SRS Newsletter

President's Message

October was the month for getting down to business!

With the completion of a successful Annual Meeting & Course in Prague, new committee chairs have taken up positions and are getting down to business. We all met during the cabinet meeting in Chicago, October 14-15, 2016. For those who have not been to this meeting, the cabinet meeting is when we invite all committee chairs, together with council chairs and board of director members to meet together.

The aim of the meeting is three-fold; firstly, action plans for the upcoming year, in the form of “committee charges” are put together; secondly, open discussions allow dialogues and inter-committee and inter-council coordination and collaborations; and finally, this is an occasion for informal interactions between the different participants with the Board of Directors and Presidential Line members.

Prior to the cabinet meeting, we had an afternoon retreat on new educational initiatives of SRS. Committee chairs were made aware of the work of the Education Task Force, which was formed after a retreat in Orlando in March 2016.  While I reported briefly on our work during the business meeting in Prague, we wanted greater dissemination of this initiative, and hence organized this afternoon retreat. We also invited an education expert, Joseph Green, PhD to talk to us on adult learning, as well as to comment on some of our work to date.

In brief, the rationale for having an Education Task Force are as follows: while we feel that SRS is a great brand name with highly regarded educational offerings, there are gaps. In particular, our courses are not tiered, format is not consistent, and content is not standardized. The task force consists of myself as the chair, together with the rest of the Presidential Line and Laurel Blakemore, MD; Marinus de Kleuver, MD, PhD; John Dimar, II, MD; Lawrence Haber, MD; Praveen Mummaneni, MD; Luis Munhoz da Rocha, MD; Rajiv Sethi, MD; Daniel Sucato, MD, MS; and Muharrem Yazici, MD. Our aims are multiple, but the two main ones for the coming year are: (1) to develop a new tiered curriculum and (2) to develop SRS-led courses, in which the course will be organized by SRS in close collaboration with local and regional spine societies, and delivering a curriculum designed by SRS.

Dr. Blakemore chairs thEducation Task Forcee curriculum development group and they have been using a Delphi approach, involving some 139-deformity surgeons from around the world, to define the curriculum. They have just completed the second iterative round, and are currently analyzing the results.

Professor De Kleuver and Benny Dahl, MD as past and current chairs of the Worldwide Course committee, are overseeing development of our first SRS regional course titled “SRS Current Concepts in Spine Deformity”. This will be in close cooperation with Eurospine and chaired by Martin Repko, MD (Czech Republic), Alpaslan Senkoylu, MD (Turkey). The course will be held March 30 – April 1, 2017 in Prague. Our aim will be to attract 100-150 participants from the region and around the world to attend. This will be an interactive course based on the SRS core curriculum, with four half-day sessions, ranging from foundation knowledge to early onset scoliosis and degenerative deformities.  We are excited about this course, as this will herald a series of changes in the way that SRS connects and delivers our global deformity education, from these current concepts courses, to hands-on (cadaveric) courses, to live-surgery courses, as well as our flag-ship IMAST and Annual Meeting. When thinking about global deformity education, we realize that this is a huge undertaking, and we shall solicit expert help as we go forward, as well as to regularly review and learn from the changes we make. As members of SRS, we will need all of your to help organize, teach, and disseminate this mission.

With the holiday season upon us, I wish all of you, your family and loved ones a great end-of-year filled with blessings and joy.

Kenneth MC Cheung, MBBS(UK), MD(HK), FRCS, FHKCOS, FHKAM(Orth)
SRS President 2016-2017

In Memoriam

Pier Giorgio Marchetti, MD
1931-2016

Pier Giorgio Marchetti, MD died October 15, 2016 at his home in Bologna, Italy, after a prolonged illness. He was 85 years old.

Professor Marchetti, a former Director at the historical Rizzoli Orthopaedic Institute and of the Orthopaedic Department of the University of Bologna, became a fellow of the Scoliosis Research Society in 1975. Widely known in Italy and Europe for his expertise in scoliosis and other spinal conditions, he trained in his earlier years under the famous orthopaedist, Oscar Scaglietti (1906-1993) at the Orthopaedic Institute Toscana in Florence. Prof. Scaglietti, originally at the orthopaedic clinic in Bologna, moved to Florence in 1956 to become Professor of Orthopaedics.

A native of Pisa, Prof. Marchetti was born in 1931 in Gaiole in Chianti in the Province of Siena, just twenty-five miles south of Florence. He studied at the prestigious Florentine School, The Oaks and went on to obtain his degree in medicine in 1956. In 1960, he was appointed to a one-year fellowship in scoliosis under Dr. John Cobb (1903-1967) and Dr. Philip D. Wilson, Jr. (1920-2016) at The Hospital for Special Surgery in New York. In 2010, the Pier Giogio Marchetti, MD, Award for International Achievement was established to recognize an outstanding lifetime achievement in orthopaedic surgery by an international fellow who trained at Hospital for Special Surgery (HSS). The first award was presented that year by Dr. Thomas P. Sculco, HSS Surgeon-in-Chief (2003-2013) to Professor Marchetti on his 50th anniversary as a fellow at HSS.

