SRS Newsletter
March 2012

President's Message

SRS president

Greetings from Dallas, Texas, where the springtime's warmth and emerging colors are upon us. This has been a wonderful year to be a part of the SRS team, as the Society's productivity has never been greater.

Much has happened since our last newsletter in December. We held a productive Board of Directors (BOD) meeting during the February 2012 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting in San Francisco, California, USA. From the committee reports delivered, our 33 committees and ten taskforces are hard at work completing their numerous charges. These are year-long tasks and we're fortunate to have strong leaders in the committee chair positions. The next day, we held a half-day seminar on the development of Appropriate Use Criteria (AUC) and Medical Decision Modeling. Teryl Nuckols, MD, an expert with the RAND Corporation, joined us as we further explored this concept for our Society. Earlier in October 2011 at the Cabinet Meeting, we'd held an introductory half-day primer course on this topic. James O. Sanders, MD has written a wonderful article about these critical issues of AUC and Clinical Practice Guidelines in this newsletter. I urge you all to read it. These concepts and the criteria and guidelines which will be developed will have a tremendous impact on all of us in the future. SRS is working to be a part of that development and have an input into how this activity proceeds.

Congratulations to Mark Dekutoski, MD and Joseph Perra, MD co-chair and past-chair, respectfully, of the Education Committee, who assembled an excellent SRS portion of the FOSA Specialty Day at the AAOS Annual Meeting. Their program revolved around our Society's beginning involvement with the development of Medical Decision Modeling and AUC in Adult Lumbar Degenerative Scoliosis. This project is important because of its potential to have an impact on public policy makers and third-party payers, two areas of significant importance to Society members. The presentations were very well received by the many spine surgeons in attendance.

The RAND Corporation is submitting a proposal to SRS to further develop this Adult Lumbar Degenerative Scoliosis project, utilizing the RAND/UCLA Appropriateness Method, with the goal of creating useful and productive AUC. Our corporate supporters recognize the importance of this project and have made a commitment to assist in the funding of this endeavor.

I had mentioned in my previous President's Message that SRS was exploring the possibility of launching a public awareness campaign to emphasize the importance of spinal deformity care. We contacted three national public relations firms for proposals and scrutinized each of these proposals carefully. We learned a lot. First, this would be an expensive project, and one in which we'd need to rely on the expertise of public relations personnel, none of whom are currently part of SRS. Second we recognized that we are already deeply engaged in many areas of public awareness through our website's patient stories, white papers, interaction with patient support groups (National Scoliosis Foundation and Scoliosis Association) to promote activities such as June Scoliosis Awareness Month, the promotion of scoliosis screening, E-Text development, the emerging social media such as Facebook, and many more. As the SRS BOD discussed this potential project more in-depth, it became increasingly apparent that we should direct our energy and finances toward our Society's strengths, those being education, research, and outreach. As a result, we will not be pursuing a public awareness campaign at this time.

Our Society's final application to become an ACCME accredited institution has been submitted and an interview with the ACCME was held in March. Glenn Rechtine, MD, CME Committee Chair, has been deeply involved in the application process along with Tressa Goulding, CAE, CMP and Courtney Kissinger from our executive office. A final decision will be made by ACCME in July. If we are fortunate enough to become a CME provider, there are many potential educational events for members that would allow for CME credits.

Our international Traveling Fellowship will be slightly different this year. For the first time, we will have a senior member accompany our traveling fellows. Michael McMaster, MD, DSc, FRCS (Scotland) will join Ian Harding, BA, FRCS (Orth) (United Kingdom), Srinivasa Vidyadhara, MS, DNB, FNB (India), and Elias Papadopoulos, MD (Greece) as they tour Philadelphia, Dallas, and St. Louis prior to the Annual meeting in Chicago, Illinois, USA.

With regard to our primary educational events of the year, the Program Committee (Daniel J. Sucato, MD, MS - Chair), Education Committee (Mark B. Dekutoski and John R. Dimar, II, MD - Co-Chairs), and IMAST Committee (Christopher I. Shaffrey, MD - Chair) have been organizing excellent programs for IMAST in Istanbul in July, as well as the Annual Meeting and Pre-Meeting Course in Chicago in September. This year, more than 1,200 abstracts were submitted for podium and poster presentations. I've had an opportunity to review the preliminary programs for both meetings, and they are outstanding in the quality of presentations, and with regard to the new ideas on organizing the programs. The one-day Pre-Meeting Course will focus on the last decade of changes in spine deformity treatment, with particular emphasis on what has or hasn't led to improvement for patients.

As you'll recall, late last fall the E-Text was made available to everyone who visits the website. Not only does this resource provide valuable educational opportunities to members, it has great potential for residents and fellows in training, international spine surgeons, and many ancillary personnel. As of the end of January 2012, there have been approximately 2,700 pages viewed by 259 individuals; 150 of whom are non-members. To me, this spells success for this project. Please continue to pass this information on to all of your residents and fellows, as well as patients when appropriate.

In February 2012, New Delhi, India was the site of a very successful SRS Worldwide Conference. Three more Worldwide Conferences are scheduled for this year: in Amsterdam, Netherlands (Spine Week May 30-31), Tel Aviv, Israel (October 18-19), and Ho Chi Minh City, Viet Nam (November 30-December 2). Currently, there are four Worldwide Conferences scheduled for 2013, including Brazil (April 27-28), Cappadocia, Turkey (April 17), Kharkiv, Ukraine (May 23-24), and Bosnia/Herzegovina (November 1-2). A fifth 2013 Worldwide Conference may also be held again in China. All of these outreach educational endeavors truly reflect the incredible international expansion of our society.

Please take the time to visit the new Research, Education, and Outreach (REO) Fund page on the website and consider making a donation to it. Your financial generosity will strengthen our society and demonstrates your strong commitment to the future of the SRS. Our goal is to have every member make a donation to this fund, regardless of the amount. We'd like to include you in this group!

As before, I sincerely thank all of our members involved in leading efforts for this society. There is always room for more interested members who wish to participate in committee work, and I encourage everyone to give this strong consideration. Soon you'll be receiving a request for submitting your name for 2012-2013 committee appointments. Please respond positively!

All of us on the Presidential Line (President-Elect Kamal N. Ibrahim, MD, FRCS(C), MA; Vice President Steven D. Glassman, MD; and Immediate-Past President Lawrence G. Lenke, MD; and I) hope your 2012 is already proving to be a fantastic year.

