Dear SRS Members,
Greetings again from the windy city, Chicago. We are coming out of the cold winter and looking forward to a pleasant spring. I hope you all will enjoy the spring and the summer.
Summer for SRS leadership, committee chairs, and our dedicated staff is a very busy time, as we prepare for our most important functions: the 20th International Meeting on Advanced Spine Techniques (IMAST) and the 48th Annual Meeting & Course. The 20th Annual IMAST will be held in Vancouver, British Columbia, Canada from July 10 to the 13. It will be a great meeting with Instructional Course Lectures (ICLs), Debates, and Panel Discussions with global and diverse faculty. There have been 185 podium presentations and 135 posters accepted for IMAST. There will be 20 Hands-On Workshops (HOWs), conducted by numerous companies and vibrant exhibits, with more than 25 exhibitors showing their latest products. The 20th IMAST will be the first meeting where SRS will issue its own Continuing Medical Education (CME).
Congratulations to all of you and thanks to the many members who participated in the efforts to obtain the CME accreditation. Don’t forget to purchase your tickets for the Friday Night Course Reception, which will be held on Friday the 12th of July. It will be held at the terrace within the convention center with a spectacular view of the harbor and the mountains, along with plenty of food and drink. It will be a great opportunity to socialize with your friends and colleagues. I look forward to welcoming you all to the beautiful city of Vancouver. My appreciation to Christopher I. Shaffrey, MD, Justin S. Smith, MD, and the IMAST Committee for planning an outstanding IMAST meeting.
The preparation for the 48th Annual Meeting & Course in Lyon, France will be held from September 18th to the 21st is progressing ahead of schedule. John R. Dimar, MD and the Education Committee did an outstanding job in planning the Pre-Meeting Course entitled A Global Perspective of the Management of Spinal Disease & Deformity. There will be six Lunchtime Symposia of diverse topics and three Half-Day Courses for Thursday afternoon covering: myelomeningocele, sagittal deformity, and non-operative treatments. The chosen faculty consists of both SRS and SOSORT Members, and will cover different treatment schools from around the world. The Program Committee, chaired by Suken A. Shah, MD, received 1,439 abstracts, which is a record number. After all were blindly peer reviewed, 125 papers and 106 posters were chosen for the Annual Meeting, in addition to those chosen for IMAST. My sincere thanks go to John R. Dimar, MD, Suken A. Shah, MD, and the Education and Program Committee Members.
As my presidency year will come to an end in few months, I would like to take this opportunity to recognize all members who keep SRS progressing on track and contribute to its success. We have 33 committees and 11 task forces, all of which have been busy fulfilling their charges and diligently completing any added responsibilities during the year. In this newsletter, you will find the reports from some of the committee chairs, which highlight their activities. I sincerely thank all committee and task force chairs and members for their dedication and tireless efforts.
The Fellowship Task Force, under the leadership of Mark Weidenbaum, MD completed its charges and was disbanded. The Fellowship Task Force created the equivalence criteria for certification to fairly judge member applicants that live outside of the United States. It also studied the case list reporting process. You will read more about it in this newsletter from Laurel Blakemore’s, MD Fellowship Committee report. My sincere appreciation goes to Dr. Weidenbaum and the task force for achieving their goal in a timely fashion.
June is Scoliosis Awareness Month. SRS launched a nationwide campaign to get all 50 states to issue a proclamation declaring June as Scoliosis Awareness Month. These efforts are led by SRS Communications and Program Manager, Shahree Scarborough, MS and National Scoliosis Foundation President, Joseph P. O’Brien, MBA. Thanks to many of you who helped Shahree to get proclamations issued in your state. If your state did not issue the proclamation for this year, please contact Shahree and she will work with you to get this accomplished. Last year we had 40 states and 10 cities who issued proclamations, and we would like to get all 50 states to recognize June as Scoliosis awareness month.
Developing the appropriate use criteria (AUC) for adult degenerative deformity is progressing as planned. The funds from SRS, American Association of Neurological Surgeons (AANS) as well as DePuy Synthes, Medtronic, and K2M have been received by Collaborative Spine Research Foundation (CSRF). CSRF will be in charge of distributing it to RAND Institute to perform the AUC. We should have the results in 12-18 months. Speaking of CSRF, I met with its leaders during the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting in Chicago, Illinois in March, and they invited and encouraged SRS Members to submit to CSRF for research grants. This year the SRS Board of Directors authorized $300 thousand for the two research grant cycles, plus 40 thousand dollars which was given by the Golf Champion Stacy Lewis for a named research grant. Still, the Research Committee is not able to fund all of the grant requests. Therefore the CSRF is another resource to obtain research grants.
The Awards & Scholarships Committee, under the leadership of Lawrence L. Haber, MD has completed their award selection and awarded the highest number of awards ever, 26, thanks to the newly created awards for Robert B. Winter Fellowship and OrthoPediatrics scholarships and fellowships. You can read more about these award winners in Dr. Haber’s report in this newsletter.