In 1968, he left Florence to become Director of Orthopaedics at Pisa where he stayed until 1982 when he was appointed Director of the Rizzoli Orthopaedic Institute. Just the year before, "Rizzoli" was named as a scientific research hospital by the Italian Health Ministry due to its high level of orthopaedics and traumatology. Opened in 1896, "Rizzoli" was originally founded at the end of the 19th century by the famous Bolognese surgeon Francesco Rizzoli who had bought a convent on the hill of San Michele in Bosco. Early directors of the Rizzoli Institute were Alessandro Codvilla (1861-1912), the "father of Italian orthopaedics" and Vittorio Putti (1880-1940), legendary orthopaedic surgeon who treated congenital dislocation of the hip, bone tumors, spine diseases and trauma in the early 20th century. Professor Putti's personal library and office in the Institute's Umberto Library is archived exactly as he left it when he died in 1940, after serving as the Rizzoli Director for twenty-eight years.

During Professor Marchetti's years as leader of the "Rizzoli", he founded the Biomechanics Laboratory, directed orthopaedic research studies, revolutionized orthopaedic surgical procedures and served as a mentor to many young surgeons in training. He retired from academic orthopaedics in 2006.

Professor Marchetti leaves his wife Lucilla and three children, Nicola, Federica and Guido. I will always remember how gracious his wife Lucilla and he were to me when I visited him at his home and the Institute in 2012.

Obituary was written by David B. Levine, MD with help from Dr. Sara Nanni

Professor Marchetti at his desk in Bologna. c. 2015

Historian's Corner

George H. Thompson, MD
SRS Historian

During the just completed Annual Meeting & Course in Prague, Czech Republic, your Historical Committee was very busy working on a variety of issues.

While many of us enjoyed the superb educational offerings of the meeting several of us were performing interviews of significant SRS members – past presidents, Lifetime Achievement Award winners, and significant influencers in our specialty.  Interviews were done for Randal Betz, MD; Alvin Crawford, MD; Ronald DeWald, MD; Jean Dubousset, MD; John Kostuick, MD; Lawrence Lenke, MD; John Lonstein, MD; James Ogilvie, MD; Acke Ohlin, MD, PhD, and Harry Shufflebarger, MD. It was an honor and privilege to get the interviews of these important surgeons recorded. They are now in the editing process and should be posted to the SRS Archives Website in early 2017.

Speaking of the SRS Archives website, many have noted that they are difficult to find. Here are a step-by-step instructions to help you navigate the website.

1. Visit the SRS website and click the “Member Login” link

2. Log in to your account.

3. Select Online Education

4. Select SRS Archives

5. Enjoy all that the Archives website has to offer!

The SRS physical archives are located at the University of Kansas Medical Center (KUMC).  

If you attended the Opening Ceremonies of the Annual Meeting & Course you witnessed the transfer of a preserved spinal specimen with Harrington Rods. This specimen was donated to the Harrington Archives by Dr. Piet Van Loon.

Additionally, Evalina Burger has graciously decided to donate her collection of the original Prof. Dommisse slides and notes on spinal cord blood supply to the SRS Archives.

If you have any items that you feel would be meaningful additions to the SRS Archives, please contact Ashtin in the SRS office, aneuschaefer@srs.org. The Harrington Archives and Blount Archives are also located at KUMC.

The committee looks forward to continuing to preserve the history of our Society and the field of spine deformity.

Chair: George H. Thompson, MD Committee: Behrooz A. Akbarnia, MD; Jason E. Lowenstein, MD; Terry D. Amaral, MD; Alejo Vernengo-Lezica, MD; Patricia N. Kostial, BSN, RN; Jay Shapiro, MD; Hani Mhaidli, MD, PhD

New Committee Leadership

Congratulation and a warm welcome to the following SRS members on their appointments as committee chairs for 2016-2017.