My best to you,

B. Stephens Richards

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


James Warren Tupper

James Warren Tupper, MD

4/20/1928 ~ 12/27/2011

Jim Tupper was born April 20, 1928 in Billings, Montana, USA, and passed on in Seattle December 27, 2011 of complications following open-heart surgery. A strong, athletic man who thrived despite numerous accidents and injuries, Jim fought optimistically to recover from cardiac surgery with the same determination that characterized his approach to every other challenge life presented. He died peacefully, generously sharing his love with others to the end. Jim moved to Seattle with his parents, Warren Ernest and Ada Frances Tupper, at age two. He loved Seattle and spent his childhood playing in vacant lots behind Seattle Pacific University, skiing, and boating in the San Juans. An outstanding student, he played football and tennis at Queen Anne High School. Jim studied pre-medicine at the University of Washington (for which he retained a lifelong affection); he was a member of the Phi Delta Theta Fraternity, rowed three years on varsity crew, and met Sylvia Marie Nilsen, whom he married on June 6, 1953. Following his graduation from the University Of Pennsylvania Medical School in 1953, he completed an internship at the University of Michigan and residency in orthopedics at the University of Washington. He served as a navy physician during the Korean War, both in the Pacific and stationed at Bremerton. Jim trained in Texas with the renowned spine surgery pioneer, Paul Harrington; following this personal mentorship, he returned to Seattle and specialized in scoliosis treatment and research, along with general spine and neck surgery. Hired by orthopedic surgeons Forest Flashman and John Stewart, Jim helped establish the Seattle practice that became Orthopedic Physician Associates.

A successful surgeon and compassionate physician, Jim was a founding member of the Scoliosis Research Society and respected internationally as a lecturer and teacher. Jim and Sylvia became the parents of five fortunate children. While medicine fascinated Jim, he was always most committed to his family, with whom he skied, water-skied, hiked, jogged, rowed, boated, sang, and engaged in a plethora of work projects. An avid athlete and outdoorsman, he was a founder of Skiers Inc. at Crystal Mountain and a member of the Ancient Skiers. He loved construction and crafting furniture and other wood-based objects. In collaboration with a contractor friend, he built the family home in Laurelhurst and much of a vacation home on Lake Goodwin. Following his retirement from medicine in 1986, he was continually engaged in projects for others, and especially enjoyed teaching his grandchildren how to use a chain saw and split wood. A committed member of University Congregational Church, Jim valued "honesty and integrity" above all else in human relations. Jim is survived by his wife Sylvia; children Brad, Christy, Kari, and Kathie; grandchildren Haley, Hillary, Helaina, Seth, Luke, Kaelyn, Lauren, William Seth, Anna, James, Shannon, and Kyle; and great grandchildren Josiah, Peter, and Devin. He was preceded in death by his parents, his siblings Margaret and Tom, and his son Carl.

Published in The Seattle Times on January 1, 2012

Barbara Jane Manna, RN

Barbara Jane Manna, age 66, of Overland Park, Kansas passed away on Saturday, April 23, 2011 at Kentucky University Medical Center. Manna was born on May 26, 1944 in Pittsburgh, Pennsylvania, the daughter of Jane (McCarty) and James Unangst. She graduated from Sewickley, Pennsylvania College of Nursing in 1965 and worked as a registered nurse at Kentucky University Medical Center for 35 years. Barbara married Ronald A. Manna in Pittsburgh, Pennsylvania in 1965. Prior to working at the Kentucky University Medical Center, she was a nurse at five other hospitals, two of which were VA Hospitals, while her husband Ronald served in the United States Army. She enjoyed golf, playing bridge, quilting and playing in the hand bell choir at her church, The United Methodist Church of the Resurrection. Survivors include her husband, Ronald; three sons, Mark (Priti Lakhani) Michael (Jennifer) and David (Dawn) two sisters, Kathy (Jim) Brede and Debbie Hein; one brother, Robert Unangst and five grandchildren, Paul, Jacob, Ellie, Anthony and Andrew. She was preceded in death by her parents. Manna was a SRS Associate Member.

Published in Kansas City Star on April 26, 2011


Kenneth "Van" Jackman, MD

Kenneth "Van" Jackman, MD, Emeriti Professor of pediatric orthopaedics at the University of Rochester, age 69, passed away peacefully at his home on Upper Saranac Lake surrounded by family on Wednesday, August 18, 2010 after a six-month battle with Amyotrophic Lateral Sclerosis (ALS). He is survived by his loving family, wife Carol, of 46 years, son Stephen V. Jackman, MD (Dana Schultz) of Pittsburgh, Pennsylvania, daughter Lauriann J. Garland (Jim) of Seattle, Washington, grandchildren Connor and Dylan Garland, and Reilly and Piper Jackman, sister Diana Raney of Pasadena, California, USA, brother-in-law Dirck Benson Jr. (Cary) of Princeton, New Jersey, and golden retriever, Ceilidh. He received his Bachelors degree at Pomona College in 1963, his Medical Degree at the University of Rochester in 1967, and served at the US Naval Hospital Guam, 1969-71. In Saranac Lake, he was a member of Search and Rescue Association of the Northern Adirondacks (SARANA), Adirondack Amateur Radio Assoc (AARA) and a naturalist volunteer at The Wild Center (Natural History Museum of the Adirondacks). A former Eagle Scout, he volunteered with the Otetiana Council, Boy Scouts of America. An avid bag piper, he had been a member of the Rochester Scottish Pipeband, Feadan or and Ceilidh Connection. A bagpipe concert in celebration of his life took place September 19, 2010. Kenneth Jackman was an Active Member of SRS.

Published in Rochester Democrat and Chronicle on August 29, 2010.

Aaron W. Perlman

Aaron W. Perlman, MD

Written by Alvin H. Crawford, MD

Aaron W. Perlman, an Orthopaedic surgeon and founder of the Cerebral Palsy Clinic at Cincinnati Children's Hospital Medical Center, died on March 19, 2011. He was 96.

He began practicing medicine in 1946 and after 1970; he devoted his practice exclusively to children. He did his residency in orthopaedics at Jewish Hospital in Cincinnati and a pediatric cerebral palsy fellowship with Winton Phelps, MD at John Hopkins University in Baltimore. He attended scoliosis clinics with John Moe, MD and became a member of the Scoliosis Research Society in 1974.

"He told me that the best decision he ever made was when he focused his practice exclusively on pediatric orthopaedics," said colleague Alvin H. Crawford, MD. "He said it was the most fun he ever had." For more than 30 years, the two colleagues met weekly to review cases at Cincinnati Children's Hospital.

Dr. Perlman, a longtime partner of Freiberg Orthopaedics, was the founding director of orthopaedics at Cincinnati Children's, a position he held from 1965 to 1978. He was also an Active Member of the Scoliosis Research Society.

He established the cerebral palsy clinic at the hospital in 1973, and by the late 1980s, it had developed into a nationally recognized, multidisciplinary program and was renamed in his honor in 1994.