Two important subjects, which are a part of my platform, are surgical safety and new educational venues. I assigned Kit M. Song, MD, MHA to lead the Surgical Safety Task Force. The Task Force will present a Lunchtime Symposium in Lyon, France about how to address surgical safety when problems arise and is working on creating checklists in the case of unexpected neurological events during spine surgery. These will be available by the time of the Annual Meeting. Frank J. Schwab, MD is leading another task force to explore new CME accredited educational venues. The Task Force is sending out a survey to all members asking for their suggestions for new educational venues. Please respond to this survey, as every member’s input is very important and valuable. One of the fulfillments of this task force is the accredited Cadaver Course, which will be conducted in Chicago, Illinois, October 3-5, 2013. The co-chairs Lawrence G. Lenke, MD and Christopher I. Shaffrey, MD have assembled an excellent faculty for a completely hands-on course.
The Worldwide Conferences Committee, under the leadership of the current chair, Ahmet Alanay, MD and Chair-Elect Marinus de Kleuver, MD, has presented six courses for 2013. The first was in Brazil in April in association with the Brazilian Spine Society (BSS), which I attended, and was very successful with approximately 350 attendees. Thank you to the course co-chairs, B. Stephen Richards III, MD and Luis E. Munhoz Da Rocha, MD. I invite all of you to attend any of these courses; beside the high quality of the educational program, it is a good opportunity to visit new places and meet new friends. All courses are listed on the SRS website.
As I have done in my previous communications, I would like to encourage all of you to donate to Research, Education, and Outreach Fund, “REO Fund.” Your gift will ensure the continuous success and strength of this great society. Our goal is to have all members participate regardless of the amount. I would like this year to fulfill the 100x100 slogan: 100% participation through a gift of at least $100. Donations can be done with online registration for the Annual Meeting, your Membership Dues payment, as well as on site at either meeting.
In closing, I would like to thank the Presidential Line: President-Elect Steven D. Glassman, MD, Vice President John Dormans, MD and Past President B. Stephen Richards, III, MD for their continuous support. I also express my sincere gratitude to our very capable staff under the leadership of the Executive Director, Tressa Goulding, CAE, CMP their dedication, expertise, and hardwork are exemplary. Thanks Tressa, Courtney, Cydni, Nilda, Katy, and Shahree.
I look forward to seeing you in Vancouver.
Best wishes to all,
Kamal N Ibrahim, MD, FRCS(C), MA
Page Walker Nelson, MD
Page Walker Nelson was a year ahead of me in the Baylor orthopaedic surgery program. I was not fortunate enough to have a rotation with him, but from what I heard from other residents, he was well liked by residents and staff. I did have the opportunity to see patients he had cared for and his work was always of the highest character.
He practiced with Dr. Paul Harrington for a period of time before entering private practice. He had a keen interest in scoliosis and was an advocate for the use of prophylactic antibiotics. He was an early member of the SRS, joining in 1973 and continuing after retirement as an emeritus member.
Dr. Nelson had a great interest in art, photography, and music and sang in the choir of the Central Presbyterian Church and the Houston Chamber Singers.
He was devoted to his wife Marjorie, his children and grandchildren. My last opportunity to visit with Page and his wife was about ten years ago at a Texas Orthopaedic Society dinner, when they sat at a table with Shirley and me. We had a truly delightful visit.
Page Nelson was a good and caring orthopaedic surgeon and will be greatly missed.
Albert E. Sanders, MD
San Antonio, TX
Brian G. Smith, MD
Advocacy Committee Chair
The SRS Advocacy Committee continues on its mission to promote awareness of scoliosis and its care by working to ensure that June is recognized as Scoliosis Awareness Month in states around the country. Every state in the Union has been approached through appropriate channels whether it is State Legislature or the Governor’s office to acknowledge and recognize Scoliosis Awareness Month in June of 2013. Each state has an SRS co-sponsor that is helping to facilitate this process and this has been headed by SRS staff member Shahree Scarborough, MS the Advocacy Committee liaison.
The SRS Advocacy Committee also is supporting the efforts of Joe O’Brien, MBA and the US Bone & Joint Initiative for developing World Scoliosis Day in October of 2013.
A recent significant focus of the Committee has been to support the SRS leadership in the American Academy of Orthopaedic Surgeons (AAOS) Unified Research Agenda (URA) with spine topics. The committee came up with a series of topics that they developed with appropriate references for the SRS Board of Directors. Topics felt to be worthy of inclusion or focus of the AAOS URA include patient safety issues in spinal deformity surgery such as infection, neuro-monitoring, the aging spine, and care of adult deformity. The committee has benefited from the strong support of all its members and especially the assistance of its staff liaison, Shahree Scarborough, MS.