Ram Mudiyam, MD, MBA - Adult Deformity Committee
Jeffrey S. Kanel, MD - Awards & Scholarships Committee
Evalina L. Burger, MD - Bylaws & Policies Committee
David H. Clements, III, MD - CME Committee
Mathew D. Hepler, MD - Coding Committee
John P. Lubicky, MD - Communications Committee
Laurel C. Blakemore, MD - Core Curriculum Task Force
David W. Polly, Jr., MD - Corporate Relations Committee
Steven D. Glassman, MD - Directed Research Task Force
Serena S. Hu, MD - Development Committee
Praveen V. Mummaneni, MD - Education Committee
Kenneth MC Cheung, MD - Education Task Force
Amer F. Samdani, MD - E-Text Committee
Kamal N. Ibrahim, MD, FRCS(C), MA - Ethics & Professionalism Committee
David W. Polly, Jr., MD - FDA Task Force
Hee Kit Wong, MD - Fellowship Committee
J. Abbott Byrd, III, MD - Finance Committee
Ferran Pellisé, MD, PhD - Global Outreach Committee
Lawrence G. Lenke, MD - Globalization Committee
Scott J. Luhmann, MD - Growing Spine Committee
D. Raymond Knapp, MD - Health Policy Committee
George H. Thompson, MD - Historical Committee
Ronald A. Lehman, Jr., MD - IMAST Committee
Henry F.H. Halm, MD - IMAST Committee
David W. Polly, Jr., MD - Long Range Planning Committee
Darrell S. Hanson, MD - Morbidity & Mortality Committee
David W. Polly, Jr., MD - Nominating Committee
Richard Hostin, MD - Non-Operative Management Committee
Kevin M. Neal, MD - Patient Education Committee
Michael G. Vitale, MD, MPH - Pediatric Device Task Force Joint Project Team with POSNA
Muharrem Yazici, MD - Program Committee
Patrick T. Cahill, MD- Research Grant Committee
Rajiv K. Sethi, MD - Safety & Value Committee
Andre Luis F. Andujar, MD - Translation Committee
Todd Milbrandt, MD - Website Committee
Benny T. Dahl, MD, PhD, DMSci - Worldwide Course Committee
John R. Dimar, II, MD - Education Council
J. Abbott Byrd, III, MD - Finance Council 
Mark Weidenbaum, MD - Governance Council
Frank J. Schwab, MD - Research Council

 

Casting for Early Onset Scoliosis – Why, When and How

Presented by the Scoliosis Research Society's Growing Spine Committee

Monday, December 12, 2016 at 8:00pm EST.

Cost: Free to Members and Non-Members

Chairs: Robert P. Huang, MD and James O. Sanders, MD

Upon completion of this webinar, participants should be able to:

  1. Identify both the indications and the contraindications of cast treatment of early onset scoliosis.
  2. Describe the important technical aspects of applying a proper scoliosis cast
  3. Discuss common pitfalls in scoliosis casting and how to avoid them.
  4. Determine when scoliosis casting should be abandoned and other methods used instead.
Casting Webinar Agenda
8:00 – 8:05pm Introduction Robert P. Huang, MD & James O. Sanders, MD
8:05 – 8:10pm Natural History James O. Sanders, MD
8:10 – 8:20pm Role of Casting in EOS Charles E. Johnston, MD
8:20 – 8:30pm EDF Casting Technique Jacques D’Astous, MD
8:30 – 8:40pm Results of EDF casting Peter F. Sturm, MD
8:40 – 9:00pm Questions & Panel Discussion Panel

This activity has been planned an implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the sponsorship of the Scoliosis Research Society (SRS). SRS is accredited by the ACCME to provide continuing medical education for physicians.

The Scoliosis Research Society (SRS) designates this web activity for a maximum of 1 AMA PRA Category 1 Credit™.

Register at http://www.srs.org/professionals/online-education-and-resources/webinars.

Finance Council Update

J. Abbott Byrd, III, MD
Finance Council Chair

Four committees comprise the Finance Council, the Development Committee led by Serena Hu, MD; the Corporate Relations Committee and Long Range Planning Committees led by David Polly, Jr., MD, and the Finance Committee led by myself.

The Development Committee enjoyed a robust year in 2015 as total donations, boosted in a large part by the SRS 50th anniversary fund drive, totaled approximately $250,000.  As of September 13 of this year, total endowment donations are $86,450 with $58,240 from members, $6,867 from non-members and $21,342 from other organizations.  Dr. Hu and her team are working hard to increase member donations by the end of the year and to that end you will be receiving a letter asking that you keep the SRS in mind as you plan your end of the year charitable contributions.  I would encourage all to dig deep for the SRS as this will enhance continued funding of SRS research projects.  Dr. Hu is also planning a challenge based fundraising activity based on members and their training program to create a “Family Tree” of fellowships represented by the SRS membership.  I won’t spoil this unique concept with more information but look for the details in a future letter from Dr. Hu.

The Corporate Relations Committee continues to work hard maintaining our current corporate relationships and developing new ones.  We have recently added two new members to the Double Diamond status bringing the total to five.  Corporate support, including exhibitors, grants and advertising, totals approximately $2.2 million per year and plays an important part in allowing SRS to continue its mission.

The Long Range Planning Committee is tasked with securing sites for future meetings.  Upcoming Annual Meetings & Course and IMAST meetings are as follows: 

2017       Annual Meeting - Philadelphia     IMAST - Cape Town
2018       Annual Meeting - Seoul               IMAST - Los Angeles
2019       Annual Meeting - Montreal          IMAST - Amsterdam

As you are able to see, these are exciting venues that will ensure meeting success.