The College of Medicine established the Aaron Perlman Award in his honor to recognize the resident who "shows the greatest compassion for patients and exemplifies the highest quality of patient care."

"The three things that were most important to him were his work, his family, and his community," said his daughter, Amy Pearl Parodi of Los Altos, California. "He had a voracious appetite for learning and life and endurance that lasted until the very end. We were all touched by his values and the impact he had on so many people."

He loved nature and was active in the Ohio Chapter of the Nature Conservancy, the Civic Garden Center of Cincinnati and Oxbow Inc. He and his wife loved to travel, and were supporters of the Cincinnati Art Museum, the Cincinnati Playhouse in the Park and the Cincinnati Symphony and LaSalle Quartet.

Website Updates

Michael S. Roh

Michael S. Roh, MD
Website Committee Chair

SRS E-Text Open to Public: The SRS E-Text is a compendium of chapters covering a wide variety of topics relevant to spinal deformity, written by experts in the field. Though initially reserved for SRS members, the E-Text may now be accessed by the general public and healthcare professionals alike. SRS members should feel free to refer other physicians and providers, medical students, and interested patients to the E-Text site ( as a valuable educational resource, and full access will be granted following a simple registration process.

Non-Operative Videos Posted: Paul Sponseller, MD, with the help of Kristin Venuti, NP, has contributed two professional videos of adolescent patients sharing their experiences of undergoing active brace treatment for spinal deformity ( Though the SRS website showcases numerous patient stories involving surgical outcomes, these non-operative videos focus on the benefits of bracing and the positive perspectives related by two teenagers being treated for idiopathic scoliosis and Scheuermann's kyphosis respectively. These videos can provide a personal message of cooperation and hope to young patients with spinal deformities, in a manner not previously made available. Congratulations to Dr. Sponseller and his team for identifying and filling this need in the treatment of our younger patients.

SRS Facebook Page Expansion: Though SRS launched its Facebook page only last year, with the help of Ahmad Nassr, MD, our presence in the realm of social media has expanded rapidly. News, information, and videos are regularly posted and updated by SRS staff, with plentiful positive feedback from fans. For example, the non-operative videos were posted, and within months, had been viewed thousands of times. For all SRS members, we encourage you and your staff to "Like" the SRS Facebook page (, which will allow us to reach out to more patients and providers.

Expansion of Website Translations: In the interest of increasing the SRS presence as an international organization with global membership, the project of translating the SRS website into multiple languages is underway. Though modest portions of the website have been addressed in the past, a more comprehensive and ongoing translation of the website represents a substantial undertaking, which will be directed chiefly by Website Committee Members Michael Flippin, MD, and Tony Rinella, MD. By making the SRS website more accessible and relevant to spinal surgeons and patients around the world, we hope to increase the role of SRS in education, advocacy, and delivery of care.

Chair: Michael S. Roh, MD Committee Members: John F. Sarwark, MD; Christopher Bergin, MD; Mark B. Dekutoski, MD; John R. Dimar, MD; Andrew G. King, MD; Adrian Gardner, FRCS; Glenn R. Rechtine, MD; Ron El-Hawary, MD; Jwalant S. Mehta, FRCS; Ahmad Nassr, MD; Matthew J. Geck, MD; Anthony S. Rinella, MD; Ross R. Moquin, MD; Behrooz Akbarnia, MD; Munish C. Gupta, MD; Mark D. Rahm, MD; Michael Flippin, MD; Stefan Parent, MD, PhD

CPGs and AUCs - What Do the Abbreviations Mean, and Why Should I Care?

James O. Sanders

James O. Sanders, MD
Evidence-Based Committee Chair

Levels of Evidence Based on Study Design
1 Randomized Clinical Trials
2 Non-Randomized Clinical Trials or Cohort Studies
3 Case Controlled Series
4 Case Series
5 Expert Opinion

As you may know, the American Academy of Orthopaedic Surgeons (AAOS) and North American Spine Society (NASS) have been heavily involved in creating evidence-based Clinical Practice Guidelines (CPGs). AAOS is currently beginning development of Appropriate Use Criteria (AUC), which was previously pioneered by the American College of Cardiology (ACC). At the 47th Annual Meeting, a Lunchtime Symposium explained these tools along with the more fundamental tool, systematic reviews.

Many people are familiar with the older version of the guidelines, which were based upon expert opinion. However, expert opinion has fallen on hard times. Many of the experts in earlier guidelines were found to have significant conflicts of interest and strongly biased views. Guidelines developed by expert opinion have not held up under scrutiny, and modern guidelines require the best evidence of all - our literature.

Developing a guideline requires a detailed systematic review of the literature. A systematic review differs from standard reviews by critically analyzing the strength of the evidence. High-quality comparative analysis ranks higher than non-comparative case series, which rank higher than expert opinion. Without a quality systematic review aimed at answering the important questions, then CPG's and AUC's are no better than our opinions.

Grades of Recommendation Based Upon The Quality of Supporting Evidence
Grade Evidence
Strong Multiple Level I Evidence Sources
Moderate One Level I, or Multiple Level II/III
Weak One Level II or III, or Multiple Level IV
Inconclusive Insufficient or Conflicting Evidence
Consensus No Evidence, but Expert Work Group Opinion

Evidence-based CPGs then ask the questions, "what works" and "what does not work" in the diagnosis and treatment of patients. The strength of a guideline reflects the quality of the questions asked and the strength of the underlying literature. Individual recommendations are graded based on the evidence strength, which also reflects whether the recommendation is likely to change with further research.

Evidence-based CPGs use language that is often intimidating to physicians, and the poor levels of evidence in orthopedics have often been very disappointing.

However, without this structured questioning, other evidence-based items such as AUCs and Practice Improvement Modules (PIMs) are meaningless. For example, with high-quality evidence against vertebroplasty, an AUC or PIM for vertebroplasty would be useless. The advantage of well-done CPGs is that they synthesize a large amount of literature, allow flexibility in decision-making, and can help establish research priorities.

But, because medical literature is often not definitive and clinicians must still practice in uncertainty, AUCs were developed as a structured technique by the RAND Corporation to help define the boundaries of acceptable practice. I.E., "in whom is it useful?" AUC are designed to combine the best available evidence with the collective judgment of experts to produce a statement regarding the appropriateness of performing a procedure based on the patient-specific symptoms, medical history and test results. For example, in AIS, is it appropriate to operate on a 15 degree thoracic curve, or on someone with a soon to be fatal disease versus a healthy immature adolescent with a 75 degree thoracic curve?