Committee Chair: Brian G. Smith, MD Committee Members: Vishwas R. Talwalkar, MD; Matthew D. Hepler, MD; Robert H. Cho, MD; Jochen P. Son-Hing, MD; Baron S. Lonner, MD; Steven M. Mardjetko, MD, FAAP; Linda P. D’Andrea, MD; Michael D. Daubs, MD; Gary T. Brock, MD; Joseph H. Perra, MD; Joseph P. O’Brien, MBA; Stanley E. Sacks, MA.
Lawrence L. Haber, MD
Awards & Scholarship Committee Chair
This continues to be a banner year for SRS Awards and Scholarships. Since the last newsletter we have awarded two Life-Time Achievement Awards, the Blount Humanitarian Award, the Global Outreach Program (GOP) Travelling Fellowship and scholarships Nuvasive and Orthofix. In addition we had the exciting task of awarding the first Robert B. Winter Fellowship and the new Orthopediatric Travelling Fellowships and North American Scholarships. We need to thank all our corporate sponsors, the Robert B. Winter Foundation and our membership for their generosity and for enabling us to improve spine education worldwide. Below is a list of award winners.
SRS Lifetime Achievement Awards
George H. Thompson, MD-Chief of Pediatric Orthopaedic Surgery
Rainbow Babies and Children’s Hospital Cleveland, OH
Professor Case Western Reserve University
Ian A.F. Stokes, PhD – Research Professor Emeritus, University of Vermont
Walter P. Blount Humanitarian Award
Bettye A. Wright, PA, RN
Robert B. Winter Global Outreach Fellowship
Krishna Kumar Ramachandran Nair, MD, India, Amrita Medical Institute
Global Outreach Visiting Fellowships
Fady Michael Ibrahim, MD- Cairo, Egypt, Ains Shams University
Tie Liu, MD- Beijing, China – Chao Yang Hospital, Capital Medical University
Kawu Ahidjo Abdulhadin, FWACS – Abuja Nigeria, University of Abuja Teaching Hospital
Tomas Rolando Minueza Mejia, MD- San Pedro Sula, Honduras – Medical Cliinic los Andes
Edgar G. Dawson Visiting Fellowship
Han Jo Kim, MD- Dr. Kim is visiting Khaled Kebaish, MD in Baltimore, MD.
Global Outreach Educational Scholarships
Hrutvij Rajendra Bhatt, MD, Nadiad India
Andrei Joaquim, MD, Caminas City, Brazil
Naveen S. Tahasildar, MD, Hubli, India
Gaurav Raj Dhakal, MD, Kokata, India
Ahmad Allam, MD, Minia, Egypt
Ndubuisi Ebere Duru, MD, Enug, Nigeria
Orthopediatric International Pediatric Traveling Fellowship
Mohsen Karami- Tehran, Iran, Taleghani University
Miklos Tunyogi-Csapo, Hungary, University of Pecs Medical School
Eduardo R. Luque Award
Javier Pizones, MD, PhD. Dr. Pizones is visiting Lawrence G. Lanke, MD and Peter O. Newton, MD.
Orthopediatric North American Resident or Fellow Meeting Scholarships
Elias Dakwar- Shriners of Philadelphia
Andrew Pugely- University of Iowa
Robert Murphy- University of Tennessee
Michael Merrick- Grand Rapids Medication Education Partners- Michigan
Brian Kaufman- George Washington University
Courtney Odonnell- University of Washington- Seattle
Avrum Joffe- Rady Children’s Hospital, San Diego
Brett Lafleur- Wright State University, Ohio
Chair: Lawrence L. Haber, MD Committee Members: Stephen J. Lewis, MD; Youssry MK El-Hawary, MD; Suken A. Shah, MD; Charles E. Johnston, MD; Hubert Labelle, MD; Hilali H. Noordeen, FRCS; Saumyajit Basu, MD; Matthew E. Oetgen, MD; David M. Montgomery, MD; Avraam Ploumis, MD; John M. Wattenbarger, MD; Khaled Kebaish, MD; Hani Mhaidli, MD; Mohammad Mostafa Mossaad, MD.
Paul D. Sponseller, MD
The finances of the Scoliosis Research Society (SRS) continue to be healthy. The excellent financial management by the SRS staff and Dan Nemec, MBA, CAE on both the income and the expense sides of the budget, has allowed the Society to continue and maintain a healthy research agenda as well as expand its educational offerings. Attendance at both 19th International Meeting on Advanced Spine Techniques (IMAST) and the 47th Annual Meeting & Course in 2012 was better than expected, due to the strength of the educational programs. This allowed us a modest overage beyond expenses. Industry support for SRS educational programs accounts for 30 percent of our income. Fortunately, industry support continues to be nearly steady, at over $1.12 million, despite competitive pressures. We do need to be flexible enough to weather any changes in the future, and the Board of Directors monitors our support closely. The upcoming year brings an extra expense, as we cover the subscription costs for SRS’s new journal Spine Deformity.