As regards the Finance Committee not much has changed since my Treasurer’s Report published in the September newsletter.  SRS continues to be on sound financial footing with total assets of $12. 7 million which is an increase from $11.9 million in 2015.  Our research endowment is $8.3 million with $4.4 million in the REO fund managed by Rockefeller and $3.9 million in the Legacy OREF fund managed by Vanguard.  Rockefeller has enjoyed 11% annualized returns over the last five years and Vanguard, who we just joined, posted a 3.89% gain over the last 3 months ending in September.  Rounding out the $12.7 million is $4 million in cash (operating and research) and $400,000 in other assets.  The two main revenue generators for SRS are the IMAST and Annual meetings.  The final projected net income for the IMAST meeting is $62,000 which is unfortunately $210,000 short of budget due primarily to decreased revenue from registrations (though higher than 2015 they did not reach expected levels) and increased expenses primarily from Wi-Fi and audio/visual.  Final numbers for the Annual Meeting are not in yet but it is anticipated that the meeting will meet or exceed budget.  The five Worldwide Courses have a combined net income of $4,000 through August with two courses left to go while the Hands-On Course are budgeted to have an income of $69,000.  All numbers should be finalized by the end of the year.

It is a pleasure to serve as Treasurer of SRS and if I may answer questions, please contact me.

Education Council Update

John R. Dimar, MD
Education Council Chair

The Education Council Chair is responsible for the coordination of the affairs of 12 committees that are integral to planning and presentation of the Scoliosis Research Society’s annual educational activities.These activities are then regularly presented to the Presidential Line (PL), who offer their expertise and guidance to the council chair to convey to the committee chairs. The committees recently met at the annual October SRS Cabinet Meeting in Chicago, IL and are embarking on next year’s regular responsibilities and many new exciting endeavors.

To highlight the activities of a few of the committees, the IMAST Committee, co-chaired by Ronald Lehman, MD and Henry Halm, MD continues to work on improving the educational experience for next year’s meeting in Cape Town, South Africa in July 2017.  The Education Committee, chaired by Praveen Mummaneni, MD, has already convened to plan the educational program for the SRS Annual Meeting & Course in Philadelphia, PA for September 2017.  The Program Committee, led by Muharrem Yazici, MD is actively planning next year’s scientific program for the Annual Meeting and will be instituting new innovative paper presentation opportunities for the abstract submissions. 

The Worldwide Course Committee, now chaired by Benny Dahl, MD, PhD continues to interface with international spines societies to plan collaborative educational activities in addition to a new initiative in planning the SRS Current Concepts in Spine Deformity Course, in cooperation with EUROSPINE, which will be held in Paruge in March 2017.

The Website committee, now chaired by Todd Milbrandt, MD, MS continues to refine and update the electronic platform of SRS with many new visual media additions.  A new and exciting mission has been undertaken by the establishment of a core curriculum task force led Laurel Blakemore, MD that has recently completed the second important round of the Delphi Process necessary to advance the critical SRS effort to develop our core curriculum on spinal deformity. 

Finally, the remaining committee chairs and members are diligently working hard to improve all aspects of the SRS educational related activities in an effort to provide the finest educational platform in spine and will be reporting their individual committee activities in upcoming newsletters. 

Governance Council Update

Mark Weidenbaum, MD
Governance Council Chair

The eight committees that make up the Governance Council have been busy and productive. Here is a “sound bite” summary of some of their activities:

Bylaws and Policies (Chair -Evalina Burger, MD) – Introduced a Policy statement allowing candidates for the position of Director-at- Large to qualify for that position by having been on at least four committees, of which a minimum of two were as an Active Fellow. This was approved at the Board of Director’s Meeting in Prague.

Coding (Chair-Matthew Hepler, MD) - The committee is working to optimize SRS representation and input for coding activities in concert with NASS and AAOS, and to develop succession planning for this important function. The Committee has also been working to develop the “Coding Corner” section on the SRS website and to make this a searchable entity (not simply a PDF) for SRS members.

Communications (Chair-John Lubicky, MD) –After careful evaluation the committee has concluded that the newsletter continues to have specific value (President’s Report, committee reports, etc.) and should continue. In addition the committee is hoping to work with AAOS Now Editors on spine articles to ensure accuracy and relevance.

Ethics (Chair-Kamal Ibrahim, MD, FRCS(C), MA) – The Presidential Line has directed that the Ethics Committee be a standby committee to handle ethical issues.  In addition, the committee will provide quarterly newsletter articles on pertinent subjects and areas of interest.

Fellowship (Chair-Hee Kit Wong, MD) – The Fellowship Committee reported that the SRS has maintained steady, healthy growth and that we are up to 1,325 Members.  Furthermore, although our current US/OUS (outside US) distribution is approximately 2:1, this will change in the future since more than half of our growth is now coming from OUS Candidate Members.  The committee is also in the process of developing an online membership application.

Globalization (Chair-Lawrence Lenke, MD) –In a sign that SRS has succeeded in its effort to become a truly global society, the Board of Directors has decided to sunset this Committee.  Much work (particularly by Dr. Lenke) has gone into this committee over the years and all who contributed are greatly appreciated. A carefully crafted exit plan will maximally utilize everyone involved.

Health Policy (Chair-Raymond Knapp, MD) – Gary Brock, MD the past committee chair, has just come off an incredible year where he successfully engaged several new ambassadors for SRS. This included supermodels/Victoria’s Secrets Angels Martha Hunt and Lindsay Ellingson.  They attended Research Capitol Hill Days with several of these ambassadors. The board is also in the process of evaluating a unique proposal to disseminate our message via digital media.

