Children's was the arrival in 1971 of John E. Hall, MD, a man with the vision to accept new techniques, the intelligence to appropriately apply them and the inventiveness to improve and expand upon them. It was his dedication to teaching the principles of spinal deformity care that established Children's as a major center for spinal care.

Historical Table

Committee Chair: Behrooz A. Akbarnia, MD Committee Members: Nathan H. Lebwohl, MD, Past Chair; Vishal Sarwahi, MD; David H. Clements, III, MD; Azmi Hamzaoglu, MD; Reinhard D. Zeller, MD; Lawrence I. Karlin, MD.

Fall 2012 Nomination Committee Update

Lawrence G. Lenke, MD
Nominations Committee Chair

Lawrence G. Lenke, MD

The Nominating Committee has completed its important work of determining new members for the Board of Directors, the Fellowship Committee and the Vice President. After many conference calls, data gathering and vetting, the Nominating Committee are pleased to present the following slate that will be voted on at the first Business breakfast meeting at the 47th Annual Meeting on Thursday, September 6th, 2012 in Chicago, Illinois, USA.

Board Members:
Todd J. Albert, MD
David H. Clements, III, MD
Muharrem Yazici, MD

Fellowship Committee Member:
Munish C. Gupta, MD

Vice President:
John P. Dormans, MD

I would like to thank all members of the committee for their diligent work.

Committee Chair: Lawrence G. Lenke, MD Committee Members: Serena S. Hu, MD; Peter O. Newton, MD; Paul D. Sponseller, MD; Mark Weidenbaum, MD

Public Relations Committee Update

Andrew G. King, MD
Public Relations Committee Chair

Andrew G. King, MD

The job of the Public Relations Committee is to be the interface between the society and the public. The committee has sought to distribute topical and unbiased information about scoliosis, and to promote members of the Scoliosis Research Society as the first choice for spinal deformity diagnosis and treatment.

In the past this has taken the form of newsletters and brochures, but with the advent of the internet and social media, consumers have been accessing many different sources for their information. The society and the Public Relations Committee have been taking steps to restructure our PR efforts to conform to this change.

Brochures are still helpful, especially for reading material in doctor's waiting rooms, but we need to get the message out through media such as Facebook, blogs such as REDDIT, and videos on YouTube.

We would encourage SRS members at large to send us videos, slide presentations, or other communications that they think would help highlight the society as a trusted source of balanced information on scoliosis. These would be vetted by the committee and used appropriately, working closely with the website and compelling stories committees.

Stacey Lewis

We also seek prominent spokespeople, such as WPGA golf sensation Stacey Lewis, who has had scoliosis surgery.

With the pending 50th anniversary of the SRS, we will be looking to show the public the huge changes for the better in scoliosis care over the last half century. We would appeal to our Emeritus Members for early material on scoliosis treatment that would offer a contrast to modern procedures.

The SRS has a great story of success and we need to get it out to the public.

Committee Chair: Andrew G. King, MD Committee Members: Michael O. LaGrone, MD; Walaa Elassuity, MD; Gregory R. White, MD; Ian Bruce McPhee, MD, FRACS; Robert M. Bernstein, MD; Lori A. Karol, MD; Allen L. Carl, MD; Angela M. Strader, RN.

ICD-10: What does it mean for you?

R. Dale Blasier, MD, FRCS(C), MBA
Chair SRS Coding Committee
Donna Lahey, BSN, CNOR
NASS Coding Committee

R. Dale Blasier, MD, FRCS(C), MBA

October 1, 2014 is the date that ICD-10 will go into effect.

ICD-9-CM and ICD-9-PCS (International Statistical Classification of Diseases and other Health Problems) have been the standard code sets used for reporting diagnoses and inpatient procedures in the United States since 1979. This 34 year old system was implemented by the World Health Organization (WHO) for the purpose of reporting morbidity and mortality information for vital health statistic tracking and research. This classification system is no longer capable of keeping up with the advances in medical practice, treatment, health information needs, or payment processes.