Grades of Recommendation and Recommendation Language
Grade Language
Strong "We Recommend"
Moderate "We Suggest"
Weak "It is an Option"
Inconclusive "We Can Neither Recommend for nor Against"
Consensus "In the Absence of Reliable Evidence, it is the Opinion of the Workgroup That . . ."

AUCs are developed in three stages and require a quality understanding of the literature. In their initial stage, the important parameters of a disorder are defined. During this initial phase, a matrix is composed of various plausible clinical scenarios. During the second phase, another group assesses the reasonableness of the scenarios. Finally, in the third phase there is a discussion and ultimately a ranking of the level of appropriateness for a procedure on a scale of 1-9 ranking from inappropriate to necessary. This last group must have less than 50 percent of the participants involved in the actual performance of the diagnostic technique or procedure.

Scenarios ranked as inappropriate (1-3) should not be performed. Those ranked necessary (7-9) should be performed, and, if they are not, should be promoted. Those in the middle group (5-8) are potential subjects for research studies.

Having a basic understanding of systematic reviews, CPGs and AUC is important because will become more important under pressures to provide high value care. Each of these are methods of making the underlying scientific evidence well understood and help us bring the best practices to our patients.

Chair: James O. Sanders, MD Committee Members: David W. Polly, MD; Steven D. Glassman, MD; Jacob M. Buchowski, MD; Charles H. Crawford, III, MD; Justin S. Smith, MD; Douglas C. Burton, MD; Serena S. Hu, MD; Baron S. Lonner, MD.

Upcoming Worldwide Conferences and India Conference Update

Ahmet Alanay

Ahmet Alanay, MD
Worldwide Conference Committee Chair

Worldwide Conference 2012The first Worldwide Conference of 2012 was held in New Delhi, India with great participation! Munish Gupta, MD was the SRS Chair for the conference and has prepared the report below. You can also visit the SRS website to see more highlights.

We are now looking forward to the upcoming conference in Amsterdam, Netherlands, May 30-21, 2012. This will be a two half-day program during Spineweek in one of Europe's most attractive meeting venues. The third conference in 2012 will be in the beautiful city of Tel Aviv, Israel, on October 18-19. Drs. Mark Weidenbaum and Yizhar Floman are working on an upscale program and accepting volunteer faculty applications. We will be finalizing this year's WWC program with a conference in Ho Chi Minh City, Vietnam on November 30-December 2. Vietnam is a country with thousands of years of cultural heritage and magnificent landscapes! Any members interested in participating are welcome to contact the SRS Office.

Munish Gupta

Munish Gupta, MD
Worldwide Conference Committee Member

Worldwide Conference 2012Another successful SRS Worldwide Conference (WWC) was completed in India's capital, New Delhi. The WWC was held during the Association of Spinal Surgeons of India's Annual Meeting (ASSICON), which ran February 23-26. During the two half-day sessions, four topics were covered: Early Onset Scoliosis, Adult Deformity, Treatment of Severe Deformity with Spinal Osteotomies, and Complications. Each topic had lectures and case discussions with ample time for questions. With more than 350 pre-registrations along with numerous on-site registrations, the conference hall was packed and rows of physicians were standing in the rear. The audience was engaged and enthusiastically participated in lively discussions.

The course evaluations were laudatory and revealed that the participants regarded the SRS course highly. The evaluations collectively showed that the topics were found to be useful by 84% of the attendees with the case discussions being noted as especially educational. Even though only a few had attended an SRS meeting before a majority (74%) of the attendees stated that they would attend a similar course and asked for SRS meeting information and membership materials.

The hospitality extended by the local hosts was tremendous and well-appreciated, in particular by Arvind Jayaswal, MD and Harvinder Chhabra, MD who organized the ASSICON meeting. My sincere thanks to the faculty who took time away from their family and practice to make this course a great success.

Committee Chair: Ahmet Alanay, MD Committee Members: Kamal N. Ibrahim, MD, FRCS(C), MA; Kenneth J. Paonessa, MD; Mark B. Dekutoski, MD; John R. Dimar, MD; Mohammad El-Sharkawi, MD; Hassan Serhan, PhD; Christopher Hamill, MD; Peter F. Sturm, MD; Muharrem Yazici, MD; Munish C. Gupta, MD; Youssry El-Hawary, MD; Scott D. Hodges, DO; David H. Clements, MD; Marinus De Kleuver, MD, PhD; Mark Weidenbaum, MD

Worldwide Conference 2012 Worldwide Conference 2012

Research Grant: Fall 2011 and Spring 2012

John M. Flynn

John M. Flynn, MD
Research Grant Committee Chair

The Research Grants Committee is completing a significant transformation, designed to responsibly distribute very limited funding, increase the number of reviewers evaluating each grant and improve grant recipient accountability. These changes have required new limits on grant awards, a new model for grant reviews, and careful scrutiny of outcomes from grants awarded.

For the fall 2011 cycle, the committee received 23 grant applications requesting $1,063,351 in funds. Applications came from the United States, Canada, China, Egypt and Spain. These grants competed for $127,323. Grants were reviewed by four teams, each with four to five experts. All members of the teamed reviewed all grants and consensus decisions determined the results. Eleven applications were rejected, eight were asked to revise and resubmit in the Spring Cycle and four were funded totaling $87,000.

Funded grants for fall 2011 cycle:

"Treatment of the Growing Spine with Bisphosphonates: Mechanical Properties and Healing"
Small Exploratory Grant, $10,000
Michelle Caird, MD, University of Michigan

"Validation of a Genetic Test to Predict the Risk of Curve Progression in Adolescent Idiopathic Scoliosis"
New Investigator Grant, $25,000
Benjamin D. Roye, MD, MPH, New York Presbyterian Morgan Stanley Children's Hospital

"Study of Neural Connectivity, Functional Activation and Grey Matter Volume of the Sensorimotor Network in Idiopathic Scoliosis"
Standard Investigator Grant, $32,000
Julio Domenech, MD, PhD, Hospital Arnau de Vilanova, Spain

"Coagulation in Scoliosis Surgery"
New Investigator Grant, $20,000
Patrick Bosch, MD, Children's Hospital of Pittsburgh of UPMC

The spring 2012 grant application site opened on February 1; the due date is April 1. Due to limited funds for 2012, the maximum award amount for Standard Investigator and Evidence-Based Medicine Grants has been reduced from $100,000 to $50,000.

The Research Outcomes Sub-Committee met at the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting to work on updating the outcomes report to prepare for posting it to the website. The Research Outcomes group is closely scrutinizing each grant to be certain that work is completed, reports are submitted on time, and the results are presented and published, so SRS Members get maximum benefit from their generous support of the SRS research program.