Historical (Chair-George Thompson, MD) – The Historical Committee had major success during the Annual Meeting in Prague conducting videotaped interviews of past presidents and securing the Van Loon specimen (a spine fused with a Harrington Rod) which was donated during the Opening Ceremonies.   The committee will also continue to work on the SRS historical timeline.

All of the committee chairs, past-chairs, and members deserve our collective thanks for putting so much time and effort into their committee work.

Research Council Update

Frank Schwab, MD
Research Council Chair

 The Research Council (RC) interacts between the Board and various committees, ensuring smooth communication and achievement of mutually set goals. The RC includes the following committees: Adult Deformity, Growing Spine, Morbidity & Mortality (M&M), Non-Operative Management, and Research Grants. A brief synopsis of current priorities is as follows:

Adult Deformity: Chair, Ram Mudiyam, MD, MBA

A Sagittal Alignment patient brochure has gone through several revisions in cooperation with and the Patient Education Committee. This is anticipated to be completed this year. Additionally, a review paper on MIS and cervical aspects of spinal deformity will be written. A key new topic for the committee relates to shared decision making, with the goal of developing a document outlining risks of ASD surgery and being a resource for surgeons and patients during discussion of treatment and particularly surgical care. The recently distributed survey was one element of this project.

Growing Spine: Chair, Scott Luhman, MD

An important effort within this committee has been to develop a webinar. This will be offered free to members and will broaden the role of the SRS in educational opportunities. Learnings from this effort will poise the society to offer direct learning opportunities and perhaps offer CME online through a series of webinars. The committee also plans to pursue a membership survey related to Magec use and will update a white paper on early onset scoliosis.

Morbidity & Mortality:  Chair, Darell Hansen, MD

The ongoing focus of this committee is to ensure reporting by the membership and offer value back to the members through reviews, publication and evolution of the database (ex. infection, return to OR). While most data requests come from SRS members, the committee will also pursue internal projects should there be a lull in member requests. In order to provide regular value to members, anonymous reports on M&M data for individuals will be sent out offering benchmark values of the larger membership pool. The committee is also exploring additional ‘optional’ fields for deeper data.

Non-Operative Management: Chair, Richard Hostin, MD

The committee ran a Lunchtime Symposium at the Annual Meeting and is awaiting feedback and interest by membership for future educational events. An ongoing task also relates to monitoring activity by the USPSTF on the topic of early detection for AIS. A new activity of the committee is submission of a survey examining variations of the membership in regards to bracing for AIS: indications/time worn, monitoring of brace use, weaning.

 Research Grants: Chair, Patrick Cahill, MD

This committee plays a critical role for SRS in supporting research across the spectrum of spinal deformity. Ongoing activities relate to grant reviews of the numerous submissions in the bi-yearly funding cycle. As the level of submissions has steadily gone up, funding has become more competitive and the committee will be tracking the long-term success of grantees and conversion to larger grants once SRS support ends. There is an ongoing need for external reviewers in genetics research.

Evidence Based Medicine and 3D Task Forces

The Evidence Based Medicine Task Force has completed the work they were tasked to accomplish. The final papers are awaiting publication. Thus the Task Force has been disbanded.

Likewise, the 3D Task Force has been working diligently for several years and will continue their work outside of the SRS Task Force structure. SRS will continue to provide encouragement and meeting space for the group during the SRS Annual Meeting.

Clinician Scholar Career Development

Baron Lonner, M.D.
Board of Specialty Society of AAOS representative for SRS

The future vitality of our specialty will be determined by the commitment of our young and upcoming generation of surgeons to leadership in clinical care, research, and education.We, as members of the Scoliosis Research Society must foster these leaders of the future.

The AAOS, OREF, and ORS have sponsored a highly popular program, the Clinical Scholar Career Development Program which is a 1.5 day workshop taking place in Rosemont, Illinois on Sept. 21-23, 2017.  Application opens January 1, 2017 and closes March 11, 2017. To apply, go to www.aaos.org/cscdp

The program highlights include: career timeline, collaboration with scientists, mentorship, academic promotion, grants and funding resources, and balancing it all with one’s personal life. This program will no doubt be an early highlight in the fledgling career of clinician scholars, individuals interested in combining clinical practice with academic pursuits.

The program is open to PGY 2-5, fellows, and young practitioners through the first 3 years of practice.

Please identify appropriate candidates for this important program to help nurture the future leaders of the Scoliosis Research Society.

Ethics Corner

Kamal Ibrahim, MD, FRCS(C), MA
Ethics and Professionalism Committee Chair

The committee publishes in each issue of the newsletter a case of possible ethical or professionalism dilemma and invites members to send their comments. Please send your comments to info@srs.org. The committee will collect all responses, summarize and publish them in the next newsletter. In this newsletter, the committee presents a case of professionalism relevant to second opinion consultation.