For practices throughout the United States this means change from the current 14,000 code diagnosis system (ICD-9-CM) to a new 68,000 diagnosis code system (ICD-10-CM). The current ICD-9 system can no longer accommodate new diagnoses of medical conditions or hospital inpatient procedures nor does it sufficiently specify disease etiology, anatomical site, and severity. ICD-9 also does not accurately reflect advances in medical technology, treatment or knowledge; it has limited ability to measure health care services or conduct public health surveillance; and it cannot accurately measure quality of care, outcomes, safety, and security.

The new system has five to seven characters and will permit these codes to be placed within their correct category while allowing more specificity to accommodate subcategories of diseases and health problems. Laterality will also be addressed with the new system.

Due to expanded character length in ICD-10, system upgrades to medical records will require a change from Version 4010 of the HIPAA electronics administrative transactions to Version 5010. Implementation will take great preparation, thorough planning, training, time and financial resources. Implementation will affect all areas of practice and work staff. All forms that include diagnosis codes, particularly superbills and encounter forms, will need to be updated. All staff will need to be educated. Starting implementation early will help to make this process less disruptive and will provide for a more effective and efficient transition.

Chairman: R. Dale Blasier, MD Committee Members: Jeffrey B. Neustadt, MD, Kern Singh, MD, Brandon J. Kambach, MD; Patrick Cahill, MD, Christopher DeWald, MD; Michael P. Chapman, MD, Mathew D. Hepler, MD.

Globalization Committee Update

Lawrence G. Lenke, MD
Globalization Committee Chair

Lawrence G. Lenke, MD

The Globalization Committee is working on a survey to be sent to non-North American SRS members. Its purpose is to assess several facets of our society from an international perspective. This is an attempt to see how well we are doing and what we could be doing better from their viewpoint. Hopefully this will lead to improved satisfaction for our global members and also provide impetus for other spinal deformity surgeons to consider applying for SRS membership.

The committee is also working on setting up regional subcommittees that will help in selection of World Wide Conference locations and International Meeting on Advanced Spine Techniques and Annual Meeting locations in the future. Additionally, it is hoped that these subcommittees will begin a "bottom up" type of organizational structure whereby ideas or suggestions are provided to the committee and ultimately, if and when appropriate, are brought to the Board of Directors for consideration. This was the original intention of the committee's development and it is anticipated that this will be beneficial to further globalize our society for improved education, research, and outreach goals.

Lastly, the Fellowship Criteria Task Force chaired by Mark Weidenbaum MD, which was charged with identifying ways of confirming board equivalency for prospective members, has recommended that the regional chairs of the Globalization Committee should be an integral part of this assessment. This process will be utilized in future years when candidate and active members apply for these respective positions.

Chair: Lawrence G. Lenke, MD Committee Members: Noriaki Kawakami, MD; Hee-Kit Wong, MD; David S. Marks, FRCS; Carlos A. Tello, MD; Osmar Avanzi, MD; Oheneba Boachie-Adjei, MD; Kenneth M.C. Cheung, MD

Morbidity & Mortality Committee Update

Paul D. Broadstone, MD
M&M Committee Chair

Paul D. Broadstone, MD

The M&M Committee continues to work on its charges to improve the quality and usefulness of the M&M data collection process.

As you may already know, we have implemented the new acute infection module for the 2012 collection year, which is in addition to the other three modules of death, visual acuity loss, and neurologic deficit.

We would like to take a moment to define these terms so that the data being entered is the most accurate and appropriate as possible.

Death:  Death that is attributable to a complication of the surgery or occurred during the surgical event. Current module goes for >21 days if in fact the death is traceable to the surgery or lingering complication.

Visual acuity loss (formally termed blindness): Any change in visual acuity listed by time of identification within the hospital stay. Classification is by pathology usually requiring specialty consultation.

Neurologic deficit (formally termed paralysis): Any change in the spinal cord, nerve roots, or peripheral nerves apparent within the time frames listed in the module.
Acute infection: Acute Infections that occur at the operative site in the post operative period of up to 12 weeks.

Please remember that if or when you enter any complications you must fully complete the detailed modules for each complication in the “add complication case” section. In reviewing the 2011 data collection report we found incomplete data.  Members, our data collection is only as good as the information that is entered correctly!!  Please, please complete all requested fields.  