The Robert B. Winter Fund has been established to honor our Past-President, and already contains over $316,000. Five percent of this amount will be distributed yearly and used to enhance international education. If you have a desire to honor Robert B. Winter, MD but have not done so, please contact the SRS office. The “new” Research Education Outreach (REO) Fund contains over $2.7 million which will be used to enhance our research offering. The wisdom of the Board of Directors to establish this SRS-controlled fund was born out as the market rebounded impressively over the past two years. Starting this year, we will use 4 percent of the average balance of this Board-Directed Fund to award to research. The Orthopaedic Research and Education Foundation (OREF) endowment is our other major source of research dollars, and contains $3.26 million at last report.
The research budget is largely made up of the OREF Designated Giving, distributions from our OREF account, and from the REO Fund. In 2012, the research budget contained $222 thousand available for competitive research awards. This year, President Kamal N. Ibrahim, MD, FRCS(C), MA has committed to making that amount no less than $300 thousand, in recognition of the many high-quality research projects that the committee receives. In order to maintain and build our endowment, and improve our research funding in years to come, we urge each and every SRS member to contribute what they can through the REO Fund or OREF. Our goal is to have every SRS member contribute to REO Fund in some amount, no matter how small or large, so we put our support behind our mission.
Please contact me at any time if you have questions about SRS finances. It is a privilege to be Treasurer of such a focused and giving organization.
Paul D. Sponseller, MD
Laurel Blakemore, MD Fellowship Committee Chair
The Committee thoroughly reviews Candidate, Associate and Active applications twice a year providing their recommendations to the Board of Directors (BOD) for final approval at the September and March BOD meetings.
Our Fellowship continues to grow at a gradual pace with very enthusiastic and qualified individuals. We are pleased to announce our new 2013 Fellows.
Marc A. Agulnick, MD
Rodrigo A. Amaral, MD
Dheera Ananthakrishnan, MD
Lindsay M. Andras, MD
Paloma Bas Hermida, MD
S. Samuel Bederman, MD, PhD, FRCSC
Donald J. Blaskiewicz, MD
Benjamin R. Cohen, MD, FAANS, FACS
Satoru Demura, MD
Meric Enercan, MD
Michael J. Faloon, MD, MS
Charla R. Fischer, MD
Nicholas D. Fletcher, MD
Kai-Ming Gregory Fu, MD, PhD
Diana Glaser, PhD
Matthew A. Halanski, MD
Katsumi Harimaya, MD
Alexander P. Hughes, MD
Antonio Hurtado, MD
Steven W. Hwang, MD
Brice Ilharreborde, MD, PhD
Michael B. Johnson, MD
Nima Kabirian, MD
Han Jo Kim, MD
Jean-Christophe A. Leveque, MD
G. Ying Li, MD
Marios G. Lykissas, MD, PhD
Addisu Mesfin, MD
Hideki Murakami, MD, PhD
Jambuladinne Naresh-Babu, MD
Chris J. Neal, MD
Edward K. Nomoto, MD
Gabriel Piza Vallespir, MD, PhD
Themistocles Protopsaltis, MD
Miguel H. Puigdevall, MD
Bangping Qian, MD
Kristen E. Radcliff, MD
Ra'Kerry K. Rahman, MD
Paulo José Silva Ramos, MD
Benjamin D. Roye, MD, MPH
Denis Sakai, MD
Ricardo Acacio Santos, MD
Shoji Seki, MD, PhD
Krzysztof B. Siemionow, MD
Paul Stanton, DO
Hui-Ren Tao, MD, PhD
Luis Eduardo Carelli Teixeira Da Silva, MD, MSC
Senthilnathan Thirugnana Sambandam, MBBS, MS (Ortho)
Per D. Trobisch, MD
Bekir Yavuz Ucar, MD
Akin Ugras, MD
Cheerag D. Upadhyaya, MD, MSc
Eugene Wong, MD, MS
Shu-Hua Yang, MD, PhD
Jim A. Youssef, MD
Abla M. Hamed, PhD
Marjolaine Roy-Beaudry, M.Sc
|Isabelle Turgeon, B.Sc.|
Special congratulations to our new Active Fellows (53) who have successfully completed the five-year Candidate process and are now voting members.
