I just returned from a three week trip to China, Japan, Canada, and Turkey attending multiple local and regional spine meetings in China, the ACMISST Annual Meeting in Inuyama, Japan, the ISASS Annual Meeting in Vancouver, Canada, and then the 6th ISMISS and 5th TURKMISS meeting in Cesme, Turkey.

It has become clear that Asian interest in MIS is increasing at a faster pace than North America (at least for nonfusion MIS decompression). At ISASS, Chinese membership is almost as high as the US, where it is second to the US in membership. In Asia, and in the Middle East, there is much more focus on pain management, MIS decompression and non-fusion MIS techniques than in North America. The techniques that I have utilized and evolved is wholeheartedly accepted with enthusiasm in these areas as contrasted to North America, where surgeons seem to focused solely on fusion or dynamic stabilization utilizing implants of all types.

Since my last message, a lot has transpired, and the perfect storm focused on endoscopic spine surgery is underway.

I am pleased to announce that I am in negotiation with the University of New Mexico School of Medicine, my Alma Mater, to establish an Endoscopic Spine Center in a multi-disciplinary setting dedicated to patient care, clinical research, and endoscopic minimally invasive spine surgery.

The multi-disciplinary faculty put together by Dr. Howard Yonas and Fred Harrington of UNM will include physical medicine and therapy, interventional pain management, endoscopic spine surgery, and traditional MIS surgery. Our intent is to make this a state-of-the-art facility.

I’m pleased to report that the least invasive access to the lumbar spine is gaining traction and interest world wide as I return from a very successful trip to Bahia, Brazil for the WCMISST III meeting. Congratulations to Pil Sun Choi, who pulled off a meeting that was attended by more surgeons than the first meeting in Hawaii, and was enjoyed immensely by those who attended and took the cruise down the Amazon. My concern is that each meeting as big as this one must have both attendee and vendor support, as it requires both support and money to have a successful meeting, or the momentum will stall.

It’s official. The Supreme Court has upheld the Accountable Care Act as Constitutional. The International Intradiscal and Transforaminal Therapy Spine Society can play a major role in providing help through innovation in surgical techniques that will help surgeons cost effectively treat the source and generators of spinal pain earlier and more cost effectively than traditional techniques that rely solely on the natural healing process. Relying solely on the natural healing process is not practical for patients, as many need pain relief to be employed or productive.

While we applaud the goals of increasing access to health care, we cannot depend solely on mandated insurance that does not have the means to pay for the cost of care. It can only be financed by higher taxes or by denying care. Insurance companies currently avoid paying by simply denying coverage as “experimental” or “not medically necessary.” IITTSS will continue to advocate for our patients by providing a forum for cost effective MIS techniques in spine care. The upcoming workshops will provide practical information for pain management and MIS surgeons.

IITS has recently changed its name to IITTSS (The International Intradiscal Therapy and Transforaminal Spine Society) partly because we lost our name to a speculator who bought the expired name and refused to sell it back for a sum we could afford. We then elected to add the year to IITS2009.org, IITS2010.org, IITS2011.org to keep the website listed. When IITTSS.org became available, I decided that we would be better off by renaming the society than to continue getting a new name each year than to pay a price we could not afford to get the domain name back. Our new website name is now permanently http://www.iittss.org.

To those members who have loyally followed us, we have continued to have yearly, but joint meetings since the 2009 meeting in Phoenix. Eric Gozlan was the 2009 president in Phoenix, Dan Gastambide, the 2010 president in Las Vegas, and Rudi Morganstern, the 2011 president. In Cancun, Ramiro Ramirez will be president this year representing IITS in 2010 at the WCMISST meeting in Bahia, Brazil.