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; Federico P. Girardi, MD; Siavash Haghighi, MD; Kirkham B. Wood, MD; Lori Dolan, MD; Jonathan H. Phillips, MD; Charles E. Johnston, II, MD, Michelle C. Marks, MD

Globalization Committee Update

Lawrence G. Lenke

Lawrence G. Lenke, MD
Globalization Committee Chair

The Globalization Committee was formed in 2011 as a refinement to the Global Affairs Advisory Board (GAAB). The purpose of this new committee is to pilot the regionalization of our society with three areas singled out to start: Asia-Pacific, Europe, and Latin America. We have elected regional co-chairs whose charges are to begin the process of adding additional members to their regional sub-committees. Those co-chairs are: Noriaki Kawakami, MD and Hee-Kit Wong, MD for Asia-Pacific, David S. Marks, FRCS and Francisco Javier Sanchez Perez-Grueso, MD for Europe, and Carlos A. Tello, MD and Osmar Avanzi, MD for Latin America. The initial goal is to formulate an infrastructure so that the flow of information and ideas regarding societal activities in these regions of the world comes also from the "bottom up" and not just from the "top-down," as has been the tradition in our society. During the Globalization Retreat held in February 2011, the formation of these regional sections was one of the end products of our very positive discussions. We plan to have the regional co-chairs present at one of the Board of Directors meetings each year to present the progress made on areas such as membership, activities, challenges, educational programs, etc. related to the mission of the SRS regarding spinal deformity care. These reports will allow optimization of the globalization of our society in the coming years. As an example of how the SRS can benefit from this new infrastructure, the Asia-Pacific region is assisting in the process of identifying a potential IMAST site in that region of the world for the 2015 IMAST meeting. Also, one of the first charges for each region, after formation of their regional sub-committees, is to prepare a region-specific questionnaire to analyze the issues germane to their region in the areas discussed above, such as recruiting appropriate new members, getting current members more involved in the society (such as membership on various committees), and exploring leadership roles for those more senior and interested. We look forward to the evolution of the Globalization Committee to optimize spinal deformity care world wide in the coming decades!

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

"The time is always right to do right." Martin Luther King Jr.

J. Abbott Byrd

J. Abbott Byrd III, MD
Ethics Committee Chair

As defined by The American Heritage Dictionary, ethics are the rules or standards governing the conduct of the members of a profession. Recognizing the importance of this topic, the Ethics and Professionalism Committee was formed in 2008 as an advisory body to the SRS Board of Directors (BOD). The primary goal of the committee is to focus on the ethical and professional issues that face both the society as a whole and its individual members and to offer some guidelines as how to address these issues.

To achieve this goal, the committee has developed a comprehensive SRS Ethics Document which was approved by the BOD in July 2011 and distributed at the 46th Annual Meeting. Hopefully, the membership has had time to read and reflect on this document which has four sections:

1) The Introduction sets the tone for the document by stating that the first priority for Fellows of the SRS is to provide ethical and compassionate care for patients.

2) The Standards of Professionalism section deals with ethical issues facing the practitioner as they care for patients on a daily basis. This was drawn heavily with permission from the Guide To Professionalism and Ethics in the Practice of Orthopaedic Surgery published by the American Academy of Orthopaedic Surgeons (AAOS) in January 2010. This fifteen-page section begins with the obligations of the spinal surgeon to the patient. Industry Conflict of Interest is addressed next and warrants special attention,given the pervasiveness of industry involvement in today's practice of spinal surgery. Adherence to these guidelines will protect both the patient and surgeon. Obligations in regard to Advertising as well as Expert Opinion and Testimony are reviewed next. Given today's litigious society, it is common for the spinal surgeon to act as an expert reviewer in medical malpractice cases. Awareness of the obligations that one incurs as an expert reviewer is mandatory. This section finishes with Research and Academic Responsibilities which is especially germane to the SRS mmbership given the emphasis which the Society places on research.

3) The Professional Medical Association (PMA) section addresses various ethical issues for SRS as an entire Society. Such issues include general budget support, society meetings, research support, fellowship and training support, committees that form Practice Guidelines and Measurement Standards, publications, product endorsements, affiliated foundations and lastly Conflict of Interest among the Presidential Line and BOD as well as any participant at an SRS activity.

4) The Ethics and Discipline Management Process section clearly outlines the adjudication process should a complaint be made against an SRS Member. While activity is the goal of most SRS committees, it is the hope of the EPC that its services in the adjudication process will not be necessary.

As Martin Luther King, Jr. said, "the time is always right to do right." Hopefully, this Ethics Document will help SRS and its membership "do right," thereby maintaining the highest standard of ethical patient care and continuing the SRS' reputation as the best spine society in the world.

Chair: J. Abbott Byrd, MD Committee Members: Denis S. Drummond, MD; Richard Hostin, MD; Michael A. Edgar, MD; Michael J. Bolesta, MD; James W. Roach, MD; Behrooz A. Akbarnia, MD; Brian G. Smith, MD.

Updating the Policy & Procedure Manual

Michael C. Albert

Michael C. Albert, MD
Bylaws and Policies Committee Chair

The SRS Bylaws and Policies Committee's primary goals are to respond to questions regarding the bylaws and to monitor activities ensuring compliance with bylaws and written policies. In addition, the committee updates the Policy & Procedure Manual when action items are approved by the Board of Directors (BOD), communicating changes to the SRS office and staff liaison. The committee continues to work on updating the Policy & Procedure Manual by soliciting edits from committee chairs. Thank you to Patrick Cahill, MD, who reviewed the entire document for duplication of content and edited as necessary. The manual is an evolving document that requires updates on a continual basis and we have requested that all committees review their respective sections on an annual basis and make recommendations for changes.

Please be aware that in May 2012, Active Members will be notified of an amendment proposal regarding the presidential stipend for a vote at the September 2012 Annual Meeting. Any questions regarding this Committee, please do not hesitate to contact Nilda Toro, Staff Liaison, or Michael Albert, MD, Chair.

Chair: Michael C. Albert, MD Committee Members: James W. Roach, MD; Manabu Ito, MD, PhD; Jason E. Lowenstein, MD; Jose Herrera-Soto, MD; Jeffrey D. Coe, MD; Karl E. Rathjen, MD

Coding for Deformity Combined with Degenerative Stenosis: A Case Example

Patrick Cahill

Patrick Cahill, MD
Coding Committee Member

Spinal deformity surgery and spinal surgery for degenerative conditions are not mutually exclusive fields. If a Venn diagram were used to describe the two fields, there would be significant overlap. Even on the level of a single patient, degenerative and deforming processes may be contributing to pathology. ICD-9, however, attempts to stratify and codify surgical procedures into one category or the other. This can be confusing for surgeons and those coding their procedures. This article will attempt to provide some guidance in surgical coding in cases where the distinction between degenerative and deformity conditions is blurry.