Peter D. Angevine, MD, MPH
Mark A. Barry, MD
Saumyajit Basu, MD
Shay Bess, MD
Patrick P. Bosch, MD
Jacob M. Buchowski, MD, MS
Patrick Cahill, MD
Michelle S. Caird, MD
Mladen Djurasovic, MD
Robert K. Eastlack, MD
Salah Fallatah, MD
Aruna Ganju, MD
Shawn R. Gilbert, MD
Hubert Lee Gooch, Jr., MD
Jonathan N. Grauer, MD
James S. Harrop, MD
Kyoichi Hasegawa, MD, PhD
Martin J. Herman, MD
Richard Hostin, MD
Enrique Izquierdo, MD
Hak-Sun Kim, MD
Wael Koptan, MD
Anant Kumar, MD
Robert Labrom, MD
Frank La Marca, MD
Ming Li, MD
Mark D. Locke, MD
Anis Mekhail, MD
Hooman M. Melamed, MD
Andrew W. Moulton, MD
Daniel S. Mulconrey, MD
Ian W. Nelson, MB, BS, MCh Orth, FRCS
Vikas V. Patel, MD
Ferran Pellisé Urquiza, MD, PhD
Peter S. Rose, MD
Yutaka Sasao, MD
Jeffrey R. Sawyer, MD
Alpaslan Senkoylu, MD
Jeffrey Scott Shilt, MD
Jochen P. Son-Hing, MD, FRCSC
Jonathan R. Stieber, MD
Sanjeev Suratwala, MD
Katsushi Takeshita, MD
Kent Vincent, MD
Michael G. Vitale, MD
Surya Prakash Rao Voleti, MS, DNB
Camden Whitaker, MD
Klane K. White, MD, MSc
Yat Wa Wong, MD
Walid K. Yassir, MD
Burt Yaszay, MD
Xuesong Zhang, MD
Yonggang Zhang, MD
New Active Fellows accepted through the Fast Track program (7).
Benny Dahl, MD
Marcel F. Dvorak, MD, FRCSC
Michael G. Fehlings, MD, PhD, FRCSC, FACS
Regis W. Haid, Jr., MD
Luis Eduardo Munhoz da Rocha, MD
S. Rajasekaran, MD, PhD
Thanh Van Vo, MD, PhD
New Emeritus Fellows (13):
David D. Aronsson, MD
Alvin H. Crawford, MD
Jean-Pierre C. Farcy, MD
Barney L. Freeman, III, MD
Glen M. Ginsburg, MD
William A. Herndon, MD
John A. Herring, MD
Dan E. Mason, MD
Paul W. Pavlov, MD, PhD
Kent A. Reinker, MD
Albert E. Sanders, MD
Earl Austin Stanley, Jr., MD
Dennis R. Wenger, MD
In late 2003, the SRS announced that the membership would be expanded to allow inclusion of qualified neurosurgery colleagues interested in spinal deformity. Prior to that time, only three orthopaedics/neurosurgeons were active in the society, who came in under the orthopaedic track. The 2004 neurosurgeon candidate class successfully completed their five year term, applied and became Active Fellows of the SRS under the new guidelines. With the inclusion of the class of 2013, the total number of neurosurgeons who have achieved active membership status in the society will reach 43.
|Neurosurgeons||Prior to 2004||2004||2005||2006||2007||2008||2009||2010||2011||2012||2013||Total|
The SRS continues to promote international participation and membership. As of 2013 we will achieve 27% total participation from members outside of North America.
|Bosnia and Herzegovina||1||1||1|
|Bosnia and Herzegovina||1||1||1|
|Peoples Republic of China||11||3||1||15||15|
|United Arab Emirates||3||3||3|
Fast Track to Active Fellowship:
The SRS would like to offer senior surgeons who have made a significant contribution to spinal deformity an opportunity to become SRS members through an accelerated approach. The Fast Track option will bypass the five year candidate period and offer an Active Fellowship, if all prerequisites are met. This option will expire June 30, 2014. Application deadlines are December 1 and June 30 of every year.
If you know of a senior spine surgeon who would be interested, please have them contact Nilda Toro, Membership Manager at email@example.com.
For more fast track details visit: http://www.srs.org/professionals/membership/fast_track_approach_to_active_fellowship.htm
Morbidity and Mortality:
Thank you to all who submitted their 2012 online M&M report. Dr. Burton, M&M Committee Chair, will present the findings during one of the business meetings at the Annual Meeting & Course in Lyon, France.
The M&M site for the 2013 reporting year is already open. The same data will be collected in 2013. Please make sure to stay ahead and enter your M&M data quarterly.
Our M&M data is available to you for your own research through a Request for Proposal that is located on the Members-Only section of the SRS website under Morbidity and Mortality.
Special Member Benefits:
Laurel Blakemore, Committee Chair
Nilda Toro, SRS Liaison
Committee Chair: Laurel Blakemore, MD Committee Members: Hilalli Nordeen, FRCS, Douglas Burton, MD Munish C. Gupta, MD and Carlos Tello, MD.
John R. Dimar II, MD
Education Committee Chair
The Scoliosis Research Society’s (SRS) Education Committee has been working diligently on finishing the planning for the 48th Annual Meeting & Course in Lyon, France. Final planning for the Pre-Meeting Course, six Lunchtime Symposiums, and three Half Day Courses was completed during the annual American Academy of Orthopaedic Surgeons (AAOS) committee meeting in March. The committee had taken an “inclusive” approach to the selection of the faculty by selecting a diverse panel of the best expert speakers from all the membership. Since the meeting is in Lyon this year, we also have invited many of our international colleagues to speak on a broad array of topics to inform the membership about the global contribution to spine surgery and offer a potentially different perspective on the treatment of spinal disease. By now most of the proposed faculty should have received letters of invitation for the meeting and they are encouraged to respond favorably as soon as possible.