Request for Proposal (RFP)
In response to the membership we have created a portal to gain access to the M&M data for your personal research through an RFP.

The official reveal of the RFP process, along with the year’s end report, will be announced during the M&M Committee report during the Member’s Business Meeting at the 47th Annual Meeting & Course in Chicago, Ill. USA, on September 7 at 7:09 AM. Shortly thereafter, we will begin to accept proposals. More information will be posted on the website in late September.  

Reminder
Active Fellows (Surgeons) are required to submit annual online M&M reports. If you choose not to submit, a $300 contribution to the M&M research collection fund will be assessed on your next annual membership dues invoice.

M&M Non-submitter assessment schedule


Year’s Report

Site Opens

Site closes

Assessed

2010 M&M Report

January 1, 2010

April 1, 2011

with 2012 Dues

2011 M&M Report

January 1, 2011

April 1, 2012

with 2013 Dues

2012 M&M Report

January 1, 2012

April 1, 2013

with 2014 Dues

2013 M&M Report

January 1, 2013

April 1, 2014

with 2015 Dues

2014 M&M Report

January 1, 2014

April 1, 2015

with 2016 Dues

2015 M&M Report

January 1, 2015

April 1, 2016

with 2017 Dues

All Candidate Fellows (Surgeons) are required to submit online annual M&M reports. Non-compliance of this requirement may hinder your chance to apply for Active Fellowship. Candidate Fellows do not have the option to opt out by paying the assessment.  You must have at least four M&M reports entered and the fifth reporting pending at time of Active Fellowship application submission at the end of your fifth year term.

Email reminders
Our primary method of M&M reminders is via email. Please make sure to read all the M&M reminders or forward to your staff person who is responsible for entering your data. If assistants are entering your M&M data, make sure that they are aware of the process, rules and deadlines prior to entering your data. 

The website is already open for the 2012 reporting year and will close April 1, 2013. 

Again, we thank you all for your commitment to the M&M program.   

ommittee Chair: Paul A. Broadstone, MD Committee Members: Michael J. Goytan, MD FRCSC; Amer Samdani, MD; Justin S. Smith, MD, PhD; Theodore Choma, MD; Douglas Burton, MD; Yongjung J. Kim, MD; Robert F. Heary, MD; Howard M. Place, MD; Jonathan E. Fuller, MD; Karl E. Rathjen, MD.

Education Council Report

Daniel J. Sucato, MD, MS
Education Council Chair

Daniel J. Sucato, MD, MS

The Scoliosis Research Society (SRS) continues to be fully committed to education with great efforts to promote our society's international presence and our members' expertise in all we do. There have been significant efforts over the past year and these are highlighted below. As the Education Council Chairman, I have been proud to watch all of the great accomplishments that have taken place in the committees under this council: Awards & Scholarships, CME, Education, E-Text, Global Outreach, IMAST, Patient Education, Program, Website, World Wide Conferences and committees. Separate reports from the Global Outreach and IMAST committees are in the current newsletter.

The Awards Committee, chaired by Stephen J. Lewis, MD, MSc, FRCSC carried on the SRS tradition of recognizing important contributors to the society and to the field of spinal deformity surgery. This year’s Lifetime Achievement award winners were Vernon T. Tolo, MD and Robert B. Winter MD; two icons in the field of spine deformity. The Walter Blount Humanitarian Award went to Anthony S. Rinella, MD for all of his great work in providing spinal care in developing countries. The Edgar G. Dawson Fellowship recipient was Justin S. Smith, MD who chose to visit Daniel K. Riew, MD at Washington University for a two to three week fellowship. The Global Outreach Program Educational Scholarships were awarded to Pankaj Kandwal, MD and Sambhav Shah, MS, while the Global Outreach Visiting fellowships went to Abdul Rakib Al-Mirah, MD and Krishna Mumar Ramachandran Nair, MD. The SRS travelling fellowships went to Ian J. Harding, BA, FRCS (Orth) (UK), Vidyadhara Srinivasa, MS, DNB, FNB (Spine) (India), Elias C. Papdopoulos, MD (Greece) and the senior fellow was Michael J. McMaster, MD, DSc, FRCS. After they complete their travels to Philadelphia, Dallas, and St. Louis, they will be heading to Chicago to visit two centers, as well as attend the SRS Annual Meeting. Finally, the Eduardo R. Luque Award went to Mauricio Montalvo, MD from Mexico. All of the awards were chosen through a revamped scoring system that was very detailed and comprehensive. This was a major undertaking spearheaded by Dr. Lewis and his committee which worked exceptionally well. He is to be congratulated on a superb job running this committee over the last three years.