Dr. Smith is a well-qualified spine deformity surgeon who works at a major, but not teaching, medical center. The hospital treats adults and children alike. Its medical staff has all specialty and subspecialty physicians, but all are in private practice with independent offices at different locations, many of which are not on the medical center campus. Dr. Smith has been in practice for 10 years with a great reputation among the staff of this medical center.

Dr. Smith saw Tina, a 10 year old girl with 35 degrees scoliosis. After a complete work up was done, he ordered a brace for her. Initial response to the brace was satisfactory but in spite of good compliance the curve progressed to 50 degrees at the age of 11 and half years thus Dr. Smith recommended surgery for spine fusion. The family had a good rapport with Dr. Smith and agreed but asked for a recommendation for a second opinion. Dr Smith recommended three spine deformity surgeons. The family chose Dr. Jones.

Dr. Jones is a full time academic faculty at the medical school in the same city and works at the children’s hospital, which is well respected and affiliated to the medical school. He has been in practice approximately three more years than Dr. Smith. Dr. Jones saw Tina and after reviewing the history, examining her and reviewing her entire radiological file, he agreed the only option is surgical fusion. Dr. Jones tells the family that although he agrees with Dr. Smith’s opinion he believes this surgery should be performed at a university hospital and with a more experienced surgeon, such as himself. He had a patient in another room that had fusion two months earlier and he brought her in to tell Tina about her experience. By the end of the visit, the family was very ambivalent about the decision. They like Dr. Smith and believe he is capable but at the same time they have developed second thoughts as a result of Dr. Jones’ discussion. However, what the family decided to do is not the focus of this discussion!

The focuses of primary concern are the professional issues involved:

  1. Was Dr. Jones honest enough in rendering his opinion about Dr Smith and his medical center, knowing this surgery is performed at many non university hospitals all over the world?
  2. Was he appropriate in trying to lure a second opinion patient his way and bringing another patient to share her own experience and assist him in his goal?
  3. Is this unprofessional behavior or acceptable, since Dr. Jones didn’t break any ethical principle?

Please send your opinion to info@srs.org. The committee will review all responses and publish their summary in the subsequent newsletter.

Chair: Kamal N. Ibrahim Committee: John P. Lubicky, Hilali Noordeen, Brent D. Adams (C), Jason Bernard (C), Ryan D. Muchow (C), Timothy S. Oswald, James M. Eule, Timothy A. Garvey, H. Robert Tuten, B. Stephens Richards III, Jochen P. Son-Hing, MD, FRCSC 

The Foreign Corrupt Practices Act (FCPA) and the Importance of Caring SRS Guidelines

Hilali Noordeen, MD
Ethics and Professionalism Committee

Hilali Noordeen, MD, a member of the Ethics and Professionalism Committee wrote the following article to draw members’ attention to this law which might affect all who work in the US and internationally as well.

As the costs of healthcare soar worldwide, doctors are a soft target for governments and for institutions, in terms of the reimbursement received for their services.  The drive to reduce these reimbursements can be couched in different forms but one of the most commonly used weapons is the idea that doctors are corrupt.  The drive for this is the public perception that being a doctor is sufficient (in itself) reward for the work they do.  It is therefore of paramount importance that doctors or organizations act to ensure that there is no hint of corruption, as part of the forefront of their governance, and are seen to be doing so.  If they do not, it will be imposed on them and used as a weapon against them.

It is extremely unlikely that there are any surgeons, particularly members of SRS, involved in any type of these activities.  This is because SRS inculcates the values of good governance in all aspects of the clinicians’ practice.  However, clinicians

  1. Have to frequently interact with the industry partners of SRS.
  2. Will need to use implants themselves.
  3. Many who operate outside US jurisdiction, but often will operate with the use of the industry partners of SRS.
  4. These industry partners will often be based in the United States.

Overview

The Foreign Corrupt Practices Act (FCPA) of 1977 was enacted for the purpose of making it unlawful for certain types of persons and entities to make payments to government officials to assist in obtaining or retaining business.  The anti-bribery provisions of the FCPA prohibited the wilful use of mail or any means of interstate commerce corruptly in the furtherance of any offer, payment, promise to pay or authorization of the repayment of money, or anything of value, to any person, whilst knowing that all or a portion of such money, or things of value would be offered, given or promised, directly or indirectly to foreign officials, to influence the foreign official in his or her official capacity.  To induce the foreign official to do or omit to do an act in violation of this or his lawful duty, or to secure any improper advantage in order to assist in obtaining or retaining business for or with, or direct business to any person.

Since 1977, this has applied to all US persons and certain foreign issues of security.  However, with the enactment of certain amendments in 1998, this anti-bribery provision now applies to foreign firms and persons who cause, directly or through agents, to act in furtherance of such corrupt payments to take place within the territory of the United States.  This essentially means

  1. That it is absolutely essential to make and keep books and records which accurately and fairly reflect the transactions and corporation.
  2. Devise and maintain an adequate system of internal accounting controls.

With reference to this, it would be worth visiting the Department of Justice website that summarizes the situation extremely well (Steven Claydon).  In a sense, the FCPA has two provisions.