We look forward to having all of our members attend the meeting and have tried to craft a highly informative and educational meeting. Most of the course activities will be Continuing Medical Education (CME) accredited and new this year, the CME credits will be expanded to include several Lunchtime Symposiums. The Pre-Meeting Course will follow last year’s agenda of having a combined meeting on topics that are relevant to all the members followed by two concurrent courses, one adult-oriented and one pediatric-oriented, followed by an afternoon session covering additional topics relevant to the entire membership. The Lunchtime Symposiums will present several fascinating topics including radiation exposure and safety, crisis management in the operating room, neuromonitoring dilemmas, and the annual report of the SRS sponsored research projects. The Half-Day Courses should also prove interesting and offer a diverse opportunity for the varied interest of all members. The three courses include Sagittal Balance, Surgical Decision Making and Surgical Techniques, the difficult challenges of treating Myelomeningocele patients and a full representation of the available non-operative and brace treatment techniques that will be jointly presented with International Society on Scoliosis Orthopaedic Rehabilitation and Treatment (SOSORT). The committee hopes that the courses provide a diverse program to meet every member’s educational needs.
The committee is currently planning the SRS yearly submissions to the AAOS and Federation of Spine Associations (FOSA) for 2014 Annual Meeting and plans to submit four symposiums to the academy. Our hope is that all members of SRS, in the future, will consider submitting either an Instructional Course Lecture (ICL) or Symposium to the AAOS on behalf of the society next year to increase our participation and exposure at the meeting.
Chair: John R. Dimar II, MD Committee Members: Mark B. Dekutoski, MD; Suken A. Shah, MD; Frank J. Schwab, MD; Ahmet Alanay, MD; Paul D. Sponseller, MD; Terry D. Amaral, MD; Christopher P. Ames, MD; Michael S. Chang, MD; Robert H. Cho, MD; Brian Hsu, MD; Andrew H. Jea, MD; Elias C. Papadopoulos, MD; Scott S. Russo, MD; Adam L. Wollowick, MD; Lukas P. Zebala, MD; Lori A. Karol, MD; Daniel W. Green, MS, MD, FACS; Sigurd H. Berven, MD; John C. France, MD; Kit M. Song, MD, MHA; S. Rajasekaran, MD, FRCS, MCh, PhD; Mark Weidenbaum, MD
James W. Roach, MD
Ethics Committee Chair
This is a report requested by the Scoliosis Research Society (SRS) Presidential Line regarding potential ethical issues arising from physician owned distributorships. A physician owned distributorship (POD) is a business entity, typically solely owned by physicians, that purchases medical implants from manufacturers and resells them to hospitals. Some PODs are also involved in manufacturing or modifying the medical implants before resale but most are only distributing the devices. The POD business plan often describes potential savings for the purchasing hospitals because the POD seeks a discount from the manufacturer and therefore offers the hospitals a lower price. Presumably the manufacturer would discount the implant because the POD either assures large volume purchasing or the POD has an exclusive arrangement with the hospital to provide the implants.1
PODs are found in 20 states with the majority thought to be in California and Texas. It is estimated that over 200 PODs exist, usually focusing on orthopaedic spine and total joint implants. Important legal concerns have been posed especially if the POD has an exclusive purchasing agreement with a hospital and the surgeon/investors of the POD also control implant selection by the same hospital. These legal issues include possible physician violation of the Stark Law regarding illegal self-referral and possible hospital violation of the anti-kickback law regarding improper inducement of referrals.2, 3
While the legal considerations exist, they are beyond the scope of this discussion which will only outline the potential ethical issues for SRS members. Even if the POD is constructed to be a proper business entity and adds value to the process of hospital implant purchasing there are still several ethical areas of concern for a practicing physician who owns a share of a POD. In the Senate Finance Committee report dated June 2011 the authors described the ethically difficult position for a POD surgeon/investor of being “the seller, buyer, and person making the decision about what is best for the patient”.2
We will consider several of the SRS Standards of Professionalism which can be directly applicable to PODs.
SRS SOP Providing Musculoskeletal Services to Patients
Standard 1. A spinal surgeon shall, while caring for and treating a patient, regard his or her responsibility to the patient as paramount.
Standard 5. A spinal surgeon shall serve as the patient’s advocate for treatment needs and exercise all reasonable means to ensure that the most appropriate care is provided to the patient.
If the POD pays the surgeon/investor based on the number of POD implants the surgeon/investor uses or if POD participation influences a surgeon to only use POD implants that are more expensive than other equally effective implants, then the surgeon/investor could be inappropriately incented to perform unnecessary surgery or unnecessarily expensive surgery. Historic evidence suggests that this can occur. Procedure utilization significantly increased in California in 1992 when physician owed imaging centers were developed4 and in a study, cited by the Senate Finance Committee, spinal fusion rates increased over 300% one year after surgeons formed a POD.2 Performing unnecessary surgery or unnecessarily expensive surgery would not be the best for the patient.
