September 2016

President’s Message

Greetings to all of our members around the world.

We have just completed an outstanding IMAST meeting in Washington, D.C. Congratulations to Ronald Lehman, Jr., MD and Henry Halm, MD and the IMAST committee for all of their work in making it a success. We had 876 attendees and there were 176 abstracts along with many symposia, debates and as always conversation at the breaks. Next year, IMAST will be in Cape Town, South Africa. It is not too early to start planning your itineraries. The Long Range Planning Committee has recommended and the Board of Directors has approved Amsterdam to be the site for the 2019 IMAST meeting.

The Annual Meeting in Prague will be outstanding. Having done a site visit last year, I will personally say, Prague is the most beautiful city that I have ever been to; you will want to spend some time seeing the sites.  Justin Smith, MD, PhD, and the Program Committee have done herculean work in reviewing  the 1541 submissions. 130 were selected for 4 minute podium presentations (53% are from outside of the US), 107 for e-posters, and 12 for case discussions. Theodore Choma, MD and the Education Committee have put together a great Pre-Meeting Course focused on risk stratification for adult and pediatric spinal deformity. There will also be a great opportunity for Lunchtime Symposia and the Thursday afternoon Half-Day Courses.

Marinus de Kluever, MD, PhD, and the Worldwide Course Committee continue to be quite active. In 2016, courses have been held in China, England (Britspine), Russia, Indonesia (the first SRS formal program ever in Indonesia). Upcoming courses are pending in Japan and Chile in2016 and, for 2017, courses have been approved in Brazil (with SILACO and the Brazilian Spine Society) and India (with ASSICON).

The future of the SRS educational efforts is being evaluated by an education task force led by Kenneth MC Cheung, MD. He and the task force are looking at how SRS should plan educational events going forward. We expect no change in the IMAST and Annual Meeting activities but do see opportunities in our Worldwide Courses and our Hands-On Courses moving forward. More information will follow from Dr. Cheung in the near future.

The Global Outreach Program continues to be very active and the committee has developed a proposed database for surgeries done at GOP sites around the world. This database would be compatible with the SRS Morbidity and Mortality reporting requirements. They have also developed a tiering structure to rate the sites. The goal is a roadmap or pathway for the sites to become self-sustaining over time. The Bulgaria site has essentially achieved this status.

SRS is in good shape financially.  Total assets are up about 3% compared to the prior year. We currently have five Double Diamond industry partners - DePuy Synthes, Globus Medical, K2M, Medtronic and NuVasive. We thank them for their significant level of commitment to our Society. We also thank all of our industry partners for the commitments they are able to make as well.

I personally think that the quality and usefulness of articles in our journal, Spine Deformity, continues to improve. In the latest issue, I really liked the paper by the Adult Deformity Committee. There were several other great articles that will affect my practice as well. The Editor, John Lonstein, MD, and his team have submitted an application for citation in PubMed. We should hear back in the October/ November time frame.

Non-fusion treatment of scoliosis has become a hot topic recently in the United States. There are not any FDA approved devices currently for anterior tethering procedures. Some surgeons are doing physician directed use of existing posterior devices to perform anterior tethering. This is the practice of medicine and is not regulated by the FDA. However, there are some caveats about advertisement and prospective research.

Members of the SRS Pediatric Device Task Force met with the FDA prior to the IMAST meeting. We learned a number of useful items. The only legal way to prospectively study an unapproved or off-label device is through an Investigational Device Exemption (IDE) study. There is a pathway to do physician led IDE’s and the task force will be pursuing the development of a boilerplate format for a physician directed IDE for anterior tethering. This will be made available for members who wish to pursue this strategy.  We also learned more about the details of what is considered an off-label promotion. If a website claims that an off label procedure or device is safe and effective, even if the physician or website has no relationship with the manufacturer of the device, that is considered off label promotion.

The SRS Presidential Line and Board of Directors are in the midst of reviewing efforts for society directed research going forward. In my time on the Presidential Line, I have become convinced of the importance of facilitating research work that is important to our Society. As I said in my IMAST presidential address, I think there are three areas that are timely and critical for us as a Society. This includes predictive modeling for curve progression based upon the initial visit and radiograph, determination of growth remaining so that growth guidance strategies can be optimally applied, and finally patient level risk calculation/prediction for adult spinal deformity surgery.  The point of this discussion is to figure out a way to do appropriate peer reviewed evaluation and support for these types of topics. This will not replace the unsolicited research proposals that the Research Committee currently reviews and recommends for funding, this will be in addition to their valuable work.

Finally, the Nominating Committee led by past president, John Dormans, MD, has proposed a slate of officers for approval by the membership at the Annual Meeting. The slate includes:

  • Vice President – Peter Newton, MD
  • Directors – Sigurd Berven, MD;  Douglas Burton, MD; and Hani Mhaidli, MD, PhD
  • Fellowship Committee – Baron Lonner, MD

Congratulations to those nominated and thank you to the committee members for their significant considered evaluation of all of the qualified candidates.

I look forward to seeing everyone in Prague very soon!

Best wishes and safe travels,

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