June 2016

President’s Message

The SRS continues to be very busy around the world!

In February, SRS held its 6th Spine Deformity Solutions: A Hands-On Course in Las Vegas with a full house. Thank you to Munish Gupta, MD and Christopher Ames, MD, and all of the faculty who participated in this event. The next Hands-On Course will be held in Hong Kong, October 15-16.

We had quite an extensive array of SRS activities at the AAOS annual meeting in Orlando, FL. The Board of Directors met, Kenneth MC Cheung, MD, led an education retreat and our members taught in several symposia, instructional course lectures and led by John R. Dimar II, MD, our section of spine specialty day. Later that same month, also in Orlando, SRS had several sessions at the AANS/CNS Joint Section meeting. This organization was led this past year by SRS member Praveen Mummaneni, MD who has aggressively increased the spinal deformity content.

Internationally, SRS participated with BritSpine, with John P. Dormans, MD, representing the Presidential Line and with the Chinese SRS in Nanjing and the Russian Association of Spine Surgeon in Moscow, with Prof. Cheung representing the Presidential Line. On May 25, I represented SRS at the annual SOSORT IRSSD meeting in Banff, Alberta in Canada. Again thank you to Marinus de Kluever, MD, PhD, and to all of the SRS members who have been participating in our Worldwide Courses.

There were many SRS members who participated in the Global Spine Congress in Dubai. While there, Prof. Cheung and I met with the AOSpine educational team to better understand their program for adult learning and education. There is perhaps some synergy to be gained by leveraging their experience in organizing levels of educational experience around the world. SRS also had a booth staffed by our Membership Manager, Arlensiu Garcia Novelli that was extensively visited by international attendees looking for information about SRS and several membership applications were submitted.

The Global Outreach Program continues its busy schedule with activities this year occurring in Dhaka, Bangladesh, Kolkata, India, Cali, Columbia. Thank you to all who participate. It is life changing for the patients served and for those who participate in serving the patients.

In addition our committees, task forces and members have been actively engaged in SRS activities. Health Policy Chair, Gary T. Brock, MD brought two young ladies to Research Capitol Hill days, both of whom have had surgery for scoliosis and both have gone on to become Victoria’s Secret models. This opened quite a few doors. Read more about their visit in his newsletter article in this issues and also in an upcoming issue of AAOS Now.

Tressa Goulding and I had the opportunity to participate in the National Orthopaedic Leadership Conference (NOLC) in Washington, D.C. We were able to jointly attend a session about non-profit boards. I have to say we both felt like the SRS is exemplary in our board engagement and activities. This is due to the very high level of engagement of our board members.

At the NOLC, a number of issues came up that are most pertinent to US members. There is significant ongoing discussion about the American Board of Orthopaedic Surgeons Maintenance of Certification program. The AAOS Board of Councilors has asked AAOS to look at alternative pathways for MOC as has occurred with the American Board of Internal Medicine. There is upcoming significant regulatory change from MACRA especially including MIPS requirements for demonstrating quality in the move to value based reimbursement. It is not clear to me personally how spine deformity surgeons will meet these requirements and qualify for the value based incentives or conversely experience the penalties.

The most significant discussion occurred over the issue of concurrent surgery. The articles in the Boston Globe have generated significant discussion and congressional interest on this topic. Many hospitals are re-examining their policies. The American College of Surgeons put together a position statement that significantly constrained the American Academy of Orthopaedic Surgeons. There was a very strong push to maintain consistency among the house of surgery. It is not clear that this does a good job of addressing the concerns and practicalities of orthopaedic surgery.

There is another issue that is beginning to become much more significant. The Food and Drug Administration (FDA) has taken a particular interest in scoliosis tethering surgery. In the US, this is physician directed or off label surgery. Much of what we do in medicine, is physician directed or off label. This may be more frequent in pediatric surgery as fewer devices have pediatric specific clearance. The SRS has a task force of concerned and involved surgeons looking at this issue. We met at the Pediatric Orthopaedic Society of North America (POSNA) meeting in Indianapolis in April.  A potential solution would be to have SRS sponsor an Investigational Device Exemption (IDE) study. We have been investigating what the implications for such an action are but that is not yet clear.  I hope to have more of an update for the Board of Directors to review at IMAST in July.

Finally, as we prepare for IMAST in Washington, D.C., Ronald A. Lehman, Jr., MD and Henry F.H. Halm, MD, have put together an outstanding program. It will be an excellent educational and scientific event in a beautiful setting. There will be something for everyone. You will learn something new at this meeting. I look forward to seeing you there!

David W. Polly, Jr, MD
SRS President 2015-2016