The overriding principle should be correct coding rather than maximizing reimbursement. The surgeon should decide the primary indication(s) for performing a specific procedure and select the code or codes for that procedure. For example, if a surgeon removes the facet joints and ligamentum flavum at a lumbar level on which she or he is operating to increase flexibility and improve correction, then the procedure should be coded as a single column posterior osteotomy (22214). However, if the structures were removed for bilateral foraminal stenosis and/or neural compression then the procedure should be billed as a decompressive procedure (63047).

The case below illustrates some of the principles of correct coding where a combination of degenerative stenosis and deformity exist. The patient is a middle aged gentleman with a degenerative spondylolisthesis fused at L4-5, then later extended to L3-4, who developed sagittal imbalance after discitis destroyed the L2-3 disc space. The pre-operational CT-myelogram shows severe stenosis at L2-3 and moderate stenosis at L1-2. The surgeon performed an L4 pedicle subtraction osteotomy (PSO), L1-pelvis posterior instrumented spinal fusion, with laminectomies from L1-3. The patient had pathology related to deformity and degenerative issues-focal kyphosis resulting in global sagittal imbalance as well as symptomatic stenosis. The surgeon performed a surgery to address these issues. The PSO and instrumentation treated the deformity and the decompression treated the stenosis.

Thus, the surgery combines several individual components: arthrodesis, removal of instrumentation, insertion of instrumentation (to pelvis), decompression, osteotomy, and insertions of allograft and locally obtained autograft.

The deformity correction is addressed by several codes including 22800 (posterior arthrodesis for deformity up to six segments), 22207 (three column lumbar osteotomy), 22842 (three to six segment lumbar instrumentation), 22848 (pelvic instrumentation), 20936 (locally harvested autograft), and 20930 (allograft). The surgeon selected these codes based on the indications and goals of the specific procedures.

Note that the arthrodesis codes are stand-alone codes, which mean that they are 90-day global codes which can be coded and billed in isolation and include pre-operative evaluation and post-operative care. Several of the other codes, (instrumentation and allograft) are add-on codes and cannot be billed in isolation. Interestingly, while it is appropriate to bill for the bone graft codes 20930 and 20936, neither is assigned any work value by Medicare, although some private payers may reimburse for this procedure. Note that even though the original instrumentation is removed, it is not appropriate to code for this procedure as it is presumed by payers to be included in the insertion procedure, according to CPT rules. This is supported by an update for CPT coding issued in February 2012 by the American Academy of Orthopaedic Surgeons (AAOS) stating:

"Guideline changes also address removal of instrumentation and insertion of new instrumentation, including all or part of the previously instrumented segments as well as reinsertion at the same level. In years past, the surgeon reported the removal of old hardware (22850,22852,22855) and also reported the placement of new hardware when the procedures were performed at different levels.

Beginning in 2012, if a new surgeon removes instrumentation at L3-L4 and inserts new instrumentation from L1 through L5, only the new instrumentation codes should be reported---not codes for both the removal of the old instrumentation and the insertion of the new instrumentation. If the surgeon removes old instrumentation."

Instrumentation to the pelvis should only be coded if the instrumentation extends to the ilium. Instrumentation to the sacrum alone does not merit use of this code. The osteotomy code 22207 is also a stand-alone code and is actually valued more than the arthrodesis code 22800, so would be listed first and the 22800 would be listed subsequently and appended by the -51 modifier so as to avoid billing again for pre- and post-operational work.

The decompression codes 63047 (lumbar laminectomy and facetectomy with foraminal decompression) and 63048 (additional level) were selected to describe the laminectomy procedures since the primary indication was decompression of neurologic structures and not malalignment or instability. 63047 is a stand-alone code, but since it is done in conjunction with the arthrodesis and osteotomy procedures and is valued less, it is appended with the -51 modifier to avoid billing again for pre- and post-op work. 63048 is an add-on code and needs no modifier.

Each of the stand-alone codes must be supported by a diagnosis from ICD-9. The arthrodesis and the osteotomy codes can be justified by 737.10, Kyphosis (acquired) (postural), or 737.41 - Kyphosis. The decompression codes can be justified by 724.02, spinal stenosis, lumbar region without neurogenic claudication or 724.03 with claudication.

Unlike surgical procedures performed in other regions of the body, spine surgeries often require several codes to properly describe what is actually done. A good working knowledge of the codes and their proper interactions is needed to accurate document and bill for the performed services.

Pre- and Post-op images

Pre- (left) and Post- (right) op images of an adult male who underwent a revision surgery for sagittal imbalance and stenosis.

Thanks to Anthony Rinella, MD and Wendy Benefeldt of Illinois Spine & Scoliosis Center and Jacob Buchowski, MD of Washington University, in assisting with the preparation of this article.

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.

Fellowship Committee Report

Carlos Tello

Carlos Tello, MD
Fellowship Committee Chair

The Fellowship Committee diligently reviews Candidate, Associate and Active applications twice annually providing its recommendations to the Board of Directors (BOD) for final approval at the September and February Board meetings.

SRS Fellowship continues to grow at a gradual pace with very enthusiastic and qualified individuals.
We are pleased to announce our new 2012 Fellows.

Candidates (36):

Brent Adams, MD
Terry D. Amaral, MD
Mehmet B. Balioglu, MD
Jason Bernard, MD, FRCS(Orth), MBchB
Serkan Bilgic, MD
Santiago Tomas Bosio, MD
Jeff Cassidy, MD
Robert H. Cho, MD
Meagan Fernandez, DO
Sumeet Garg, MD
Tenner J. Guillaume, MD
Chang Ju Hwang, MD, PhD
Seung-Jae Hyun, MD, PhD
Viral V. Jain, MD
Michael P. Kelly, MD
Patrick T. Knott, PhD, PA-C
Mun Keong Kwan, MBBS, MS(Orth)
Virginie LaFage, PhD

Annalise N. Larson, MD
Darren R. Lebl, MD
Jung-Hee Lee, MD
Takuya Mishiro, MD, PhD
Payam Moazzaz, MD
Thierry A. Odent, MD, PhD
Matthew E. Oetgen, MD
Erbil Oguz, MD
Eijiro Okada, MD, PhD
Nasir Ali Quraishi, FRCS
Scott S. Russo, MD
Masood Shafafy, FRCS(Orth)
Matthew Jon Shaw, FRCS, MBBS, FRSA
Carl R. St. Remy, MD
Ganesh Swamy, MD, FRCS(C)
Juan S. Uribe, MD
Alejo Vernengo-Lezica, MD
Barón Zárate Kalfópulos, MD