Major congratulations are in order to the CME Committee, chaired by Glenn R. Rechtine, II, MD, as the committee and the SRS leadership were notified that the SRS is now recognized, through the Accreditation Council for Continuing Medical Education (ACCME), as an independent Continuing Medical Education (CME) provider. An enormous amount of work went into the preparation of the application and the interview process to achieve this goal. Dr. Rechtine and his committee had a lot of help from the society's Executive Director, Tressa Goulding CAE, CMP, Executive Assistant, Courtney Kissinger and the entire administrative staff. This accreditation will allow SRS to offer CME credit independently for the Annual Meeting and for any of the educational offerings the society provides to its members. Congratulations to all involved with this great effort.

The Education Committee, co-chaired by Mark B. Dekutoski, MD and John R. Dimar, II, MD, had another extremely productive year requiring an incredible amount of organization to deliver excellent educational opportunities to our members and others. Some of the highlights include a joint SRS-North American Spine Society (NASS) spine deformity program which is in year two, an ICL at the 2012 American Academy of Orthopaedic Surgeons (AAOS) on degenerative spondylolistheis, a symposium that has been accepted for the AAOS 2013 meeting (which will be an abbreviated version of the SRS 2012 pre-meeting course) and continued collaboration with the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) on the topic of sagittal plane analysis and its management. The Education Committee has done an excellent job organizing the following for the SRS Annual Meeting: the Pre-Meeting Course which looks at the Decade of Evolution of Spine Deformity Management; Half-Day Course topics of infection, minimally invasive surgery (MIS) and sagittal plane deformity; and the Lunchtime Symposia of SRS Funded Research, Coding, Global Outreach, and Non-Operative Treatment. The Education Committee has also contributed significantly to the SRS Website, providing content in the area of adult spinal deformity.

The E-Text Committee, chaired by Praveen Mummaneni, MD has continued to work diligently on the content of the E-Text with strategies to keep it current and fresh through development of editorial process. Through Dr. Mummaneni's and the committees' efforts the E-Text is free of charge to everyone who registers on the website. Ongoing efforts are in place to publicize the E-Text through various SRS committees, including the Education, Website, Advocacy, and others. The E-Text Committee is exploring the feasibility of making the e-text available through e-readers (i.e. Kindle).

It was an honor to chair the Program Committee this year. We made two major changes for this year's annual meeting. First, due to the continued escalating numbers of quality abstract submissions, the committee decided to include one half-morning of a concurrent session which will allow for 15 additional podium presentations to the meeting. This will take place Friday morning with early-onset scoliosis papers in one room and adult spine deformity presentations in another. The second change is to group the Hibbs clinical and basic science award papers into one session on Friday afternoon and allow the attendees to vote through an audience response system via their smart phones. (The app will be displayed in the program and in the registration packets). For the second year, the Program Committee has organized roundtable case discussions to follow the Pre-Meeting Course on Wednesday. The topics for the roundtable discussions are: neurologic complications, adult deformity, spondylolistheisis, and other miscellaneous topics. The fifth round table discussion is one the program committee is especially excited to see: "Ultra Long-term Followup: What have we learned?" lead by Behrooz A. Akbarnia, MD.

The SRS Website Committee, chaired by Michael S. Roh, MD has been very busy working on updates to the website to include not only revised text, but also images and illustrations. The website has stayed current with all of the happenings at the SRS, including the ability to connect to the new Spine Deformity journal (a lead banner has been included on the website). Because the SRS is a global society, sections of the website have been translated into various languages. Currently five languages (Chinese, French, Spanish, Japanese and Portuguese) are represented. The website renovation includes an array of patients' success stories, as well as an improved interface for patients and families. An exciting and current additional responsibility of the Website Committee has been to create and promote the SRS Facebook page. This has been a rapidly growing part of the society with the SRS currently having over 700 Facebook "friends" who have come from 20 different countries around the globe!