Standard 13. A spinal surgeon shall disclose to the patient any conflict of interest, financial or otherwise, that may influence his or her ability to provide appropriate care.
The surgeon would violate Standard 13 is they failed to disclosure their POD involvement to the patient.
Standard 15. A spinal surgeon shall make a reasonable effort to ensure that his or her academic institution, hospital or employer shall not enter into any contractual relationship whereby such institution pays for the right to care for patients with musculoskeletal conditions.
If a surgeon’s POD was found illegal under the Federal Anti-kickback law that would be a violation of Standard 15.
Standard 16. A spinal surgeon or his or her professional corporation shall not couple a marketing agreement or the provision of medical services, supplies, equipment or personnel with required referrals to that spinal surgeon or his or her professional corporation.
Standard 16 would be violated if a surgeon’s POD was successfully convicted under the Stark law.
SRS SOP Conflict of Interest Standard
Standard 2. A spinal surgeon shall prescribe drugs, devices, and other treatments primarily on the basis of medical considerations and patient needs, regardless of any direct or indirect interests in or benefit from industry.
Similar to Standards 1 and 5 under Providing Musculoskeletal Care to Patients above, the COI Standard 2 would be violated if the surgeon placed personal economic benefit before the needs of the patient.
Standards 9. A spinal surgeon shall accept no direct financial inducements from industry for utilizing a particular implant or for switching from one manufacturer’s product to another.
Standard 10. A spinal surgeon shall enter into consulting agreements with industry only when such arrangements are established in advance and in writing to include evidence of the following:
• Documentation of an actual need for the service;
• Proof that the service was provided;
• Evidence that physician reimbursement for consulting services is consistent with fair market value; and • Not based on the volume or value of business he or she generates.
A surgeon’s business relationship with a POD should not require the use of the POD’s implants and the surgeon’s remuneration from the POD should not be determined on the surgeon’s case volume sent to through the POD.
In summary there are a number of potential ethical issues that a physician/investor may encounter if they choose to participate in a POD.
1. Steinmann J HG, Burton P, Skubic H. Surgeon Ownership in Medical Device Distribution: Economic Analysis of an Existing Model. Scientific Exhibit SE48: 2009 AAOS Annual Meeting 2009.
2. O H. Physician Owned Distributors (PODs). Senate Finance Committee 2011.
3. Bal BS BL. Physician-owned distributorships face increased scrutiny. Orhtopedics Today 2013.
4. Swedlow A, Johnson G, Smithline N, Milstein A. Increased costs and rates of use in the California workers' compensation system as a result of self-referral by physicians. The New England journal of medicine 1992; 327(21): 1502-6.
Chair: James W Roach MD Committee Members: J Abbott Byrd, MD; Richard E. McCarthy, MD; Michael J Bolesta, MD; Brian G. Smith, MD; M. Wade Shrader, MD
D. Raymond Knapp, MD
Patient Education Committee Chair
The goal of the Patient Education Committee is to coordinate the development of patient materials, primarily for the website. We began the year working on the Adolescent Idiopathic Scoliosis section on the Orthoinfo.org section of the American Academy of Orthopaedic Surgeons (AAOS) website.
We then received a proposal from Medikidz to update and edit their comic book on scoliosis. Medikidz is a medical education company which utilizes comic books with super heroes to help children better understand various disease processes. Each comic book is dedicated to a specific condition. This project was approved and our committee will furnish content for the book. In addition to educating children about scoliosis, the comic book will reflect the Scoliosis Research Society’s (SRS) involvement in the project.
The Website Committee requested the committee to evaluate and make suggestions on the patient and family educational video segment on posterior spinal fusion for thoracic scoliosis.
Lastly, the committee plans to update the Spinal Deformity handbook for patients on scoliosis and kyphosis presently available through the SRS office. We will specifically address Adolescent Idiopathic Scoliosis. Our hope is to have this booklet reviewed through the appropriate committees at Pediatric Orthopaedic Society of North America (POSNA) and AAOS and then be endorsed and utilized by all three organizations.
Chair: D. Raymond Knapp, MD Committee members: Christopher Bergin, MD; Andrew K. Cree, MD; James T. Guille, MD; Tenne J Guillaume, MD; Masood Shafafy, MD; Toni Cawley, RN ONC; Robert P. Huang, MD; Patricia N. Kostial, BSN RN; Michael C. Albert, MD; Craig P. Eberson, MD; Anna McClung, BSN RN
Jeffrey D. Coe, M.D
Adult Deformity Committee Chair
The Adult Deformity Committee has continued the projects that had been initiated by the committee under the leadership of Sigurd H. Berven, MD last year. The Adult Deformity Surgical Indications White Paper was completed in October of 2012 shortly after a committee conference call, approved by the Scoliosis Research Society (SRS) Board of Directors and Presidential Line and is now posted on the SRS website. Within the next few months, this statement will be submitted to the new SRS Spine Deformity Journal for publication.