  1. Anti-bribery.
  2. Accounting.

These provisions make it a crime for any US individual (business or employee of a US business entity) to offer or provide, directly or indirectly, anything of value to foreign government officials in order to gain an unfair advantage.

The accounting part of it makes it illegal for a company that purports to the Federal Communications Commission (FCC) to have false or inaccurate books.  Therefore there are some basic things that companies and individuals need to know in order to ensure that they remain compliant.

  1. Corruption in international business is common and frequently prosecuted.
  2. Investigation, prosecution and punishment under the FCPA is common.
  3. To understand your company’s risk of being involved in international bribery.
  4. The program requires a stand-alone international anti-corruption compliance policy with an accountable executive.
  5. That all staff are trained in this.
  6. Proper due diligence of all third parties used by the company.
  7. A set of internal controls over the company’s expenditure and assets. 
  8. Do not in any way permit or precipitate payments.
  9. Plan for the likelihood that you may be involved in an international internal investigation.
  10. Include the FCPA Terms in your international contracts. 

Officials in most companies wish to believe that they work for a clean and honest organization that hires law abiding employees. In 2010 alone, fifty two individual business people were indicted and sentenced, or were convicted and awaiting sentencing for FCPA violation. Companies must therefore assess the risk of FCPA violations in their international business. Therefore, any company that is doing international business should enact a standard of FCPA compliance policy. Having done this, it needs to ensure that its employees are trained in this compliance.

It is also essential to use due diligence with all the party companies when business is done outside of the United States.  There has to be a very robust way of controlling company expenditure assets to reflect compliance. 

It is important however to realize that if the FCPA contains an exception to ‘facilitating permits’.  However, these have to be recorded accurately on the company’s books and records, and astonishingly, written proof that a company intentionally violated the law of the country where you made the payment!  It is interesting however to note that the facilitating payment exception has never been used in an important case. 

It is also important for these companies, who have little experience in conducting international investigations, to plan for the possibility of these investigations.  The best protection for this would, of course, be to include the FCPA Terms in every international contract. 

If a company is unwilling to put in place an adequate FCPS program, then it should refrain from doing business in high risk environments, as in doing so they may have personal responsibility and may be subject to prosecution for failure to put in place a system of controls.

Please see for further information: http://www.acc.com/legalresources/publications/topten/SLD-FCPA-Compliance.cfm

Education Committee Update

Praveen V. Mummaneni, MD
Education Committee Chair

The Education Committee is responsible for the educational programs (Pre-Meeting Course, Half-Day Courses, and Lunchtime Symposia) at the Annual Meeting & Course. The feedback received from the program at the recent 51st Annual Meeting in Prague was superb. We thank the previous Education Committee Chair, Theodore Choma, MD and the presenters and organizers for a job well done.

Looking ahead to the 52nd Annual Meeting in Philadelphia, we are quite thankful for the guidance of John Dimar, MD and our president, Kenneth MC Cheung, MD. With their guidance, the Education Committee has chosen a theme for the 52nd Annual Meeting & Course: “A Multidisciplinary Approach to Global Spine Care.”

The Educational Committee is also interfacing with other organizations such as AAOS, AOSpine (Global Spine Congress), EUROSPINE, FOSA, and the AANS-CNS Joint Spine Section for co-branded offerings.  We have recruited several individuals to help with these efforts including Sigurd Berven, MD; Michael Daubs, MD; Marinus De Kleuver MD, PhD; Benny Dahl, MD, and Suken Shah, MD. The Education Committee is in close communication with the Worldwide Course Committee for international conference planning. We also interact with the Program Committee and the CME Committee to achieve our mission.

I wish to extend a personal thank you to Courtney Kissinger – our Senior Education Manager- for all of her hard work and guidance as we seek to continue the legacy of educational excellence of this Society.  

Chair: Praveen V. Mummaneni, MD Committee: Theodore Choma, MD; Muharram Yazici, MD, PhD; David Clements, MD; Nathan Lebwohl, MD; Maria C. Sacramento Dominguez, MD; Kariman Abelin-Genevois, MD; Santiago T. Bosio, MD; Robert H. Cho, MD; Robert H. Karikari, MD; Olavo Letaif, MD; Ripul Panchal, MD; Paul Park, MD; Scott Russo, MD; Jason Savage, MD; S. Rajasekaran, MD, FRCS, MCh, PhD; Richard H. Gross, MD; Yan Wang, MD; Charles H. Crawford III, MD; Paul T. Rubery, MD; Suken A. Shah​, MD; Benny T. Dahl, MD; Marco Brayda-Bruno, MD; Michael Daubs, MD

Worldwide Courses Update

Benny Dahl, MD, PhD, DMSci
Worldwide Course Committee Chair

As the new chair of Worldwide Course (WWC), I want to express my gratitude to Marinus de Kleuver, MD, PhD who has done an outstanding job as WWC chair over the previous three years. As chair-elect, I have benefited from his experience and will do my best to maintain the success of the WWC reaching out to the spinal deformity community all over the world.