The World Wide Conference (WWC) Committee was chaired again by Ahmet Alanay, MD who has done another superb job with continued outstanding global efforts for education on spine deformity. The committee organized a very successful course in New Delhi, India (with the ASSICON meeting in February) where a questionnaire showed that most participants rated the presentations as "excellent." Another course was held in Amsterdam, Netherlands (as part of SpineWeek in May) where 400 attendees were present at the SRS sessions and many attendees stopping at the SRS booth to inquire about membership. The 2012 courses are slated for Tel Aviv, Israel in October and Ho Chi Minh City, Viet Nam in December. Tentative courses are scheduled in 2013 for Brazil, Turkey, Ukraine, and Bosnia and Herzegovina. Increasingly, World Wide Conferences have become a key component of the SRS educational mission, and the success of these courses has been based in a large part on the efforts of the WWC committee.

As you can see, it has been a very successful educational year for the Scoliosis Research Society. Congratulations to all of the chairs, committee members and the outstanding staff at the SRS office for making this possible.

Committee Chair: Daniel J. Sucato, MD, MS Committee Members: Stephen J. Lewis, MD, MSc, FRCSC; Glenn R. Rechtine, MD; Praveen Mummaneni, MD; Mark B. Dekutoski, MD; John R. Dimar, MD; Kenneth J. Paonessa, MD; Christopher I. Shaffrey, MD; Christopher Bergin, MD; Michael S. Roh, MD; Ahmet Alanay, MD.

Global Outreach Survey Results

Kenneth J. Paonessa, MD
Global Outreach Committee Chair

Kenneth J. Paonessa, MD

The SRS Global Outreach Committee has been very busy during the 2011-2012 year. In addition to trying to do a total website update, we have been adding several new sites. At the 47th Annual Meeting the committee will be reviewing sites that SRS members have started in Bangladesh, Morocco, and Jamaica, as well as the possibility of a Middle East site in Egypt.  The SRS has become more global and grown with more members from around the world.  The concept of “Global Outreach “and of trying to teach spinal deformity care to surgeons in areas of the world where it has not been previously available is not new. The purpose of the Global Outreach Committee of the SRS has been to foster and encourage this in the membership of the SRS.

As part of this goal the Global Outreach Committee sent a survey to all SRS members and we would like to give you a glimpse of the results. If you attend our Global Outreach Lunchtime Symposium on Wednesday September 5th during the Annual Meeting you will also hear about this. We received responses from 203 SRS members.

Roughly 30 percent of respondents (59 members) said they had been active in global outreach with the remainder of 70 percent (138 members) saying they had not been.

Ninety percent (90%) of those who have volunteered said they make between one to three trips per year. Fifty-four percent said their trips were one week while 24 percent said they were for three to five days long, and 17 percent said they were for two weeks.
When asked why they have not yet volunteered, members’ responses included:

  • I do not know where to begin (47%)
  • I lack financial resources (27%)
  • I am not interested in global outreach (3.4%)
  • I do not feel secure practicing medicine outside my own country (6.8%)

Over 40 % gave some additional comments such as “I am a researcher how could I help,” “I am retired how could I help,” “fixing scoliosis requires a team and close follow-up,” “I have never received an official request to help participate,” and “I don’t have the time.”
When asked what areas of the world need the most help in treating patients with spinal deformities the members responded with the following, listed from most need to least need.

Africa East Coast, Africa West Coast, Africa Sahara, Central America including Caribbean Islands, Asia Southeast, Asia – Central, South America, Asia- Mideast, Africa- Madagascar, Africa – South Africa, and Europe – East.  North America, Europe –West, and Australia were all felt to be already receiving adequate care for spinal deformities.

When asked if the SRS was doing enough to promote global outreach 67 percent said yes, 33 percent said no.
When asked in what ways the SRS could better help its members participate in global outreach:

  • 51% said offer scholarships
  • 39% said better public relations
  • 53% said easier access to site options via the SRS webpage.

