Devised from a need for a professional specialty society focusing on the
spine and forged through small meetings held around the country, the
North American Spine Society has always been about expanding
its umbrella to cover all areas of spine treatment.
During its 27 years, the North American Spine Society (NASS) has seen
historic gains in membership and meeting attendance. Many within the
societys history, including its current executive director, Eric
Muehlbauer, MJ, CAE, attribute this growth to its multispecialty approach.
We have orthopedic surgeons, neurosurgeons, physiatrists,
anesthesiologists, pain management specialists and other specialties all
teaching one another what they know about spine care, Muehlbauer told
Orthopedics Today. The result is a more well-rounded, better
That multispecialty approach has its roots in leadership that, from the
beginning, saw the need for a varied approach to dealing with issues of the
No easy path
Scott Haldeman, MD, PhD, DC, was deeply involved in the process that
would eventually give rise to NASS becoming its president in 1989. While
the need for a spine society was clear in the late 1970s and early 1980s, there
was no easy path to achieving this outcome. Specialty societies were being
formed around the world, and at that time, the premier spine society was the
International Society for the Study of the Lumbar Spine
(ISSLS). ISSLS, however, had a limited membership and only held every third
meeting in North America, Haldeman noted.
American Spine Society was officially formed on July 24, 1985 from the merger
of the North American Lumbar Spine Association and the American College of
The first annual meeting of the North American Spine Society was
held July 20-23, 1986 at the Sagamore Hotel on Lake George in Bolton Landing,
Images: North American Spine Society
It became clear there was no organized forum for presenting
research and to offer spine education programs in North America, Haldeman
told Orthopedics Today. The first attempt to organize a
formal education program was called Challenge of the Lumbar Spine.
A number of researchers and leading clinicians, most of whom were members of
ISSLS, started traveling around the country putting on symposia.
Though it was a step in the right direction, Haldeman noted Challenge of
the Lumbar Spine lacked the structure necessary to gain a national foothold.
It was loosely formed and had no real organization, he said.
Each person just said Okay, I will do the next meeting, and
we organized these meetings through the support of our universities.
Challenge of the Lumbar Spine operated from 1978 to 1989, but when
efforts to get ISSLS to become more actively involved in North America in the
early 1980s did not work as well as Haldeman and colleagues hoped, it became
clear that an organized group for the education and presentation of spine
research in North America needed to be spearheaded.
That is when the organization started to form, Haldeman
NASS launched www.spine.org in 1996; a
booth at the 1997 Annual Meeting in New York showcased features of the
Amalgamation of societies
The 1984 Annual Meeting of the American Academy of Orthopaedic Surgeons
(AAOS) resulted in the formation of two spine societies: the North American
Spine Association (soon changed to the North American Lumbar Spine Association)
and the American College of Spinal Surgeons. John P. Kostuik, MD, who
would go on to serve as NASS president in 1991 was a member of the
American College of Spinal Surgeons Board of Directors.
The existence of two growing spine societies presented a rare
opportunity, and the upper levels of AAOS management suggested a merger.
There was some concern at the presidential level of the AAOS as to
how they could support two different organizations, Kostuik told
Orthopedics Today. They sort of recommended they amalgamate,
and that occurred.
In July 1985, the new organization NASS was created. Leon
L. Wiltse, MD, was briefly the first president who, at the first meeting,
turned the presidency over to William Kirkaldy-Willis, MD, and J. Elmer Nix,
MD, served as vice president.
When they started forming NASS, it was decided that it was going
to be all-inclusive and open to all physicians who treated patients with spinal
disorders, Haldeman said. As a neurologist and non-surgeon, I was
invited to join NASS to promote the multidisciplinary goal of the society. It
was a deliberate decision by the founders of NASS that this should be a spine
society, not a surgical society.
The first issue of
NASSNewsOfficial Organ of the North American Spine
Society was published in 1987.
As NASS grew in the late 1980s and early 1990s, it began to expand its
focus to cover education and the distribution of information presented at its
annual meetings. This expansion was furthered in reach and relevance by
Kostuik, who began broadening the societys range in focus toward
politics, guideline development and the transition to a more
all-encompassing association during his presidency.
Kostuik recommended that NASS no longer act as a surgical society and
accept all individuals who provided spine care on a professional basis.
The reason I recommended that at that time was I was concerned
there would be a growing dichotomy between surgeons and non-surgical
caregivers, and there would be a lack of communication and that evolved into a
total spine society, Kostuik said.
Moving into the present day
From the early 1990s to the present, Muehlbauer, who became executive
director of NASS in 1994, noted that the difference in the society is
like night and day.
We had three and a half staff when I started, and now we are up to
50, he said. We had 850 members, and now we are up to 6,700. The
funny thing is the first meeting I was at, we had 620 people. We had an outside
consultant as our meeting planner, and she said, Eh, the annual meeting
will not grow too much more than this. I thought to myself, Well,
we will see about that.
According to Muehlbauer, NASS has grown more rapidly in recent years.
We will probably go over 1,000 new members in 2011, which is our
biggest year ever, he said. I think we will be up to 10,000 members
in the next 5 years.
The change is obvious to those who have attended the meetings since the
early 1990s like Michael H. Heggeness, MD, PhD, the societys
incoming president for 2012.
It is almost unrecognizable, Heggeness said of the NASS of
today compared to the society years ago. I think it has grown in every
direction and even defined some new ones
We are now at a point where for
many spine specialists, both nonoperative and operative, we are the place to go
first, second and third for information about the spine and as a
forum for exchange of information about the spine. Our focus on science, and on
evidence-based medicine will continue.
Among the most important NASS accomplishments currently underway,
according to Heggeness, is the societys expansion into international
In 2007, NASS moved to a new
headquarters in Burr Ridge, Ill., and opened its high-tech training facility,
the Spine Education & Research Center.
An important constituency within NASS is our international
members, he said. We are now seeing a significant and continually
growing presence of international attendees at the meeting. They come from all
over the world and now comprise over 20% of the people who come to the
We are now probably at a place where many spine specialists in
Europe, South America and Asia are regarding us as the authoritative dispensers
of research and other clinical information throughout the world, he
added, noting one of the projects for his presidency is encouraging a greater
international presence for NASS. This will include increased co-sponsoring of
meetings that are held internationally.
This is something that I feel is important from a lot of
perspectives; it is almost as if we may outgrow our choice of name,
Heggeness said. I am hoping that we do.
What the future holds
As for the future, the consensus among those interviewed is apparent:
the society will continue to grow.
NASS has become the focus of all spine research
and spine clinical training in North America, Haldeman said. In my
opinion, if you want to claim that you are up to date in spine care and are a
spine specialist as opposed to just somebody treating backs
if you want
to claim that the spine is your area of expertise, you must be a member of
NASS. If you are not a member of NASS and you do not attend NASS meetings, you
are not up to date. There is nowhere else you can keep abreast of the latest
developments in spine care in North America. by Robert
- Scott Haldeman, MD, PhD, DC, can be reached at 801 N. Tustin Ave.,
#202, Santa Ana, CA 92705-3600; 714- 547-9822; email:
- Michael H. Heggeness, MD, PhD, can be reached at 6620 Main Street
#1325, Houston, TX; 713-986-6000; email: firstname.lastname@example.org.
- John P. Kostuik, MD, can be reached at 571-594-7419; email:
- Eric Muehlbauer, MJ, CAE, can be reached at 7075 Veterans Blvd.,
Burr Ridge, IL 60527; 630-230-3600; email:
- Disclosures: Haldeman, Heggeness, Kostuik and Muehlbauer
have no relevant financial disclosures.