Associate Fellows (8):

Christina Cook, PhD
Richard P. Eyb, MD
Rachid K. Haidar, MD
Hwan Tak Hee, MBBS, FRCS

Steven E. Mather, MD
Pamela R. Morrison, MS, PT, BS
Kimberly A. O'Brien, PA-C
Mary Lou Oliver, RN, BSN, MS

Special congratulations to our new Active Fellows (29), who have successfully completed the five-year Candidate process:

Takashi Asazuma, MD
Ramin Bagheri, MD
Stuart V. Braun, MD
Donita I. Bylski-Austrow, PhD
Ivan Cheng, MD
Mario Di Silvestre, MD
Craig Eberson, MD
Ron El-Hawary, MD, FRCS
Stephen T. Enguidanos, MD
Christine L. Farnsworth, MS
John A. I. Ferguson, FRACS
Ian J. Harding, BA, FRCS

Ronald A. Lehman, Jr., MD
Jason E. Lowenstein, MD
Toru Maruyama, MD, PhD
Sharon Kay Mayberry, MD
Matthew J. Mermer, MD
Michael T. Rohmiller, MD
Pierre Roussouly, MD
Maria Cristina Sacramento Dominguez, MD, PhD
David G. Schwartz, MD
David Siambanes, DO
Edward C. Sun, MD
Kelly Vanderhave, MD

New Active Fellows accepted through the Fast Track program (5):

Helton Luiz Aparecido Defino, MD
Deszoe J. Jeszenszky, MD
Keyvan Mazda, MD, MS

Alejandro A. Reyes-Sánchez, MD
Jingming Xie, MD

New Emeritus Fellows (12):

Thomas E. Bailey Jr., MD
Henk D. Been, MD
Daniel R. Benson, MD
R. Jay Cummings, Jr., MD
Thomas R. Dempsey, MD
Vance O. Gardner, MD
William C. Horton, MD

Philip J. Mayer, MD
Michael B. Millis, MD
Francisco Montalvo, MD
Scot J. Mubarak, MD
Charles T. Price, MD

Morbidity and Mortality Reminder:
2011 online M&M reports are due before April 1, 2012. This is an annual requirement for both Candidate and Active fellows (surgeons). Active fellows (surgeons) who do not complete M&M reports will be assessed a $300 fee that will go toward the research for continued M&M related research. SRS considers M&M reporting a valuable part of our membership and highly encourages submissions.

To Candidate Fellows:
As a society committed to improving the care and treatment of spine deformity patients, it is important that all members of our society continually evaluate, learn and improve in our care of these patients. This requires a critical self-review of one's cases on a regular basis. Toward this, all Candidate Fellows seeking to advance to Active status are required to submit an 11-month case list of all patients treated, which includes data on non-operative cases as well as reporting of complications and outcomes. As of September 2009, Active applicants must include non-operative patients in their case list and failure to do so will prevent a Candidate Fellow from becoming an Active Fellow. Please note that the annual online M&M report is separate from the 11-month case list.

Membership Dues:

  • As of September 2008 you will not be allowed to register for SRS meetings if your dues are not paid.
  • Dues paid at IMAST or the Annual Meeting will be charged a 20% late fee.
  • Dues can be paid online at on the Members-Only section of the website.

Fast Track to Active Fellowship Reminder:
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

The following must be verified by SRS office before an application is released:

  • 15 years or more in spine deformity practice.
  • Full professorship or equivalency.
    • Time spent in fellowship/training is not calculated.
  • A clinical practice which includes at least 20% spinal deformity.
  • Three abstracts submitted to the SRS Annual Meeting or IMAST, or one accepted, within five years of application date.
  • Have attended at least two SRS meetings, one must be an Annual Meeting, and the other may be IMAST, within five years of application date.

A complete Fast Track submission includes:

  • One copy of the completed fast track application. Provided by SRS office only.
  • One copy of your current Curriculum Vitae (CV).
  • Five letters of recommendation from current Active or Emeritus (previously Active) SRS members.
    • One of the five letters may be from the president of your local spine deformity society (non-SRS Member is acceptable).
    • Letters may be sent directly to the SRS office.
  • A non-refundable $100 USD application fee (discount for low income countries available).
  • One copy of a current photo (you may either send a hard copy with the application or email an electronic copy to

Active Fellow responsibilities:

  • Attend at least one Annual Meeting or IMAST every three consecutive years and one SRS Annual Meeting at least every five consecutive years.
  • Submit annual online Morbidity & Mortality reports (surgeons) or contribute $300 USD to the M&M research fund.
  • Pay annual membership dues on each calendar year, of $500 USD or World Bank Economy rate

    *Only Active Fellows may vote and hold elected offices within SRS

Membership Benefits:

  • Special access to the "Members-Only" section of our website to view:
    • Past meeting sessions
    • Full access to the online E-Text that covers many interesting and helpful topics
    • Our amazing historical archives
    • Quarterly on-line newsletters
    • Global Outreach Lecture Depository
  • Leadership opportunities through committee involvement
  • Educational opportunities through small group tutorials
  • Be listed on our physician locator
  • Reduced meeting registration for the Annual Meetings & International Meeting on Advance Spine Techniques (IMAST)
  • Network with premier spine surgeons from around the world.

Special News!!
We are pleased to announce that the first edition of Spine Deformity, the Official Journal of the SRS will make its début January 2013. A preview issue will be available at the 47th Annual Meeting & Course in Chicago, Illinois, USA, September 5-8, 2012. We hope to see you there!

Committee Chair: Carlos Tello, MD Committee Members: Laurel Blakemore, MD, Hilalli Nordeen, FRCS, Douglas Burton, MD and Serena S. Hu, MD.

Call from the Historical Committee: Classic Articles

The Historical Committee is developing a list of classic articles on spinal deformity. Suggestions are welcome from members to add to this historical bibliography. Please submit your suggestions as either just a standard library-style reference or a full pdf copy for inclusion in this collection. This bibliography will be available on the SRS Archives website. Suggestions? Please email Katy, Historical Committee staff liaison:

Global Outreach

Kenneth Paonessa

Kenneth Paonessa, MD
Global Outreach Committee Chair

The Global Outreach Committee has been very active since the 2011 Annual Meeting in Louisville, Kentucky, USA. The committee has encouraged the membership to help care for affected patients in developing countries as well as teaching surgeons in these areas to be able to provide care of spinal deformities. Part of the charges is also to encourage surgeons in developing countries who are interested in deformity care to attend the Annual Meetings or consider becoming a member. This helps foster the development of SRS as a truly global organization. With this in mind we have had several conference calls, a meeting at the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting, are planning several more calls and possibly a meeting during the 19th IMAST in Istanbul, Turkey.

