December 2018

Non-Operative Management Committee Update

David A. Hanscom, MD
Non-Operative Management Committee Chair

The non-operative committee is being organized into two task forces. One group, headed by Nigel Price, will be creating a framework to organize the current literature on adolescent idiopathic scoliosis bracing. The role of bracing across the age spectrum continues to evolve. Brace designs are becoming international. Scoliosis specific exercises are also being incorporated into spine care. We’ll work on sorting this out with the goal being to provide a resource for the clinician to make the brace choice for a giving patient.

The other section will be organized by David Hanscom to create a document that reflects the literature regarding what care is effective and should be implemented before recommended for adult deformity surgery. At the moment, most papers that compare surgery to non-operative care are essentially looking at “non-care”. The group is also looking defining the indications for adult deformity surgery. Other sections include sleep, stress, physical conditioning, osteoporosis, nutrition, medication stabilization and the neuroscience of chronic pain. The intent is create a working draft that can be built upon in the coming years.

Finally, we are considering taking on surgeon performance in the operating room. The goal is optimizing performance in or out of the operating room. A rested surgeon having a great time is going to execute better than a tired and distracted one. This topic crosses over into several different committees and we’ll see where it goes.

We are working on getting the smaller work groups organized and focused by the end of the year and some drafts available by early spring.


Chair: David A. Hanscom Committee: Howard M. Place, Past Chair; Linda P. d'Andrea; Kamshad Raiszadeh; Marilyn L.G. Gates (C); Ann M. Hayes (C); Turgut Akgul (C); Sabrina Donzelli (C); Jesse G. Eisler (C); Didik Librianto (C); Yutaka Nakamura (C); Stefano Negrini (C); Scott R. Rosenfeld (C); Claudio Vergari (C); Avraam Ploumis; Nigel J. Price, Chair Elect; Elian M. Shepherd; Kevin M. Neal; Michael L. Schmitz; Brian G. Smith; Theodoros B. Grivas, Advisory; Joseph P. O'Brien, Advisory