Brief History of Neurosurgical Spine Societies in the United States: Part 2

Article information

Neurospine. 2021;18(2):257-260
Publication date (electronic) : 2021 June 30
doi : https://doi.org/10.14245/ns.2142018.009
1Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, USA
2Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
3Department of Neurosurgery, University of Miami, Miami, FL, USA
Corresponding Author Sasha Vaziri https://orcid.org/0000-0003-2249-4278 Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL 32610, USA Email: sasha.vaziri@neurosurgery.ufl.edu
Received 2021 January 3; Accepted 2021 April 12.

In a previous essay [1], we examined the intertwined history of United States (US) spine surgery pioneers and achievements, and the emergence of domestic spine societies. In this follow-up article, we look towards the future and highlight the critical role of US spine societies in education, research, and advocacy.

Advancing spine care through education is a priority of larger US spine societies. The American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) Section on Disorders of the Spine and Peripheral Nerves (DSPN) was the first neurosurgical spine society in the US. The leadership for the annual spine section meeting from 2010–2021 is listed in Fig. 1. The first meeting of the DSPN chaired by Barth Green and George Sypert in 1985 included lectures and hands-on courses in spinal instrumentation to address the educational needs of a growing subspecialty of neurosurgery focused primarily on spine surgery. The DSPN annual meeting has since evolved from a small intimate group to a larger meeting of > 500 domestic and international spine surgeons presenting innovative research, case-based debates, subspecialty symposia, intersociety panel discussions, and surgical technique cadaver labs. Since 2016, the DSPN bestows the Journalistic and Academic Neurosurgical Excellence Award to the senior neurosurgical resident or fellow in an American neurosurgical program that has been academically productive in the previous 12 months and has achieved the top manuscript submitted to the annual DSPN Spine Section meeting (Table 1). Similarly, the Charles Kuntz Scholar awards the top neurosurgical residents or fellows who author outstanding abstracts (Table 2). The rapidly growing number of residents and fellow trainees attending this meeting signifies the critical role of spine societies in not only educating current members, but mentorship and professional development of the next generation of spine surgeons.

Fig. 1.

Disorders of the Spine and Peripheral Nerves (DSPN) Chairperson 2010–2021. Top row from left to right 2010–2015 DSPN Chairpersons: Christopher Shaffrey, Ziya Gokaslan, Christopher Wolfa, Joseph Chang, Michael Groff, R. John Hulbert. Bottom row from left to right 2016–2021 DSPN Chairpersons: Praveen Mummaneni, John Knightly, Marjorie Wang, Micheal Wang, Zoher Ghogawala, Michael Steinmetz.

J.A.N.E. Award winners 2016–2020

Charles Kuntz Award winners 2016–2020

Looking to the future, advancing technology may change the way in which education is delivered by societies. Neurosurgery and spine societies in the US have developed robust online educational opportunities. Examples include CNS NEXUS (a repository of neurosurgical operative techniques and approaches), The Neurosurgical Atlas, NASS video library, AO spine webinars, videos, and podcasts. Content is created and/or curated online by experts in their respective fields. The Neurosurgery Podcast by Michael Wang and John Kolcun is an example of a popular weekly audio program with guest neurosurgeons sharing expertise in the field of neurosurgery and spine. The clear benefit of digital media is the ability to provide education that is not limited by conventional constraints of geography and travel costs. Further, online education can often be accessed easily via mobile technology and when convenient based on the learner’s schedule.

The ongoing coronavirus disease 2019 pandemic has accelerated recent adoption of teleconferencing by spine societies and members. The absence of in-person meetings in 2020 and the potential for lingering travel restrictions for the foreseeable future may further establish digital media as a viable educational outlet. Despite these advantages of online education, a notable loss is the important camaraderie of shared experiences that occurs with live, in-person meetings and events. This social aspect of in-person meetings was clearly a cherished quality dating back to the first DSPN meeting in 1985 and should be preserved moving forward.

In addition to education, research is an integral mission of spine societies. Societies have established funds through charitable donations, and annual meeting and corporate sponsorship revenue to support researchers with grants and fellowships. A clear priority of spine society supported research is advancing clinical spine care through clinical trials, comparative effectiveness research, and evidence-based guidelines. As healthcare costs in the US continue to rise, comparative effectiveness and patient-centered outcomes research have increasing importance in informing surgeon practice. Six of the 100 national priorities identified by the Institute of Medicine relate directly to spine surgery [2-4].

As a result, spine societies have partnered to create surgical registries to objectively measure and demonstrate quality of care. These nation-wide registries collect longitudinal patient reported outcome measures to identify clinical efficacy for various surgical interventions and indications. A pioneering example in neurosurgery was the National Neurosurgical Quality Outcomes Database (originally N2QOD, now QOD). The spine registry component of QOD has accumulated over 25,000 patients across > 50 sites and has accounted for numerous research presentations and publications [5]. More recently, the AANS and the American Academy of Orthopaedic Surgeons have partnered to create the American Spine Registry, which will incorporate QOD into a broader platform involving neurosurgery and orthopedics [6]. Neurosurgeons and orthopedic spine surgeons have a shared interest in advancing spine clinical care, and joint collaborative registries are an opportunity to increase study populations across a spectrum of practice patterns. An important directive in the near future is to increase our knowledge base from information garnered via these registries that ultimately translates to improved patient care.