Many members gave more detailed suggestions. The most common suggestion was offering financial assistance. The next common suggestion contained the theme of being able to access well-organized trips that are already taking place with all the necessary logistics in place (e.g., lodging, equipment). Offering outreach opportunities to non-USA members and involving younger members were other notable responses.

When asked if there were areas of the world where SRS members would not feel comfortable volunteering their time:

  • 47.6% said yes
  • 52.4% said no

In the free response section, many members did not think visiting countries with unstable political climate (e.g., armed conflict, political or religious persecution) was safe. The Middle East was most frequently listed as the region in the world that was of concern. Furthermore, some were concerned about access to appropriate healthcare should they fall victim to illness during the trip.

Overall, it is interesting to note that approximately half of the members who responded to the question felt comfortable visiting anywhere in the world. This may be due to our current global membership and/or general thought that humanitarian efforts such as global outreach for spinal deformity have no boundaries. However, every effort ought to be made to make SRS endorsed global outreach activities as safe as possible.

In the upcoming months the Global Outreach Committee will be sharing the results of this survey with the Presidential Line and membership. Hopefully we can learn how better to introduce the concept of volunteering to new and emeritus members by making it easier to match a prospective volunteer with an endorsed site. The SRS endorsed sites have been researched and are only approved if they are felt safe for SRS members and their support staff. Endorsed sites are visited on at least an annual basis and have local physicians that agreed to follow patients in between visits. We are currently trying to standardize data collection in these sites so that a “ Global Outreach Study Group “can be formed to be able to analyze the results and success of these surgeries performed.

Lastly, I would encourage anyone who is interested in volunteering to visit the Global Outreach Program table at the Annual Meeting or the website for more information. Surgeons who are retired, or no longer operate, as well as researchers are invited to participate in some clinics or help in data collection for these sites. Most surgeons or volunteer staff who have been involved in Global Outreach will tell you that it is quite often a “life changing” experience. By donating a week or two you can help those in need in underserved countries and indirectly help yourself and your patients in your home countries also.

Chair: Kenneth J. Paonessa, MD Committee Members: Theodore A. Wagner, MD; Saumyajit Basu, MD; Samuel KW Cho, MD; Anthony S. Rinella, MD; Youssry MK El-Hawary, MD; Michael J. Mendelow, MD; Mohammed M. Mossaad, MD; Anthony P. Schnuerer, PA; Ahmet Alanay, MD; Kyu-Jung Cho, MD; Matthew J. Geck, MD; Hossein Mehdian, MD, FRCS(Ed)

2011 Corporate Supporters

Double Diamond Level Support

Depuy Spine K2M Medtronic

Diamond Level Support

Stryker

Platinum Level Support

Synthes Spine

Gold Level Support

Osteotech

Globus Medical

Trans1

Silver Level Support

Nuvasive Zimmer Spine  

Bronze Level Support

Ackermann Medical GmbH & Co. KG
Alphatec Spine, Inc.
Apatech
Biomet Spine
Biospace Med
BrainLAB
Ellipse Technologies, Inc.
Elsevier Canada
Exactech, Iinc.
FzioMed, Inc.
LANX
Lippencott Williams& Wilkins
NuTech Medical
Orthofix, Inc.
Orthovita
Paradigm Spine
Showa Ika
Spineguard, Inc.
Spine View
Vexim SAS
X-Spine

Sponsors In-Kind

DePuy Spine SpineCraft  

Strategic Plan

GOAL 1. Funding: The Scoliosis Research Society will have a funding base large and diversified enough to ensure financial independence in funding research and sound fiscal operating policies.

GOAL 2. Research: The Scoliosis Research Society will be the global source of research on spinal deformities

GOAL 3. Education: The Scoliosis Research Society will be the global source of education on spinal deformities

GOAL 4. Globalism: Through its members and programs, the Scoliosis Research Society will improve spinal deformity care globally

GOAL 5. Advocacy: The Scoliosis Research Society will be recognized as the leading resource for information and public policy on spinal deformities.

GOAL 6. Society Leadership: The Scoliosis Research Society will operate in a manner consistent with its stature as the pre-eminent spinal deformity society.

Vision Statement

The SRS will increase its recognition domestically and internationally as the leading source of information and knowledge on spinal disorders affecting all patients, regardless of age.