The Adult Deformity Committee will be coordinating with the Website Committee to further improve the content for patient education on adult deformity. One part of this effort will be to create a version of the Adult Deformity Surgical Indications White Paper with simplify the language so our patients can better understand why deformity surgery may be beneficial for them or their family members.
The Adult Deformity registry project has moved forward with coordination with the National Neurosurgery Quality Outcomes Database (N2QOD), which is already in place as a degenerative spinal surgery registry. The Committee, together with the N2QOD leadership (including SRS members Christopher I. Shaffrey, MD and Praveen V. Mummaneni, MD), has generated two draft registry modules, one for simple deformity and another for complex deformity. A conference call was held in early June to finalize these modules.
The Adult Deformity Committee has also been charged with developing a classification for Cervical Spinal Deformity. This is anticipated to be a multi-year project that will be based on the best evidence available regarding this aspect of spinal deformity.
Finally, the Adult Deformity Classification System initiated several years ago under the chairmanship of Frank J. Schwab, MD has achieved completion as evidence by the publication of validation studies in both marked and unmarked radiographs that have validated the reproducibility of this system.
Committee Chair: Jeffrey D. Coe, MD. Committee Members: Sigurd H. Berven, MD; Christopher DeWald , MD; Christopher P. Ames, MD; Charles Kuntz, MD,;Jung-Hee Lee, MD; Gregory M. Mundis, MD; Ferran Pellise, MD; Scott S. Russo, MD; Rajiv K. Sethi, MD; Andrew K. Cree, MD; Donald A. Deinlein, MD; Daniele A. Fabris-Monterumici, MD; Lloyd A. Hey, MD; Michael D. Kasten, MD; Michael D. Daubs, MD; Kenneth J. Paonessa, MD.
B. Stephens Richards, III, MD
Nominating Committee Chair
Between December 2012 and March 2013, the society’s membership was encouraged to submit nominations for the following positions: Vice president, Secretary-elect, three at-large members for the Board of Directors, Research Council Chair, and Fellowship Committee member. The Nominating Committee has subsequently had monthly conference calls to discuss many qualified potential candidates. The list of nominations will be finalized and, following the 20th International Meeting on Advanced Spine Techniques (IMAST) in July, the SRS membership will be presented the candidates through an SRS E-news. The nominees will then be voted upon at the first membership business meeting in September during the 48th Annual Meeting & Course in Lyon, France.
Chair: B. Stephens Richards, III, MD Committee Members: Behrooz A. Akbarnia, MD; John B. Emans, MD; Richard E. McCArthy, MD; Daniel J. Sucato, MD
Hubert Labelle, MD
3D Scoliosis Committee Chair
Over the past year, the 3D Scoliosis Committee continued its three main mandates of developing a 3D classification of Adolescent Idiopathic Scoliosis (AIS), of performing 3D analysis of scoliosis and its treatment, and of promoting 3D analysis of scoliosis.
Important work was started on the project supported by a grant from Orthopaedic Research and Education Foundation (OREF) ("Prospective Multi-center analysis on 3D factors involved in the decision to perform a selective vs. non-selective fusion in AIS"; 2012-15). Seven centers are involved in the study (Manhattan, Baltimore, Philadelphia, Miami, San Diego, Wilmington, and Montreal). The protocols for the 3D reconstruction process was developed and tested, Institutional Review Board (IRB) approvals were obtained, and the first cases were recruited in 2013.
As part of another grant from the Canadian Institutes of Health Research (“Towards a 3-D classification of AIS”; 2010-13), some fuzzy clustering analysis was done using 3D indices and a database of 183 cases. Other work is being done to analyze the torsion of the scoliotic spine.
A 3D viewer (Clindexia software) along with a small database of 3D reconstructed cases was made available to the members of the 3D Scoliosis Committee. This will allow members to visualize the spine in 3D.
One of the main challenges remains to see, and to integrate the information brought by adding the 3rd dimension. A more complete graphic display of the transverse plane (or ‘’top view’’) of scoliosis is under development to allow a better understanding of how the various curves as well as other body indices seen in the frontal plane are oriented in the 3D space and how correction in 3D can be achieved after surgery, such as in the example shown below. A working day is planned either during the 20th International Meeting on Advanced Spine Techniques (IMAST) or the 47th Annual Meeting & Course for the 3D committee to analyze 3D cases and define criteria to interpret the 3D parameters.
Chair: Hubert Labelle, MD Committee Members: Carl Eric Aubin, PhD, P.Eng; Lawrence G. Lenke, MD; Roger P. Jackson, MD; Peter O. Newton, MD; Stefan Parent, MD, PhD; Virginie C. Lafage, PhD
Double Diamond Level Support
Platinum Level Support
Silver Level Support
Bronze Level Support
Ackerman Medical GmbH
Apatech Ltd, a Baxter Co.
Lippincott, Williams, Wilkins
Osseon Therapeutics, Inc.
Providence Medical Technology
Salient Surgical Technologies
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.
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.
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