Last, advocacy has emerged as a critical mission of spine organizations to ensure patient access to spine surgical care. Spine societies advocate for patients and surgeons through guidelines taskforce committees, payor response committees, and the AANS/CNS Washington Committee. The undue pressures of the current healthcare climate often render individual spine surgeons unable to adequately express their concerns. The AANS/CNS Washington Committee serves as an important voice representing neurosurgeons and spine surgeons before the government and policymakers on issues related to accessibility of care, reimbursement, and health policy. Current initiatives include addressing unnecessary prior authorization practices by insurance companies, serving as surgeon representatives on common procedural terminology coding committees, confronting medical liability reform, and the creating of guidelines to standardize practice. With the increasing healthcare economic burden in the US, it is imperative for spine societies to serve as advocates protecting spine surgeons and their ability to continue to deliver quality care.

In his 2010 CNS presidential address, Gerald “Rusty” Rodts [7] emphasized that if we “do not improve the medical evidence for our treatments, and if we do not improve our training process to better standardize the rates and indications for spinal surgery, the federal government and private insurers will certainly redefine how we care for patients.” Led by spine surgeons, spine societies are at the forefront of education, research, and advocacy. With the uncertain healthcare landscape, spine societies will continue to have a central role in supporting US spine surgeons and advancing spine surgical care.

Notes

The authors have nothing to disclose.

References

1. Vaziri S, Resnick DK, Ames CP, et al. Brief History of Spinal Neurosurgical Societies in the United States: Part 1. Neurospine 2019;16:631–6.
2. Abdullah KG, Benzel EC, Mroz TE. Comparative effectiveness research in spine surgery. Neurosurg Focus 2012;33:E2.
3. Price-Haywood EG. Clinical comparative effectiveness research through the lens of healthcare decisionmakers. Ochsner J 2015;15:154–61.
4. Institute of Medicine (U.S.), Committee on Comparative Effectiveness Research Prioritization. Initial national priorities for comparative effectiveness research Washington, DC: Institute of Medicine of the National Academies; 2009.
5. Asher AL, Knightly J, Mummaneni PV, et al. Quality outcomes database spine care project 2012-2020: milestones achieved in a collaborative North American outcomes registry to advance value-based spine care and evolution to the American Spine Registry. Neurosurg Focus 2020;48:E2.
6. AANS and AAOS Announce the American Spine Registry [Internet]. Rolling Meadows (IL): American Association of Neurological Surgeons; 2019. Sep. [cited 2020 Dec 11]. Available from: https://www.aans.org/en/AANS-E-News/2019/10-25-E-News/AANS-and-AAOS-Announce-the-American-Spine-Registry.
7. Rodts GE Jr. 2010 CNS presidential address. Neurosurgical pioneers: foundation for future innovation. Clin Neurosurg 2011;58:1–6.

Article information Continued

Fig. 1.

Disorders of the Spine and Peripheral Nerves (DSPN) Chairperson 2010–2021. Top row from left to right 2010–2015 DSPN Chairpersons: Christopher Shaffrey, Ziya Gokaslan, Christopher Wolfa, Joseph Chang, Michael Groff, R. John Hulbert. Bottom row from left to right 2016–2021 DSPN Chairpersons: Praveen Mummaneni, John Knightly, Marjorie Wang, Micheal Wang, Zoher Ghogawala, Michael Steinmetz.

Table 1.

J.A.N.E. Award winners 2016–2020

Year J.A.N.E. Award winner
2016 Scott L. Parker
2017 Owoicho Adogwa
2018 Nitin Agarwal
2019 Andrew Chan
2020 Jetan H. Badhiwala

J.A.N.E., Journalistic and Academic Neurosurgical Excellence.

Table 2.

Charles Kuntz Award winners 2016–2020

Year Charles Kuntz IV Scholars
2016 Nitin Agarwal Michael Mcdowell
Andrew Chan Catherine Miller
Ekamjeet Dhillon Nelson Moussazadeh
Doniel Drazin Rory Murphy
Benjamin Elder Tianyi Niu
Gurpreet Gandhoke Aria Nouri
Ezequiel Goldschmidt Alp Ozpinar
Randall Graham Brenton Pennicooke
Kiyoshi Ito Kavelin Rumalla
Ricky Kalra David Salcetti
Darryl Lau Hesham Soliman
Rory Mayer Zachary Tempel
Marcus Mazur Alexandar Tuchman
Todd Vogel Anand Veeravagu
2017 Vincent Alentado Michael Karsy
Michael Cloney Evan Lytle
Doniel Drazin Allan Martin
Benjamin Elder Meghan Murphy
Rory Goodwin Aria Nouri
Peter Grunert Vijay Ravindra
Daipayan Guha Ahilan Sivaganesan
Ibrahim Hussain Vijay Yanamadala
Christian Iorio-Morin Michael Yang
Scott Zuckerman
2018 Mark Attiah Darryl Lau
Yi-Ren Chen Jay Nathan
Lee Chieng Tianyi Niu
Michael Cloney Imran Noorani
Shashank Gandhi Eric Sankey
Jakub Godzik Ganesh Shankar
Jian Guan Corey Walker
Allen Ho Vijay Yanamadala
Ibrahim Hussain Juneyoung Yi
Katie Krause Hesham Zakaria
2019 Owoicho Adogwa Anthony Mikula
Mohammed Alvi Aria Nouri
Oliver Ayling Zachary Sanford
Andrew Chan Allison Teles
Islam Fayed Zoe Teton
Shashank Gandhi Jamie Wilson
Jack Haglin Michael Yang
Allen Ho Hesham Zakaria
Sertac Kirnaz Scott Zuckerman
Mohamed Macki
2020 Oliver Ayling Anshit Goyal
John Burke Michael Karsy
Andrew Chan Mena Kerolus
Ken Chang Darryl Lau
Lee Chieng Allan Martin
Samuel Farber Anthony Mikula
Nida Fatima Harry Mushlin
Yaroslav Gelfand Roberto Perez Roman
Jakub Godzik Checai Wang
Jacob Hoffman Michael Yang