2016 has been very busy and I want to thank all the speakers, attendees, and industry partners for making the WWC conferences in Nottingham, Nanjing, Moscow, and Bali as well as the Hands-On Course in Hong Kong very successful. The last two WWC of 2016 took place in Kyoto, Japan and Santiago, Chile.

In 2017, the WWC will introduce two Current Concept Courses, in an effort to contribute to the globalization of SRS. These courses will not replace traditional WWC conferences but should be regarded as a new initiative to strengthen the collaboration between WWC, Global Outreach Program and the Education Committee.

I look forward to the next three years as chair of the WWC and thank all SRS-colleagues for this opportunity.

Chair: Benny T. Dahl, MD, PhD, DMSci,  Committee: Marinus de Kleuver, MD, PhD; Ferran Pellisé Urquiza, MD, PhD; Ibrahim Obeid, MD; Ahmed M. Shawky, MD, PhD; Zezhang Zhu, MD, PhD; Luis E. Munhoz da Rocha, MD; Yong Qiu, MD; Haluk R. Berk, MD; David S. Marks , FRCS; Rajiv K. Sethi, MD; Praveen Mummaneni, MD; Rodrigo A. Amaral, MD; Sergey Kolesov, MD, PhD; Takuya Mishiro, MD, PhD; Ibrahim A. Omeis, MD; Fernando Techy, MD; Naveed Yasin, FRCS (Tr & Ortho); Morio Matsumoto, MD; Firoz Miyanji, MD, FRCSC; Yat Wa Wong, MD

 Annual Meeting Abstract Submission Site Now OpenIMAST Abstract Submission Site Now Open

The Abstract Submission Site Now Open!

**Submission Deadline: Monday, February 1, 2017 at 11:59pm EST**

To submit an abstract, please log in to the SRS abstract submission site at http://abstract.srs.org/login.asp.

This is a new abstract submission website; as an SRS member, an account has been created for you. Emails have been sent to all members with your login credentials; if you need your information resent to you, please contact the SRS Education Team at meetings@srs.org or +1 414-289-9107. PLEASE DO NOT CREATE A DUPLICATE ACCOUNT.

For detailed information on abstract submission, including tips, tricks and frequently asked questions download the PDF of the Abstract Guide: Tips, Tricks & FAQs

KEY DATES:

November 1, 2016 Abstract Submission Site Opens
February 1, 2017 Abstract Submission Deadline
April 1, 2017 IMAST Abstract Notification
April 15, 2017 Annual Meeting Abstract Notification

 


 
 

Don't forget that ALL authors on an abstract must complete the conflict of interest disclosure information online prior to the submission deadline (February 1, 2017) for the abstract to be reviewed and considered for either program. No exceptions will be made.

We look forward to having you as a part of the Annual Meeting and/or IMAST programs. For complete information on both meetings or to submit an abstract, visit Conference & Meetings Abstract page on the SRS website.

If you have any questions, please contact the SRS Education Team at meetings@srs.org or +1 414-289-9107.

SAVE THE DATE:
24th IMAST: July 12-15, 2017 - Cape Town, South Africa - http://www.srs.org/imast2017
52nd Annual Meeting & Course: September 6-9, 2017 - Philadelphia, PA, USA - http://www.srs.org/am17

Save the Dates for 2017 SRS Meetings!

Mark your calendars for the upcoming 2017 SRS meetings and courses.

To view future SRS meetings and other spine associations and societies' meetings, visit http://www.srs.org/professionals/conferences-and-meetings/calendar.

24th IMAST: July 12-15, 2017 – Cape Town, South Africa
Cape Town International Convention Centre (CTICC)
Registration Opens: February 2017
Registration Closes: June 2017

52nd Annual Meeting & Course: September 6-9, 2017 – Philadelphia, PA, USA
Philadelphia Marriott Downtown
Registration Opens: April 2017
Registration Closes: August 2017

Spine Deformity Solutions: A Hands-On Courses

8th Spine Deformity Solutions: A Hands-On Course
June 28-30, 2017 – Nijmegen, Netherlands
Radboud Universitair Medisch Centrum

9th Spine Deformity Solutions: A Hands-On Course:
October 22-24, 2017 – Bangkok, Thailand
Siriraj Training and Education Center for Clinical Skill (SiTEC)

 Worldwide Courses

Worldwide Course in conjunction with Association of Spine Surgeons of India - ASSICON
January 26-28, 2017 – Hyderbad, India
Course Registration and Program

Current Concepts in Spine Deformity Course
March 30-April 1, 2017 – Prague, Czech Republic

Worldwide Course Operative Spine Course
April 14-16, 2017 – Ganga, India

Worldwide Course in conjunction with BSS/SILACO
April 19, 2017 – Rio de Janeiro, Brazil
Course Registration and Program

SRS precourse Complications in Surgery for Spinal Deformity in the Child and the Adult
in conjunction with the Global Spine Congress
May 3, 2017 - Milan, Italy
Course Registration and Program


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