Many of the Global Outreach Committee members have already been active in global outreach with countries they have visited including Ghana, Indonesia, Columbia, Bulgaria, Uganda and the Dominican Republic. Most of us who have had a chance to participate in these programs feel we learn as much by being involved in these programs as we potentially give back to the patients we treat.

There are several main projects that the committee has been working on this year. The first project is updating the Global Outreach Program's website. For each endorsed site, we hope to have a current description of the program with up-to-date information, including who to contact if an SRS Member wants to consider volunteering with that program and how often the sites are visited.

We will also continue to expand the list of developing countries with endorsed sites. Currently for a site to be considered an endorsed site, a SRS Member needs to complete an application, which includes information on the local surgeon's or physician's commitment to provide follow-up care of patients who have been surgically treated, and the local hospital's ability to care for patients with spinal deformities. Usually a site is visited by the Global Outreach Committee Chair, as well as an individual from the Presidential Line. Potential endorsed sites include Bangladesh, Ethiopia, Iran and possibly a site in the Middle East. Egypt is currently being investigated as a potential endorsed site. Unfortunately, the political situation has left Syria as a site that is not currently felt to be safe enough to be considered.

We plan to send out a questionnaire to the entire SRS membership to query how many SRS Members have been active in global outreach and to ask what would help encourage more SRS Members to volunteer their time and skills. The results of this survey will be presented to the SRS Membership either by future newsletter or at the Lunchtime Symposium at the 47th Annual Meeting in Chicago, Illinois, USA in September 2012.

Since many of the current Global Outreach sites see patients with rare diseases, such as tuberculosis and deformities that are worse than those seen commonly in developed countries, we would like to create a Global Outreach Database and Study Group. By combining the information from several of these endorsed sites, we hope to provide some information about the prevalence of these severe deformities and potentially provide some guidance in their best treatment. We hope to be able to also present this information at the Lunchtime Symposium.

Another on-going project is helping the current active Global Outreach Sites with the never-ending need to obtain donations of equipment to perform surgical treatments and have access to the neurophysiologic monitoring necessary to do safe treatment of spinal deformities. This is a project that Global Outreach Committee Past-Chair, Theodore Wagner, MD has been very active in pursuing a steady source of implants for patients in these developing countries along with our current committee. We are also working to see if a source of neuromonitoring technologists or neurophysiologists can be obtained through collaboration.

Lastly our Global Outreach Committee will present a Lunchtime Symposium at the 47th Annual Meeting in Chicago, Illinois, USA. We hope to provide the results of our survey to the SRS Membership and some early results from our Global Outreach Study Group. Please remember to sign-up for this when you register for the Annual Meeting.

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)

Governance Council Update

Hubert Labelle

Hubert Labelle, MD
Governance Council Chair and Secretary

The Governance Council consists of (in alphabetical order) the Advocacy and Public Policy, Bylaws and Policies, Coding, Ethics, Fellowship, Globalization, Historical, Industry Relations, Newsletter, and Public Relations Committees. The main responsibility of the council is to act as liaison between committees within the council and the Board of Directors (BOD). I am happy to report the all of the committees have active charges and are engaged in activities in support of the SRS.

The Advocacy & Public Policy Committee, chaired by Vishwas Talwalkar, MD, has prepared a statement discussing the indications for spinal fusion in Adolescent Idiopathic Scoliosis, intended to serve as a resource for SRS Members in a variety of scenarios such as discussions with administrators and/or third-party payers. This document is undergoing revision and will soon be made available to members. The committee is also involved in promoting the SRS website as the primary source of information for patients, families and providers. A plan to promote placement of a direct link to the SRS website from the homepages of members and their institution has been initiated and will be implemented this year. Finally, committee members have developed a set of generic slides providing a brief summary of the history and mission of SRS for use by the membership in local public speaking engagements. These slides are being edited and will be made available for download from the SRS website.

The Coding Committee, chaired by R. Dale Blasier, MD is actively pursuing its goal of helping members understand the correct coding by preparing coding case examples and articles for publication in each newsletter. Committee members are preparing and will be holding a Lunchtime Symposium for this year's Annual Meeting in Chicago, Illinois, USA on the subject of ICD-10 and what it means to the deformity surgeon. As future charges, the committee would like to develop sets of ''bundled'' codes which describe spinal deformity surgery and would like to continue to prepare members for conversion from ICD-8 to ICD-10.

Last year, following a successful Globalization Strategic Retreat held on February 14, the BOD decided to morph the former Global Affairs Advisory Board into a Globalization Committee chaired by the immediate past president, with regional coordinators from specific regions. Each regional coordinator is charged with working with members in the region to identify local concerns, issues and opportunities and to bring those to the Globalization Committee for discussion and possible action by the BOD. The committee is currently chaired by Lawrence G. Lenke, MD and up to now, has formed three regional subcommittees for Asia-Pacific, Latin America and Europe, with the goal of having these regional subcommittees fully operational by Spring 2012 to begin working on their charges.

The Corporate Relations Committee, formerly known as the Industry Relations Committee, led by Lawrence G. Lenke, MD, has reviewed, approved and distributed the 2012 Corporate Partner Support Program, and is actively meeting with our corporate partners to insure that appropriate processes are followed and that value is delivered to both parties in the preparation of our meetings.

The Newsletter Committee is chaired and edited by Vicki Kalen, MD. The committee is busy producing quarterly newsletters and always welcomes ideas for articles or new features on an ongoing basis. Feel free to contact Dr. Kalen at

The Public Relations Committee, chaired by Andrew G. King, MD, is reviewing educational and promotional videos before they are released to national media and to make sure that the SRS is the best source for educational material. They are also working in liaison with the Website Committee to produce "compelling stories," and with the 50th Anniversary Task Force in a public relations initiative that will show the great improvements in scoliosis care over the past 50 years.

As for the Bylaws and Policies, Ethics, Fellowship and Historical Committees, their updates are included in this newsletter.

The next meeting of the Governance Council will occur at IMAST in Istanbul, Turkey this July.

Chair: Hubert Labelle, MD Committee Members: Vishwas R. Talwalkar, MD; Michael C. Albert, MD; R. Dale Blasier, MD; J. Abbott Byrd, MD; Carlos A. Tello, MD; Lawrence G. Lenke, MD; Behrooz A. Akbarnia, MD; Vicki Kalen, MD; Andrew G. King, MD.

2011 Corporate Supporters

Double Diamond Level Support

Depuy Spine K2M Medtronic

Diamond Level Support


Platinum Level Support

Synthes Spine

Gold Level Support


Globus Medical


Silver Level Support

Nuvasive Zimmer Spine  

Bronze Level Support

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

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.